Cerebral Aneurysm

A cerebral aneurysm, also called a brain aneurysm, is a weakening in the outer wall of a blood vessel in the brain. The weak spot can potentially fill with blood and balloon outward. In addition to pressing on nearby nerves and brain tissues, a bulging aneurysm can potentially burst and spill blood into the surrounding area (hemorrhage). A ruptured cerebral aneurysm is a medical emergency that can disrupt the delivery of essential oxygen to the brain and lead to a life-threatening stroke.

The team in Tampa General Hospital’s renowned Neuroscience Institute and Skull Base Surgery Center offers world-class care for patients with cerebral aneurysms and other complex brain conditions. In recognition of our outstanding outcomes, TGH has earned the prestigious “high performing” designation for Neurology and Neurosurgery from U.S. News & World Report for 2023-24.

Cerebral Aneurysm Causes

Aneurysms typically form at arterial branch points, which tend to be their weakest links. Some cerebral aneurysms are present at birth due to a genetic abnormality. Certain hereditary diseases are also associated with aneurysms, including:

• Arteriovenous malformations (AVMs)
• Connective tissue disorders, such as Ehlers-Danlos syndrome
• Polycystic kidney disease (PKD)

Some factors that can increase the risk of developing a cerebral aneurysm include:

• A family history of brain aneurysms
• Head trauma
• High blood pressure
• Atherosclerosis
• Smoking
• Excessive consumption of alcoholic beverages

Cerebral Aneurysm Symptoms

Most brain aneurysms are small, have a low risk of rupture and do not cause symptoms. Sometimes, an unruptured cerebral aneurysm will leak a small amount of blood into the surrounding brain tissues (sentinel hemorrhage), which may cause warning signs such as:

• Pain above or behind one eye
• A dilated pupil in one eye
• Double vision and other vision changes
• Numbness and weakness
• Paralysis on one side of the face

In most cases, however, the first sign of a cerebral aneurysm appears when it ruptures. The symptoms of a brain hemorrhage can include:

• An excruciating headache
• Light sensitivity
• A stiff neck
• Nausea and vomiting
• Impaired balance and coordination
• Drowsiness
• Back or leg pain
• Seizures

Cerebral Aneurysm Diagnosis

Sometimes, an unruptured cerebral aneurysm is discovered during a diagnostic test performed for an unrelated reason, such as a computed tomography (CT) or magnetic resonance imaging (MRI) scan. Alternatively, a sentinel hemorrhage may cause noticeable symptoms. In addition to a complete medical history and physical examination, the diagnostic process for a cerebral aneurysm may include:

• Cerebral angiography – A physician will insert a thin, flexible tube (catheter) into an artery in the leg, then pass the catheter up to the brain. After injecting contrast dye through the catheter, the physician will capture X-ray images of blood vessels in the brain.
• Magnetic resonance angiography (MRA) – Using a combination of MRI technology and intravenous (IV) contrast dye, a physician can visualize blood vessels in the brain in detail.
• Cerebrospinal fluid (CSF) analysis – A physician will insert a thin needle into the lumbar spine and draw a small amount of cerebrospinal fluid. A lab technician will then analyze the sample for evidence of bleeding in the brain.

Cerebral Aneurysm Treatment Options

Treatment for a cerebral aneurysm can vary depending on its location and size and whether it has ruptured. Some options include:

• A “wait and watch” approach
• Platinum coil embolization
• Flow diversion with stents
• Microvascular clipping
• Artery occlusion and bypass

Effective treatment for a cerebral aneurysm requires in-depth knowledge about the brain and nervous system as well as a specialized skill set and extensive experience. TGH’s Center for Skull Base Surgery includes some of the most well-respected neurosurgeons in the world. Our team has mastered intricate skull base surgical techniques as well as the use of robotics, intraoperative MRI and other advanced technologies, allowing us to expertly plan and safely perform these complex procedures for our patients.

Choose TGH for World-Class Care

If you would like to learn more about the outstanding team at TGH and our approach to diagnosing and treating cerebral aneurysms, call (800) 822-3627 to request an appointment.