Over time blood vessels tend to enlarge and bulge, and, finally, they could rupture. In the brain it is especially dangerous as any cerebral hemorrhage leads to extremely heavy condition up to disability and death. That is why the treatment of aneurysm in brain (above mentioned enlargement of cerebral vessels) is one of the main subjects of neurology.
The symptoms of brain aneurysm are often hidden but there are a few sings that you might have this disease:
- Permanent headache in the same location
- Distorted vision (double or blurred)
- Enlarged pupils
- Pain behind and above eyes
- Speech problems
- Numbness and weakness
But those symptoms also could be related to others neurological issues, so it is better to have an appointment with a doctor for examination. If you have cerebral aneurysm, it is to be treated surgically and there are two main methods to do this:
- Open clipping;
- Endovascular surgery.
Classical treatment for aneurism is ‘clipping’, when a surgeon clips aneurism preventing so the blood from flowing through it. To reach a diseased area the neurosurgeon performs craniotomy, open brain surgery. First, he or she makes an incision, then, opens the skull, and, finally, dissecting through the brain finds aneurysm and places a clip. It takes 1-2 month to recover after this kind of operation.
Today, more advanced ‘mini’ craniotomy is also possible. The principle of surgery is the same but the surgeon makes a small hole, less than 5 cm, and operates via this opening. It is less traumatic method but still invasive and it has the same recovery time as previous one.
Modern approach is to perform aneurysm surgery with minimally invasive methods. Endoscopy is allows to make treatment both with general or local anesthesia. The specific operation for cerebral aneurysm is named ‘endoscopic coiling’. A neurosurgeon makes a small incision and, then, catheter is introduced into a vessel. The catheter is filled with radio agent, which allows the surgeon to see what is happening in the vessels on monitor.
Then, a thin metal wire (platinum) is introduced into the vessels via catheter. This wire is just not more than twice thicker (sometimes even thinner) than human hair. When the wire reaches aneurism, it enters into it and is packed inside as a coil not giving a blood to flow there. Something it is also needed to introduce a stent or balloon helping the coil to pack aneurysm. It makes aneurysm disappearing over time.
The advantages of endoscopic treatment of brain aneurysm not only that it is less traumatic but also with endoscopic coiling it is possible to reach some places that were unreachable before and, thus, to heal the conditions that were considered as inoperable in the past. At the same time, the skull remains intact. Recovery time could be less than 1 month.
More severe condition arises when aneurysm has been ruptured. The burst causes a subarachnoid hemorrhage (SBH), when blood spread in a brain. This might be revealed in the following symptoms:
- Very bad sudden headache
- Nausea or/and vomiting
- Sudden pain behind and above eyes
- Drooping eyelid
- Sudden changes in vision
- Sudden trouble with moving
- Stiff Neck
- Loss of awareness
- Weakness and numbness
Having some of above symptoms you should immediately turn to qualified medical help as you might be in need of emergency lifesaving measures. Treatment of ruptures aneurysm includes relieving of the symptoms, surgical correction of hemorrhage area, supporting medicine and prevention of further complications. The patient stays in intensive care unit for 1-2 weeks. The methods of treatment are chosen based on a number of factors as location of the ruptured aneurysm, its type, the size of lesion, general state of patient’s health etc.
At present both open surgery and endovascular method are used. Based on International Subarachnoid Aneurysm Trial, the life risk or risk of disability in one year after treatment is lower of 22.4% in patients with endovascular coiling against those who had traditional open surgery. So, today, many medical centers turn to endovascular surgery as to more effective and less invasive method. Clinics in Germany have necessary technical and professional base for qualified diagnostic and treatment of cerebral aneurysm. The best treatment is a timely treatment, as preventive measures allows significantly reduce mortality in patients and give the patients all the chances for normal life.