An aneurysm is an outpouching of the wall of an artery. The exact cause of aneurysm formation is unknown, but may be related to a congenital defect in the elastic portion of the artery wall, that is injured over time by the stresses of daily life. Cerebral aneurysms (aneurysms occurring in the brain) are often discovered incidentally (while investigating other problems), but may be identified after rupture (bleeding) or if causing symptoms of compression of a neurological structure.
The major blood vessels of the brain divide into smaller and smaller vessels, like branches of a tree. It’s at these division points, which are often weaker than other areas of the vessels, where aneurysms tend to occur. Cerebral aneurysms tend to occur most often in people older than 40, and in women more often than men.
In the Athens area, you can rely on Dr. Woodall (and his partners at Georgia Neurological Surgery) for the experience, expertise, and caring required by patients seeking treatment for serious brain conditions such as cerebral aneurysm.
Symptoms of Cerebral Aneurysm
A cerebral aneurysm that hasn’t ruptured usually doesn’t show symptoms, unless it’s large enough to press on nerves and tissues of the brain, causing facial pain, numbness, or vision problems. Otherwise, they’re usually detected during tests for other conditions.
A ruptured cerebral aneurysm will cause bleeding into the brain, known as a hemorrhagic stroke (or subarachnoid hemorrhage), and can present as a severe headache along with other symptoms, including:
- Nausea and vomiting
- Drowsiness, dizziness, or confusion
- Neck stiffness
- Blurred or double vision
- Sensitivity to light
- A drooping eyelid
Because a ruptured cerebral aneurysm can be fatal or cause permanent neurological conditions, it requires immediate emergency care.
Causes of Cerebral Aneurysm
The causes of a cerebral aneurysm are unknown, but there are several factors that may play a role. Although most cerebral aneurysms are not inherited, you may be at higher risk if two first-degree relatives (parent, sibling, or child) have had them.
Certain conditions, some of which do not actually occur in the brain, can increase your risk for cerebral aneurysms. These include:
- Autosomal dominant polycystic kidney disease
- Ehlers-Danlos syndrome
- Fibromuscular dysplasia
- Low estrogen
- Marfan syndrome
The risk of cerebral aneurysms can also increase due to lifestyle behaviors, including:
- Alcohol consumption
- Cigarette or drug use
- Dietary choices that lead to or worsen high blood pressure or high levels of cholesterol
Treatment of Cerebral Aneurysm
Depending on your individual situation, surgery may be required to stop the flow of blood from the aneurysm. The procedure may be:
- Craniotomy — meaning a traditional “open” surgical procedure. An open craniotomy involves the surgical removal of part of the skull so the surgeon can place a titanium clip across the neck of the aneurysm to prevent blood flow. The skull is re-secured after clipping is completed.
- Endovascular — “inside the blood vessel.” This minimally invasive surgery uses very small skin punctures and a small plastic tube called a catheter, inserted into an artery (usually through the groin or the wrist) and directed to the location of the aneurysm. Then, the surgeon will treat the aneurysm using:
- Detachable coils (tiny spirals of platinum wire) will be passed through the catheter and into the aneurysm.
- For larger or harder-to-treat cerebral aneurysms, a small stent (flexible mesh tube) will be placed in the artery.
Compared to traditional open surgery, the endovascular treatment does not require craniotomy (opening of the skull), obviates the need for a skin incision, and generally requires a shorter hospitalization. Recovery is also well-tolerated.
Recovery from Cerebral Aneurysm Surgery
Patients having coil embolization performed can expect to spend one night in the hospital, in the intensive care unit. If a stent is being used, patients will be placed on medication to reduce the likelihood of blood clot formation on the stent (usually a combination of aspirin and Plavix).
Patients may feel a generalized sense of fatigue after any invasive procedure done under general anesthesia; that feeling usually resolves within four to six weeks. If the femoral artery (a large artery in the groin) is used as the access site, Dr. Woodall recommends his patients avoid any heavy lifting or strenuous activity for two weeks. If the radial artery (wrist) is used, patients can return to their normal activities as soon as they are feeling up to it. Patients undergoing a craniotomy tend to spend approximately two to three days in the hospital following surgery, and should avoid strenuous activity or heavy lifting for four to six weeks.
Contact M. Neil Woodall, MD, Today
If you have been diagnosed with a cerebral aneurysm and wish to learn more about the treatment options such as endovascular treatment and microsurgical clipping, Dr. Woodall has the skill, care, and experience to ensure you receive the treatment you need—without leaving the Athens area. Contact our office today.