Brain Aneurysm Treatment in India

A brain aneurysm is a condition in which there is a bulge in the blood vessels in the brain. The continuous pressure from blood circulation can lead to the rupturing of these blood vessels causing bleeding inside the brain.

Associated Anatomy

The blood vessels of the brain

Alternate Name of Brain Aneurysm

Also known as an intracranial aneurysm.

Brain Aneurysm Causes

The exact cause of a brain aneurysm is still under intense research. But scientists associate the condition with the following causes:

• Smoking: Tobacco products can irritate and weaken the brain’s blood vessels.
• Blood infection: The colonisation of blood vessels from pathogens causes the bulging of blood vessels.
• High blood pressure: Over time, pressure can build up around the blood vessels causing them to bulge out of their shape.
• Amphetamine and cocaine usage: Recreational drug usage has been known to form aneurysms in the blood vessels.
• Brain injury: Physical trauma to the brain from accidents can cause an aneurysm.
• Plaque buildup in arteries: A condition known as atherosclerosis can also cause the bulging of the inner walls of the blood vessels.

Brain Aneurysm Symptoms

• Headache
• Impaired vision
• Dilated pupils
• Loss of sensation in the face or head
• Tingling in the face or head region
• Pain in the eye region, both upper and behind
• Pain around the neck region
• Dizziness
• Nausea
• Vomiting
• Loss of concentration
• Confusion
• Impaired speech
• Loss of feeling in the arms and legs
• Myocardial infarction

Brain Aneurysm Stages

Aneurysms are classified based on their size and shape. The classifications are:

• Small:15 mm in size
• Large:15-25 mm in size
• Giant: 25-50 mm in size
• Supergiant: Over 50 mm in size

Brain Aneurysm Diagnosis

An angiogram is used to distinguish cerebral aneurysms from infundibular dilutions. Infundibular dilutions are the widenings caused at the origin of the cerebral artery. Researchers are still trying to figure out whether to classify this as a form of the pre-aneurysm. It can be a potential source of bleeding. Yet, a rupture at this stage is rare.

Tests for Diagnosis of Brain Aneurysm

Magnetic radio angiography (MRA) and computed tomography angiography (CTA) can detect large aneurysms. To detect smaller aneurysms, an angiogram is used. For a rupture, a lumbar puncture procedure is used to evaluate the cerebral spinal fluid. Then, the red blood cell (RBC) count is taken into consideration for a final diagnosis.

Brain Aneurysm Treatments

Brain surgery

In emergencies, when the aneurysm ruptures, brain surgery is needed to close the rupture.

Microvascular clipping

During this surgical procedure, minor cuts are made in the skull to access the aneurysm. The aneurysm is pinched off and sealed using metal cap clips. This procedure blocks the blood supply to the aneurysm.

Flow diversion

In this method, no cuts are required on the skull. Instead, the surgeon uses a catheter to reach the aneurysm and fill it with wire balls made up of platinum. Over time, this blocks blood flow to the aneurysm. A rupture is, therefore, not possible at this spot.

Risk Factors of Brain Aneurysm

• Hypertension: High blood pressure damages the blood vessels and can create ruptures inside them.
• Genetics: Aneurysms can be caused because of inherited genes or due to diseases gained because of inherited genes such as Marfan’s syndrome, which affect the walls of blood vessels.
• Alcoholism: Moderate consumption of alcohol has been a known risk factor.
• Fitness: High body weight is a known risk factor for developing aneurysms.
• Cocaine: The usage of this drug has been associated with the formation of aneurysms inside the blood vessels of the brain.
• Female gender: The disease affects females more than males.
• Family history: The disease occurrence rates in closely related family members are also a risk factor.

Brain Aneurysm Prevention

Primary Prevention of Brain Aneurysm

• Fitness: Maintaining healthy body weight through regular high cardio exercises.
• Healthy diet: Having a proper and balanced diet with an even mix of carbohydrates, proteins, and fats.
• Therapy sessions are recommended for alcohol abuse and drug (Cocaine) abuse.
• Blood pressure: Maintaining ideal blood pressure with proper care and medications.
• Avoid smoking at all costs. Approach rehabilitation centres if needed.

Secondary Prevention of Brain Aneurysm

After the initial episode of a brain aneurysm, patients are advised to follow all the preventive measures prescribed for the primary prevention of the disease.

Possible Complications of Brain Aneurysm

When an aneurysm ruptures, the blood from the rupture can leak into the space around the brain leading to a condition called a subarachnoid haemorrhage. This causes intense headaches in the patient. Other complications include vasoconstriction of blood vessels that can then lead to tissue death in a condition known as vasospasm.

Epidemiology of Brain Aneurysm

• 30 to 60 years old: This is the most affected age group.
• Women: Females are more affected by this condition than men.
• Under the age of 16: Brain aneurysms for persons below 16 are rare.

Expected Prognosis of Brain Aneurysm

Prognosis depends on the size and location of the aneurysm. The risk of a rupture at this location depends on the size of the aneurysm. For example, small aneurysms have a very low risk of rupture as compared to larger-sized ones. The location of the aneurysm and the patient’s age, fitness, and mental condition contribute to the prognosis.

Natural Progression of Brain Aneurysm

The healing of an aneurysm without medical intervention is very rare. Ruptures in blood vessels occur because of an untreated aneurysm, and ruptures require emergency treatment. It is advised to be treated immediately for aneurysms that are larger than 7 mm in diameter because of the risk of rupture.

Pathophysiology of Brain Aneurysm

A bulge in a blood vessel at a point of weakness that is filled with blood is called an aneurysm. The high pressure in this region pushes the blood against the blood vessels, creating pressure on the walls of the blood vessels, causing them to enlarge outward. The weakness in this region can be because of multiple factors, such as genetics or inherited hereditary conditions, which predisposes the person’s weaker inner linings of the blood vessels to bulge out of proportion.