A brain aneurysm is a weakened area in the lining of a blood vessel in the brain where blood accumulates, causing a bulging of the blood vessel wall. Most brain aneurysms do not cause any symptoms, but a ruptured aneurysm can lead to bleeding into the area surrounding the brain—a dangerous condition known as subarachnoid hemorrhage. In this video, I discuss the characteristics, formation, rupture, and treatment of brain aneurysms.
TRANSCRIPT:
A brain aneurysm is a weakened area in the lining of a blood vessel in the brain where blood accumulates, causing a bulging of the blood vessel wall. While estimates vary, it is thought that brain aneurysms may occur in somewhere between 2 and 5% of the population. Most brain aneurysms, however, do not cause any symptoms, but larger aneurysms may cause symptoms by putting pressure on brain tissue and in a small percentage of cases, an aneurysm may rupture. The rupture of a brain aneurysm can cause bleeding into the area surrounding the brain---a condition known as subarachnoid hemorrhage. Subarachnoid hemorrhage is an extremely dangerous situation with high rates of fatality.
The mechanisms underlying the formation and rupture of brain aneurysms are still not completely understood. It is thought, however, that an aneurysm may typically originate with damage to the wall of a blood vessel, followed by an inflammatory response that ends up further weakening the blood vessel wall. The weakened vessel wall allows blood to accumulate in that section of the blood vessel and increases the risk of the vessel rupturing. There are a number of factors that may influence the likelihood of aneurysm rupture, such as the size, location, and rate of growth of the aneurysm, as well as patient factors such as smoking, alcohol consumption, hypertension, and a family or personal history of aneurysm rupture.
A ruptured aneurysm requires emergency treatment, which typically involves one of two approaches: surgical clipping or endovascular coiling. Clipping involves surgery to open the skull and place a metal clip at the base of the aneurysm to prevent blood flow into the aneurysm. Coiling is a less invasive procedure that involves passing a catheter into an artery and threading it through the body to reach the aneurysm. Tiny platinum coils are then released into the aneurysm to block blood flow into the aneurysm.
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