Brain Aneurysm

At MUSC Health, our neurosurgeons treat brain aneurysms regularly with a specialized team of nurses and technicians with experience to handle complex treatments and offer the best opportunity for a positive outcome.

If a brain aneurysm has not ruptured, MUSC Health can treat it with a routine procedure. However, a ruptured brain aneurysm is an emergency that must be treated immediately. Accurate early diagnosis of a ruptured brain aneurysm is critical for avoiding a devastating outcome. If a family member has had a brain aneurysm, you should get screened as soon as possible. It can save your life.

What is an aneurysm?

Aneurysms are weaknesses in artery walls that cause bulging in the artery. When aneurysms burst, they cause bleeding and cut off blood flow to the nearby body part. Burst brain aneurysms are fatal about half the time, and of those who survive, about two-thirds suffer brain injury.

The good news is that MUSC Health physicians use newer, safer and more effective tools to diagnose and treat more brain aneurysms than ever before.

What causes brain aneurysms?

There is no single cause of a brain aneurysm. Aneurysms develop over time through wear and tear on the artery. It is important to stop smoking and control blood pressure, but many brain aneurysms are a result of genetics.

What are the warning signs of brain aneurysms?

Most aneurysms form without warning, but sometimes they start with a headache.

About 30,000 people annually experience a ruptured brain aneurysm. Because there are generally no symptoms prior to bursting, it is important to recognize the risk factors for brain aneurysms.

Risk Factors

The number one risk factor for a brain aneurysm is a family history. If a close relative has had one, that dramatically increases the chances you might have one. Other risk factors include smoking, high blood pressure and previous experience with aneurysms. Women are more likely to experience them than men. African Americans and Latinos are also more susceptible.

If a family member has had a brain aneurysm, you should get screened as soon as possible. A negative test for aneurysms is simply a snapshot in time and not a guarantee that one won’t develop. Individuals who have strong risk factors are encouraged to get tested periodically over the course of their lives.

What are the treatments for brain aneurysms?

Because every brain aneurysm is different, the treatment for each is unique, depending on the age and health history of the patient, the size and position of the aneurysm and other risk factors. Older, less healthy patients and those with family members who have experienced bleeding aneurysms are at greater risk of a ruptured aneurysm. The doctor may order a diagnostic test for an individual who is at high risk. If an aneurysm is detected, the treatment may be one of the following:

• Monitoring – Many aneurysms are small and don’t pose immediate risk. The doctor will order periodic diagnostic tests, like an MRA (a magnetic resonance angiography that looks specifically at blood vessels) or CTA (CT angiogram) scan to monitor it. This is the least risky and invasive option, but it is not appropriate for aneurysms that have a high risk of bursting. It is estimated that 50% to 80% of brain aneurysms never rupture.
• Coiling – In this procedure, coils are snaked through the arteries from the groin or wrist into the bulge in the brain artery, filling it up and preventing blood from flowing into it. The coils promote clotting inside the aneurysm and healing in the artery. The coil come in a variety of sizes and shapes and are held into place with a balloon or stent.
• Clipping – This is a more invasive procedure in which an incision is made in the skull and a tiny clothespin is clipped on the neck of the aneurysm to choke off blood flow into the aneurysm.
• Diverting – A mesh sleeve is inserted in the artery bypassing the aneurysm and directing blood to flow normally. Some blood may flow through the mesh into the aneurysm, but because it has nowhere to go, the blood clots, sealing off the bulge.

Following treatment of an aneurysm, most patients are monitored thereafter for the progress of the treated aneurysm and for the possibility of future aneurysms. Roughly 20% of patients experience multiple aneurysms. Individuals with strong risk factors may require lifelong monitoring.