Aneurysms
What is an Aneurysm?
An aneurysm is an abnormal, weak spot on a blood vessel wall that causes an outward bulging of the vessel. The wall of the aneurysm becomes stretched out and thin similar to an inflated balloon. Aneurysms of the brain, otherwise known as cerebral or intracranial aneurysms, are a serious medical condition which can rupture or leak and lead to serious brain damage or death. Brain aneurysms can be saccular (like a balloon), involve all walls of the artery (fusiform) or split the walls of the artery (dissecting). All three forms are potentially deadly. Aneurysms are more common in females than males, and the most significant risk factors are a family history of aneurysms, and smoking.
Symptoms & Diagnosis of Brain Aneurysms:
Most aneurysms unfortunately do not typically cause symptoms until they have ruptured. However, some aneurysms can present with symptoms such as localized headache, vision changes, pain above or behind the eye or dizziness which can prompt consultation and further evaluation by a specialist.
Detection of a brain aneurysm often will involve advanced imaging such as a CTA, an MRA or a cerebral angiogram. Many aneurysms are found incidentally when patients are undergoing these tests for the evaluation of other medical conditions.
A CTA is a non-invasive technique where a CT is performed after contrast dye is injected, allowing for the evaluation of the blood vessels of the brain.
An MRA is a non-invasive technique similar to an MRI, except it is the blood vessels being evaluated rather than the brain itself.
A cerebral angiogram is a minimally invasive procedure where a flexible catheter (like a long skinny straw), is inserted in the artery of the upper thigh or wrist and guided using xray and contrast dye into the arteries of the neck so that the most highly detailed pictures can be obtained. This information is then often used to guide the best treatment option for the patient.
Brain Aneurysm Treatment
Not all aneurysms need to be treated, and those that are not are typically watched closely with yearly imaging. Aneurysms that need to be treated can be treated with open surgery and clipping or a minimally invasive endovascular procedure. Open surgery is performed by a Neurosurgeon and involves opening the skull and placing a clip across the aneurysm. Endovascular surgery for aneurysms involves “coiling” or “flow diversion.” In coiling, the operator uses a small catheter to pack small metal coils directly into the aneurysm, which prevents blood from flowing into the aneurysm, effectively removing it from the circulation. Flow diversion involves placing a device across the aneurysm to divert flow away from the aneurysm. Over time the aneurysm will thrombose and shrink to nothing.
Due to its minimally invasive nature, endovascular treatment of aneurysms has replaced open clipping as the primary treatment of most aneurysms. Dr. Geraghty has been treating aneurysms endovascularly for over 8 years now and has the full compliment of endovascular techniques at his disposal.