A weak or unusual spot on a blood vessel that results in an outward ballooning or bulging of the artery wall is known as brain (cerebral) aneurysm. This condition may affect any vessel in the body but which are there in the head can result into a serious medical condition. Most of these brain aneurysms are unnoticed and results in no symptoms. The rupturing of the brain aneurysm can release blood inside the skull and can cause a stroke. Subarachnoid hemorrhage is the condition where there is a rupturing of the brain aneurysm. The usual location of brain aneurysms is the circle of the Wilis.
An aneurysm may form due to an inherited tendency of a person or can also form due to hardening of the arteries. Following are the factors that can increase the possibility of an aneurysm or a person already has an aneurysm and there are chances of rupturing –
Following tests are performed for diagnosing brain aneurysm –
Cerebral angiogram: The insertion of the catheter is done from a blood vessel in the arm or groin. Through the vessel, the catheter is then moved up into the brain. Now inside the cerebral artery, a dye is injected. This dye enables a doctor to see aneurysms on the x-ray. This x-ray test is ideal for locating small brain aneurysms.
Computed tomography (CT) scan: This test helps in identifying the bleeding happening inside the brain.
Magnetic resonance angiography (MRA): The pictures of the blood vessels in the body can be taken by using pulses of radio wave energy and a magnetic field.
Computed tomography angiogram (CTA) scan: CTA is considered as a more accurate test as compared to CT scan. CTA involves special computer techniques, a mixture of CT scanning and dye (contrast material) that are injected in blood for producing images of blood vessels.
The treatment for aneurysm depends on several factors. These factors include absence or presence of symptoms, location and size of the aneurysm, absence or presence of some risk factors for aneurysm rupture and lastly the medical condition or age of the patient. There are two surgical treatments for brain aneurysm –
Endovascular Coiling or Coil Embolization: This minimally invasive procedure is used for treating cerebral aneurysm. A catheter is placed through a blood vessel in the groin that reaches the blood vessels into the brain. In order to advance the catheter into the aneurysm and to the head, fluoroscopy which is a type of x-ray is used. The small platinum coils are then placed through the catheter in the aneurysm. These small platinum coils are visible on x-ray and also provides the proper shape of the aneurysm. Rupturing is then prevented as the coiled aneurysm becomes clotted off. The entire procedure is performed under local or general anesthesia.
Open Craniotomy (surgical clipping): During the surgical procedure, a part of the skull is removed. An aneurysm is then exposed by the physician. A metal clip is placed across the neck for preventing the flow of the blood inside the aneurysm sac. The skull is then sutured back together after the completion of clipping.
The cost of aneurysm surgery in India is very cost-effective as compared with other developed countries. Aneurysm surgery is regarded as one of the safest surgeries in India. Also the success rate of this surgery is higher in India.
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