Brain Aneurysm

Brain aneurysm refers to the enlargement or bulging of a blood vessel in the brain.

In most cases brain aneurysm is asymptomatic and goes unnoticed. The bulge represents a weak part in the wall of the blood vessel and is prone to rupture.

Rupturing of the aneurysm causes bleeding into the skull leading to hemorrhagic stroke.

Bleeding in the brain is a potentially life-threatening situation and requires immediate medical attention.

Angiography and CT scan are used in the diagnosis of the condition.

Treatment includes neurosurgery to clip the bubble on the blood vessel. The aneurysm is filled with a coil that prevent bleeding. 

Brain aneurysms may be asymptomatic until there is a leakage or rupture.

Ruptured aneurysms cause symptoms like

• Mild or severe pain or headache
• Dilated pupils
• Drooping eyelids
• Sensitivity to light
• Nausea or vomiting
• Blurred vision
• Stiff neck
• Weakness on one side of the body
• Loss of consciousness
• Confusion
• Convulsion

Leakage of blood from the aneurysm result in sudden, excruciating headache.

Large un-ruptured aneurysm may press against the surrounding tissues causing symptoms like

• dilation of pupil,
• pain above the eyes,
• blurred vision,
• numbness or weakness on one side of the body,
• and drooping eyelid.

Brain Aneurysm is caused by weakening of the walls of the blood vessels. Aneurysms are usually seen in the branches or forks of the blood vessels, where the walls are weaker.

They are most commonly seen at the base of the brain. There are many risk factors for aneurysms.

Buildup of plaques in the blood vessels makes it rigid. Pressure on these blood vessels weaken the walls, causing them to bulge or expand.

Hypertension and cholesterol increase the chance of developing atherosclerosis. Other risk factors include

• Age
• Smoking
• Hypertension
• Drug abuse
• Traumatic injury to head
• Alcohol abuse
• Blood infections
• Lower estrogen levels

There are certain risk factors that are present at the time of birth like family history, abnormally narrow aorta, polycystic kidney disease, inherited connective tissue disorder, and cerebral arteriovenous malformation.

As brain aneurysm remains asymptomatic, it is hard to diagnose before rupture of blood vessel.

In most of the cases the aneurysm is detected only after the rupture of the bulge. Based on the symptoms, imaging techniques are suggested to detect aneurysms.

CT scans help to visualize the blood vessels and bleeding in brain. In CT angiography, a dye is injected to help locate the aneurysm or rupture.

When the blood vessel ruptures red blood cells can be found in the fluid surrounding the brain, called cerebrospinal fluid. Cerebrospinal fluid test that shows the presence of red blood cells is a positive indicator of rupture within brain.

MRI also helps to visualize the network of blood vessels and the presence of aneurysm. Cerebral angiogram is another imaging technique commonly used in detecting brain aneurysms.

In this procedure a special dye is injected into the arteries. It travels throughout the brain and helps to make clear images of the blood vessels in brain. 

Two major treatment methods of brain aneurysm are surgical clipping and endovascular coiling.

• Surgical clipping – in this procedure, the aneurysm is accessed by opening the skull. A small clip is then placed at the neck of the bulge to prevent blood flow to the aneurysm. This prevents leakage or rupture of aneurysm.
• Endovascular coiling – this is a less invasive procedure in which a catheter is inserted into an artery and led to the aneurysm. The catheter is usually inserted into an artery in the groin. A soft platinum wire is pushed into the bulge with the help of the catheter. The soft wire coils in the bulge and blocks the blood flow. This causes the blood to clot that seals the aneurysm completely.

Other treatments help to alleviate symptoms of aneurysms like pain.

This includes pain killers used to treat headache.

Calcium channel blockers are medications that help to prevent narrowing of blood vessels.

Vasopressor injections help to prevent stroke caused by insufficient blood flow.

Seizures are treated by anti-seizure medications.

Un-ruptured brain aneurysms are sealed off by surgical clipping or endovascular coiling. This reduces the risk of rupture or leakage of aneurysms.

This treatment is based on the size and location of aneurysm.

There are no definitive measures for preventing brain aneurysms.

But the risk of developing aneurysms can be reduced considerably by quitting smoking, managing hypertension, reducing alcohol intake, cutting down on caffeine, exercising regularly, and maintaining a healthy body weight. 

A few alternative and homeopathic remedies exist for brain aneurysm.

In homeopathy, veratrum viride is used to control pulse rate.

Other medications used include

• gallicum acidum,
• ergotinum,
• baryta muriatica,
• aconite,
• digitalis,
• gelsemium,
• and laurocerasus.

Many dietary supplements and herbal medicines claim to be helpful in preventing and treating symptoms of brain aneurysms.

Mangosteen juice is one such plant product that is considered to helpful in controlling aneurysms.

Black cohosh, dang qui, hawthorn, and motherwort are other herbal remedies that are thought to be effective in treating cerebral aneurysms. 

Lifestyle modifications are necessary in order to cope with brain aneurysm.

Quitting smoking,

• avoiding drug abuse,
• limiting alcohol use,
• eating a healthy diet,
• regular exercise,
• limiting caffeine,
• and avoiding strenuous physical activity help to control the condition.

Surgical treatment of a ruptured aneurysm require support from family and friends.

Talk to experts to understand better about the condition. Being a part of the support groups help to cope with the situation.

There are several risks and complications associated with brain aneurysm.

Rupture of aneurysm may result in re-bleeding, vasospasm, hydrocephalus, and disrupt the balance of electrolytes in the body.