What Is a Brain Aneurysm?
A brain aneurysm is a weakened area in the wall of a blood vessel that begins to bulge outward. Some aneurysms are small and never cause symptoms. Others grow over time, press on nearby structures, or rupture.
If an aneurysm ruptures, it can cause bleeding around the brain, also called a hemorrhagic stroke. A ruptured aneurysm is a medical emergency.
Treatment recommendations depend on several factors, including the aneurysm’s size, shape, and location, whether it has ruptured, and the patient’s overall health.
How Are Brain Aneurysms Treated Without Open Surgery?
Many aneurysms can be treated through an endovascular approach. Instead of opening the skull, the physician typically accesses the vascular system through a small puncture in the wrist or groin.
Thin catheters are guided through the arteries until they reach the aneurysm. Advanced imaging allows the physician to see the blood vessels in real time and deliver treatment with precision.
The goal is to stop blood from continuing to flow into the aneurysm while preserving normal blood flow through the parent artery.
Coiling: Filling the Aneurysm From the Inside
One common endovascular treatment is aneurysm coiling. During this procedure, tiny platinum coils are placed inside the aneurysm.
The coils help slow or stop blood flow into the weakened area. Over time, the body forms tissue around the coils, helping seal the aneurysm from circulation.
Different types of coils may be used depending on the aneurysm’s size and shape. Some help create a supportive frame, while others help fill the aneurysm more completely.
Flow Diversion: Redirecting Blood Flow
Another treatment option is a flow diverter. A flow diverter is a specialized mesh device placed inside the parent artery, across the opening of the aneurysm.
Rather than filling the aneurysm, the device redirects blood flow away from it. As less blood enters the aneurysm, the body’s natural healing process gradually seals the weakened area.
Over time, new tissue grows along the vessel wall and incorporates the device, creating a smooth new pathway for blood to move through the artery.
How Physicians Navigate Such Small Blood Vessels
Aneurysm treatment requires physicians to navigate some of the body’s smallest and most delicate blood vessels. Many brain arteries are only a few millimeters wide, roughly the width of a strand of cooked spaghetti.
Advanced angiography systems create detailed images of blood flow in the brain, and software can subtract bones and other structures from the image to leave a clear view of the vessels. This creates a roadmap for treatment.
Biplane imaging systems provide two views at once, helping physicians understand the vessel pathway from multiple angles. This is especially important when navigating the curves and branches of the brain’s circulation.
What to Expect: Medication and Follow-Up Care
When a device such as a coil or flow diverter is placed inside a blood vessel, the body may respond to it as a foreign surface, and blood can form clots on or near the device if it isn’t properly managed.
For this reason, some patients need antiplatelet or blood thinning medication after certain aneurysm treatments. The type and length of medication depends on the device used, the patient’s condition, and the physician’s recommendation. This is an important part of treatment planning and follow-up care.
Benefits of Minimally Invasive Aneurysm Treatment
Depending on the patient and the aneurysm, minimally invasive treatment may offer:
- Smaller access sites
- Less disruption to surrounding tissue
- Shorter recovery times than some open procedures
- Treatment options for aneurysms that may be difficult to reach surgically
- Precise repair using advanced imaging and specialized devices
Not every aneurysm requires treatment, and not every aneurysm is best treated endovascularly. The decision depends on careful evaluation by a specialist.
Receive Treatment from the Experts at Neuroscience Group
Modern aneurysm care has moved far beyond a one-size-fits-all approach. For many patients, the neurointerventional and endovascular teams at Neuroscience Group can repair aneurysms from inside the blood vessel itself, using advanced imaging, tiny catheters, coils, flow diverters, and other specialized devices, often without opening the skull.
Learn more about our neurointerventional services or meet our specialists, Dr. Victor Hugo C. Benali, Dr. Todd R. Peebles, and Dr. Dana M. Defta to find the right care close to home.
Frequently Asked Questions
What causes a brain aneurysm?
A brain aneurysm forms when part of an artery wall weakens and begins to bulge. High blood pressure, smoking, a family history of aneurysms, and certain inherited connective tissue conditions can raise the risk. In many cases, there is no single clear cause.
What are the symptoms of a brain aneurysm?
Most unruptured aneurysms cause no symptoms and are found during imaging for another reason. A larger aneurysm may press on nearby nerves and cause headaches, vision changes, or a drooping eyelid. A ruptured aneurysm often causes a sudden, severe headache, nausea, a stiff neck, or loss of consciousness. Call 911 right away if these symptoms appear.
Does every unruptured brain aneurysm need treatment?
No. Many small aneurysms have a low risk of rupture, and a specialist may recommend monitoring them with regular imaging. The decision to treat depends on the aneurysm’s size, shape, location, and growth, along with your age and overall health.
What is the difference between coiling and flow diversion?
Coiling places tiny platinum coils inside the aneurysm to block blood flow into it. Flow diversion places a mesh device in the main artery, across the aneurysm’s opening, to steer blood past it. Flow diverters are often used for larger aneurysms or those with a wide opening, where coils alone may not stay in place.
How is endovascular treatment different from brain aneurysm surgery?
Traditional open surgery, called surgical clipping, requires opening the skull to place a small clip at the base of the aneurysm. Endovascular treatment reaches the aneurysm through the blood vessels, starting from a small puncture in the wrist or groin, so the skull stays closed. Your specialist will recommend the approach that fits your aneurysm.
What is recovery like after endovascular aneurysm treatment?
For an unruptured aneurysm, many patients stay in the hospital for a night or two and return to most normal activities within about a week. Recovery after a ruptured aneurysm takes longer and depends on how much bleeding occurred. Your care team will give you instructions based on your procedure.
Will I need follow-up care after treatment?
Yes. Most patients have follow-up imaging to confirm the aneurysm remains sealed. Some patients also take antiplatelet medication for a period of time after treatment, especially after a flow diverter is placed. In some cases, an aneurysm treated with coils may need additional treatment later.