Cerebral aneurysms are like small balloons which form on the arterial blood vessels in the brain.
Cerebral aneurysms occur in 3-5% of the population, and around 1% of all people have more than one aneurysm. Cerebral Aneurysms are more common in females, and people over 60 years of age.
Most aneurysms are small and don’t cause any symptoms or problems. Some aneurysms will rupture and cause a subarachnoid haemorrhage. If this happens there is a high risk of stroke and death. Treatment is therefore aimed at quickly dealing with cerebral aneurysms which have ruptured, as well as identifying those at high risk of rupture and preventing this complication from occurring.
Modern treatment options for cerebral aneurysms include:
- Clipping of the aneurysm. This involves brain surgery in which a special clip is placed across the base of the aneurysm. This excludes the aneurysm from the blood circulation, and can cure the problem. The risks of this surgery can be significant, and should be carefully considered.
- Coiling and/or stenting. These techniques, known as ‘endovascular’ therapies, involve reaching the aneurysm by placing a small catheter in the femoral artery (in the groin) and feeding this up to the brain. The aneurysm can then be filled with coils, thereby preventing blood from getting inside it and causing it to rupture. It can also be excluded from the circulation by placement of a stent across its base. These procedures are generally lower risk than traditional aneurysm clipping surgery, however the success rate is not as high.
Deciding which treatment option is best depends on a number of factors, including the location of the aneurysm, and the size of its ‘neck’.
Individuals with 2 or more close relatives who have had cerebral aneurysms are at higher risk of developing aneurysms themselves. Regular screening with CT or MRI angiograms may be recommended for those individuals.