The Diagnosis and Treatment for Brain Aneurysms

Carol Roach By Carol Roach, 19th Jul 2015 | Follow this author | RSS Feed
Posted in Wikinut>Health>General Health>Diseases & Infections

The following article will explore the diagnosis and treatment of brain aneurysms.

How to prepare for your appointment

The Montreal Neurological Institute is a world renown research center and hospital specializing in the diseases of the brain.

One of the scariest conditions to think about is having a brain aneurysm. Many Montrealers automatically think death when they think aneurysm, but how many people actually know what a brain aneurysm is?

What many Montrealers do not know is that there are different types of aneurysms; but today we will be talking about a brain aneurysm.

Brain aneurysm diagnosis

Brain aneurysms
will be detected and diagnosed in Montrealers, once they ruptured and the patient is sent to emergency by ambulance. However, they are also diagnosed before they are ruptured, if detected when a patient is going though brain imaging tests for another disorder as well.

If an aneurysm is found, you would be sent to a neurologist or neurosurgeon to discuss the treatment and any other further tests which may be needed.

Preparing for the appointment

Of course, you will shocked or concerned and you will want to ask the doctor questions. Preparing them in advance will help you to remember what you want to ask before the appointment date.

What questions you should ask your doctor about a brain aneurysm

What is an aneurysm?
How did I get an aneurysm?
How big is it and where is it located?
Can tests determine if the aneurysm has ruptured?
What happens if the aneurysm ruptures?
What happens if the aneurysm doesn’t rupture?
What kinds of tests do I need to go through to determine the severity of the aneurysm?
What are the treatment and options?
Will my insurance cover the testing and treatment for an aneurysm?
Can I wait before going through more testing?
How can I prevent the aneurysm from rupturing? Is there certain lifestyle changes I need to make?
Can I go back to work prior to or subsequent to surgery?
How much time do I have to take off of work?


Your doctor may have questions to ask you as well. These questions could include:

Do you smoke, drink, or take drugs?
What medication are you currently using or have used in the recent past? Especially if you are being treated for high blood pressure, high cholesterol, or any of diseases of the blood vessels, or other blood conditions?
Is there a family history of heart or stroke, or aneurysms, in the family?

Diagnosis of a brain aneurysm

Diagnosis of a brain aneurysm

So important to the treatment of aneurysms is the ability to be armed with knowledge about the condition and what you can do prevent aneurysms, and what you must do after one has been determined. Ask your doctor for any literature he may have on the subject of aneurysms. If he does not have any at his office, ask his nurse where you can pick up some information. Also, ask other people you know who have had an aneurysm and survived. Ask at the hospital if there is a support group or counseling available and if all else fails, do your own Google searches and visit you public library for information.

The Screening and Diagnostic Tests for Brain aneurysms

What are the tests to know if a person has an aneurysm

If an aneurysm is suspected, the patient will undergo a series of tests to determine if the aneurysm has ruptured and if there is bleeding in the space between the brain and its lining. This kind of bleeding is referred to as subarachnoid hemorrhage. You might also be tested to see if you may have had a different kind of stroke.

You will probably undergo the same tests, if you have a severe headache, pain above the eye, or behind the eye, and if one side of your face becomes paralyzed. These symptoms are a strong indication that you may have a brain or cerebral aneurysm.

Diagnostic tests used to determine a brain aneurysm often called a cerebral aneurysm


CT scan – Computerized Tomography

The CT scan is the first test used to determine if an aneurysm is present. The CT scan is a specialized X-ray taken of the brain. Its function in this case, is to determine if a rupture and subsequent bleeding has occurred. The CT scan will take images or slices of the brain, and will look for blood. Often a dye is injected into the brain to make it easier to trace the blood flow and thus the exact location of the aneurysm. A similar test call the CT angiography may be used in its place.

Cerebrospinal fluid test


The Cerebrospinal fluid test used when there is evidence of a ruptured aneurysm; yet, ,the CT scan did not pick up the bleeding (subarachnoid hemorrhage). This bleeding is likely to enter the red blood cells found in the cerebrospinal fluid which is found in the brain and spine. The doctor will do a lumbar puncture or spinal tap which is a needle that will extract some of the fluid so that it can be analyzed for blood.

MRI - Magnetic resonance imaging

The MRI is often provides a clearer picture of the brain than a CT scan. The MRI uses radio waves and a magnetic field to look for blood in the brain, resulting from a ruptured aneurysm. The MRI images are not only two sides or slices, like the CT scan, but can be viewed as three-dimensional as well.

Cerebral Angiogram


The cerebral angiogram also known as a cerebral arteriogram is a series of x-rays similar to the CT scan, only dye is injected into very large arteries by a thin tube called a catheter. The tube will go past the heart and directly to the brain. The catheter is usually first inserted into the groin to chart the progress of the blood flow to the brain. This procedure is more evasive than the others and is used only when other tests do not yield the results expected.

Screening for aneurysms is it done?

Normally the brain imaging tests are not used for screening purposes. However, if there is a history of brain or cerebral aneurysms in the immediate family, or if the patient has a congenital disorder that puts him or her at risk for possible aneurysms; at that time the screening may be recommended.

Surgery and Other Treatments for Brain aneurysms


There are two types of surgery for a brain aneurysm:surgical clipping and endovascular coiling

Surgical clipping

This procedure involves removing part of the skull to get to the aneurysm. The surgeon will then clip the aneurysm to cut off the blood supply from the blood vessel that feeds into it.

Endovascular coiling


With an endovascular coiling procedure, the surgeon will insert a long hollow plastic tube called a catheter into the artery in the groin area and weave it all the way up to the brain aneurysm. Then a guide wire will push a platinum wire through the catheter and into the aneurysm. This wire will coil into the aneurysm and disrupt the blood flow and allow the blood to clot. This clotting will seal off the aneurysm.

Surgery is not without risk, it can cause bleeding in the brain. Though endovascular coiling is less evasive it still can cause re-bleeding. Your doctor will decide if this procedure is right for you based on your general health and other medical factors.

Additional Treatment options

Ventricular catheters

Ventricular catheters are used to to reduce the pressure in the brain from hydrocephalus, which is excessive cerebrospinal fluid caused by a ruptured aneurysm. The surgeons will place a catheter into the ventricles (spaces where the cerebrospinal fluid will build up) to drain the fluid into a bag outside of the brain.

Shunt surgery


A shunt which is a silicone rubber tube, and a valve may be used to drain the fluid from the brain down into the abdominal cavity.

Brain aneurysm treatment

Apart from surgery, the other treatment options includes treating the symptoms and managing health care.

Analgesic pain relievers

Analgesic pain relievers such as Tylenol (acetaminophen) are prescribed for headaches.

Calcium channel blockers

This medication stops calcium from entering the cells in the walls of the blood vessels. The calcium channel blockers may help to prevent vasospasms which are the abrupt narrowing and widening of the arteries, a complication that occurs with a ruptured aneurysm.

Studies on nimodipine, in particular, reduces the risk of delayed brain injury resulting from a hemorrhage (subarachnoid hemorrhage )of a ruptured aneurysm that has produced an insufficient amount of blood flow to the brain.

Additional Treatment options


Vasopressor


A vasopressor will elevate blood pressure so that it can pass through narrow or restricted arteries.

Angioplasty


An angioplasty is a procedure where a catheter is inserted into the blood vessel and it inflates a tiny balloon that opens up the vessel to allow blood to pass through. The angioplasty can also allow a drug called a vasodilator to open up the restricted blood vessel as well.

Anti-seizure medications


Anti-seizure medications such as phenytoin (Dilantin, Phenytek) valproic acid (Depakene) and levetiracetam (Keppra) stop seizures resulting from a ruptured aneurysm.

Rehabilitative therapy


The damage from a ruptured aneurysm can be extensive. Montrealers often require speech, occupational, and physical therapy.

Unruptured brain aneurysms


When the aneurysm has not ruptured, treatment may still include a surgical clipping or endovascular coiling to seal off or contain the aneurysm and prevent it from rupturing. However, the risks for these procedures might indeed outweigh the benefits.

A neurosurgeon or neurologist will determine if the surgery would be warranted. Such factors to take into consideration would be family history of ruptured aneurysms, your age and health, whether or not you have high blood pressure, the size and location of the aneurysm, and if there are other congenital risk factors to consider.

If you have an unruptured aneurysm you have to take care of your health and consider a lifestyle change. You would need to maintain a proper weight and to exercise, and stop smoking or taking recreational drugs. You would need also to limit your intake of caffeine and consult your doctor before taking any drugs; even aspirin, which can prevent blood clotting. Finally, you would need to be careful about straining yourself as it can spike your blood pressure.

Previous link

Brain Aneurysms: Symptoms, Causes and Complications

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Comments

author avatar brendamarie
19th Jul 2015 (#)

wow, very interesting article. What a horrible thing for anyone to have to go through

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