Brain Aneurysm – An Intracranical Bleed

A brain aneurysm is a localized dilation or ballooning of a blood vessel due to weakness in the artery supplying the brain. The most common type is the saccular aneurysm, also known as the ‘berry’ aneurysm, which is a round outpouching in the blood vessel. In some cases, there is uniform dilation of the blood vessel, leading to a ‘fusiform’ type of aneurysm. Chronic hypertension can lead to microaneurysms, known as Charcot-Bouchard aneurysms, which occur in small blood vessels that supply the deeper parts of the brain. Depending on the size of the aneurysmal sac, aneurysms are classified as small (< 15 mm in diameter), large (15 – 25 mm), and giant (> 25 mm).

At Hannah Joseph Hospital, we specialize in the diagnosis and treatment of brain aneurysms. Our team of experts is dedicated to providing the highest level of care to patients affected by this serious condition.

Incidence and Risk Factors

The incidence of brain aneurysms is difficult to estimate, though their prevalence is about 5% in the normal population. Approximately 50% of these aneurysms rupture, causing devastating symptoms. Around 2% of aneurysms present in childhood. Congenital defects in the muscular layer of the artery that supplies the brain can lead to cerebral aneurysm formation. Other factors such as atherosclerotic disease, hypertension, infections, and trauma can predispose individuals to aneurysm formation.

Clinical Features

Rupture of an aneurysm is the most frequent presentation, leading to hemorrhage inside the brain. The sudden onset of severe headache, usually associated with vomiting, syncope (fainting), neck pain, and photophobia, are its cardinal symptoms. It can lead to a transient fainting episode, which may be ignored by a common man. Headache is the presenting symptom in 97% of cases. Some patients experience a warning headache with neck stiffness a couple of weeks earlier. Apart from headache, patients may develop focal neurological weakness or numbness of the limbs. A few patients may develop seizures, and some may lapse into a coma, depending on the severity of the bleed following an aneurysmal rupture. Ocular bleeds can occur in 20-40% of cases of aneurysmal rupture/subarachnoid hemorrhage.

Diagnosis

At Hannah Joseph Hospital, we use advanced diagnostic tools to detect and evaluate brain aneurysms:

– CT Scan of the Brain: A quality CT scan can detect a bleed in the brain and its location.

– MRI: This may be helpful in the subacute stage of a small subarachnoid hemorrhage.

– Cerebral Angiogram: MR-Angio, 3D CT Angio, or Digital Subtraction Angiography (DSA) remain the gold standard for evaluating cerebral aneurysms. These techniques can demonstrate the source of the aneurysm leak in 90% of cases and reveal the status of the parent artery or blood vessel harboring the aneurysmal complex.

Treatment

The treatment for an aneurysm at Hannah Joseph Hospital depends on the condition of the patient, the location of the aneurysm, and the experience of the operating neurosurgeon. Surgical “clipping” of the aneurysm is considered the optimal treatment for most aneurysms that have ruptured to prevent rebleeding. When the aneurysmal neck cannot be clipped due to the complex location of the aneurysm or the poor medical condition of the patient, ‘coiling’ of the aneurysm using endovascular techniques may be considered. These detachable platinum coils can promote thrombosis of the aneurysmal sac to control bleeding.

Concomitant medical therapy to control cerebral swelling, enhance good circulation in the brain, and provide artificial ventilatory assistance as needed are also part of the treatment protocol. The ultimate outcome depends on the neurological condition at admission to the hospital, the radiological picture of the ruptured aneurysm complex, and the age of the patient. Younger age and a good neurological status at admission favor a better prognosis.

Comprehensive Care at Hannah Joseph Hospital

At Hannah Joseph Hospital, we are committed to providing comprehensive care for patients with brain aneurysms. Our multidisciplinary team includes neurosurgeons, neurologists, and critical care specialists who work together to deliver the best possible outcomes for our patients. We use state-of-the-art technology and the latest treatment protocols to ensure that our patients receive the highest standard of care.

Trust Hannah Joseph Hospital for Expert Care

Brain aneurysms are a serious medical condition that requires prompt diagnosis and treatment. At Hannah Joseph Hospital, we offer a comprehensive approach to managing brain aneurysms, from advanced diagnostic imaging to cutting-edge surgical techniques. Our goal is to provide the best possible outcomes for our patients, ensuring their well-being and swift recovery.

If you or a loved one is experiencing symptoms of a brain aneurysm, don’t hesitate to contact Hannah Joseph Hospital. Our team of experts is here to support you on your journey to recovery, providing compassionate care and the highest level of expertise.