What is an aneurysm?
An aneurysm (also called a cerebral aneurysm, brain aneurysm or intracranial aneurysm) develops from a weakened area in the wall of a brain artery. Over time, the weak spot can grow and begin to balloon out from the artery. This bulge is called an aneurysm.
Causes and risk factors that affect the development of an aneurysm include:
- Congenital weakness in the artery wall
- Chronic high blood pressure
- Bloodstream infections
- Family history of aneurysms
- Use of certain drugs, such as cocaine
- Traumatic head or neck injury
What are the symptoms of an aneurysm?
People with aneurysms often have no symptoms, especially if the aneurysm is still small. If it grows large enough to impact the brain or press on the surrounding nerves, you may experience symptoms such as:
- Pain above or behind the eye
- Blurred vision or double vision
- Numbness or weakness
If an aneurysm ruptures, it causes bleeding around the brain – a condition called a subarachnoid hemorrhage (SAH). This is a very serious condition that must be treated immediately. Symptoms of a ruptured aneurysm come on very suddenly and can include any of the above symptoms, plus the following:
- Sudden, often severe headache
- Nausea or vomiting
- Loss of consciousness
- Loss of balance
- Difficulty speaking
How are aneurysms diagnosed?
At UCLA, we use the most advanced technology and latest imaging systems to diagnose brain aneurysms quickly and accurately. In many cases, an aneurysm is only discovered once it has ruptured, but we do everything possible to diagnose and manage them before they rupture. During your examination, your expert team may use any of the following imaging techniques to locate and assess your aneurysm:
- Magnetic resonance angiography (MRA) is a non-invasive test that uses magnetic resonance (MR) technology to create images of blood vessels in the brain.
- Computed tomography angiography (CTA) is a non-invasive test that uses injected contrast dye and CT scanning to identify abnormalities of the brain blood vessels.
- Cerebral angiography is a procedure in which physicians inject contrast dye to provide detailed images of the blood vessels of the brain. This allows them to precisely identify the location, size, and shape of the aneurysm. Cerebral angiography is the gold-standard imaging test to analyze the blood vessels of the brain and spine.
How are aneurysms treated?
Following your diagnosis, you and your team of cerebrovascular specialists will discuss the options for treatment and management of your aneurysm. We will customize a treatment plan based on your age, overall health, size, location and shape of the aneurysm. As part of a large academic medical center, the UCLA cerebrovascular team has a long history of technological development and testing innovative devices in clinical trials. Patients will be evaluated for newer treatments and clinical trials as appropriate. Treatment options include:
- Nonsurgical monitoring: If your aneurysm does not require immediate surgery, we will create a customized monitoring plan, watching it closely and regularly.
- Microsurgery: There are several open microsurgical techniques that may be used to treat aneurysms, including but not limited to:
- Microsurgical clipping: In this technique, the neurosurgeon places a titanium clip across the neck of the aneurysm to cut off blood flow, eliminate pressure on the aneurysm and prevent rupture.
- Extracranial-intracranial bypass and trapping: Bypass surgery is used to trap the aneurysm and redirect blood flow around it.
- Wrapping: This technique involves wrapping the aneurysm in fabric to support it and help prevent rupture. Wrapping is typically used in combination with microsurgical clipping.
- Minimally invasive endovascular surgery: Endovascular surgery techniques are performed using a catheter inserted through an artery in the groin (or sometimes the arm) to the brain where the aneurysm is located. This avoids making open incisions in the head and speeds recovery. Endovascular techniques used to treat aneurysms include:
- Micro-coiling: Small platinum wires called coils are placed into the aneurysm to seal it off and prevent blood flow into it. Coiling is sometimes performed with balloons or stents designed to hold coils in place. The Guglielmi detachable coils (GDCs) that are now standard for treating complex aneurysms were developed by researchers at UCLA.
- Flow diversion: In this technique, stents are inserted into the artery to divert blood flow away from the aneurysm so that the blood vessel wall may heal.
- Parent vessel occlusion: This technique, in which surgeons block the vessel feeding blood to the aneurysm, is more rarely used as a method for stopping blood flow into the aneurysm.
To schedule an appointment at the UCLA Cerebrovascular Program, please call 310-825-5111 or click here to request an appointment.