​Brain Aneurysm

Aneurysm is the bulging out or sac formation of a portion of an artery from where its wall has weakened. Aneurysms are of different types occurring in different parts of the body, but, one of the most common types is the Cerebral Aneurysm or Brain Aneurysm. Brain aneurysm is usually formed in the major arteries that are deeply rooted in the brain structure. It expands and forms a balloon like shape due to continuous pressure build-up of blood flow at the weakened portion of the artery.

Some of the major causes that might lead to the formation of brain aneurysm include high blood pressure, high cholesterol, smoking, a family history of brain aneurysm, a traumatic head injury, or an infection. However, some factors might be congenital and become major cause of developing aneurysm in both children and adults. These include;

  • Inherited tissue disorders such as Ehlers-Danlos syndrome

  • Inherited kidney disorder such as Polycystic Kidney Disease

  • Another brain disorder such as cerebral arteriovenous malformation (brain AVM)

  • A family history of brain aneurysm

Aneurysm may differ in size, shape and location within the brain structure. If the artery wall becomes very weak and thin, the sac expansion increases to such an extent that it leaks out blood or in worse cases, even ruptures, and releases blood into the surrounding area within the brain, leading to a disorder known as subarachnoid haemorrhage (SAH). After this occurrence, you or your child needs to be operated urgently or it may lead to haemorrhagic stroke.  

Symptoms for aneurysm vary for each case. An unruptured aneurysm is usually asymptomatic, in some cases; however, it may show symptoms like:

  • Dizziness

  • Headache

  • Eye pain

  • Dilated pupil

  • Troubles in vision

  • Seizures

  • Numbness on face

Sudden and severe headaches are symptomatic of a ruptured aneurysm, and are sometimes accompanied by;

  • Dizziness

  • Confusion

  • Vomiting

  • Stiff neck

  • Blurred vision​

Symptoms of aneurysm are similar to those of other medical ailments. But, if you or your child show any of the above symptoms, especially sudden headaches, and if you have had a history of aneurysm in your family, then you can seek consultancy from our doctors at the Mind and Brain Service Line at The Aga Khan University Hospital.​​
Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.​​

Your doctor will carry out the diagnosis through certain tests in order to detect aneurysms which include:

  • Computed Tomography (CT) Scan: It produces cross-sectional images of the brain which help in viewing the affected blood vessels. This test serves as the initial step in determining the occurrence of bleeding.

  • Computed Tomographic Angiography (CTA): A dye is inserted during the production of images of the brain that helps in locating the aneurysm.  

  • Magnetic Resonance Imaging (MRI): It also produces detailed images of the brain that provides clear view of the brain and blood vessels.

  • Magnetic Resonance Angiography (MRA): A dye is inserted during the production of images of the brain that helps in locating the aneurysm.

  • Arteriogram or Cerebral Angiogram: After the aneurysm has been detected, a more comprehensive test of your child shall be conducted known as the diagnostic cerebral angiogram. To obtain the angiogram, a catheter and a dye is inserted into the blood vessels to get their detailed images. This helps in determining the exact size and type and location of the aneurysm, its relation with the surrounding area and other arteries and veins of the brain, and hence, helps in structuring a proper treatment plan.​

For both ruptured and unruptured aneurysm, any one of the following two surgeries would be selected based on various factors related to the aneurysm and your child’s health.

  • Microsurgical Clipping

This is an open surgery (craniotomy) in which an opening is made in the skull to reach the aneurysm, and a metal clip is employed to clip off the base of the aneurysm so as to stop the blood flow into the artery from which the aneurysm has formed. The clip is left in the brain and the patient usually recovers in a few weeks.

  • Endovascular Coiling

This treatment does not require an open surgery but fluoroscopy (a type of X-ray) is used to view the whole procedure. Platinum coils are attached to a catheter which is inserted into the blood vessels till it reaches the artery where the aneurysm is located. The spring shaped coils are then released into the aneurysm. They block the aneurysm and cause the blood entering into it to clot

Some non-surgical treatments may also be used in combination with the above mentioned surgeries such as:

  • Pain relievers

  • Anti-seizure medicines

  • Intervention techniques to prevent stroke from insufficient blood flow

  • Rehabilitative therapy​

Please click here for some guidelines on what to do before your surgery.​​
Please click here for some guidelines on what to do on the day of your surgery.​​

If the aneurysm is not treated in time, then high risks of bleeding, re-bleeding and further damage to brain exist. This may result in paralysis, seizures and problems in vision and speech.
Since brain surgery involves dealing with blood vessels and brain, there is always a risk of occurrence of some complications in general. These complications are also associated with endovascular coiling and microsurgical clipping such as:

  • Loss of consciousness

  • Paralysis of one half of the body

  • Blood clot

  • Bleeding

  • An area of swelling caused by a collection of blood (hematoma)

  • Loss of the ability or speak or the ability to understand speech (aphasia)

  • Infection

  • Rupture of unruptured aneurysm

During Endovascular Coiling, a dye is inserted to view the blood vessels on fluoroscopy. This dye might impose some allergic reaction to your child.​

Please click here for some guidelines on what to do on after your surgery.​​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

 The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

 The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage​
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The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.​