BRAIN ANEURYSM

CONTENTS

What are brain aneurysms?

What happens when an aneurysm ruptures inside the brain?

What is coil treatment for brain aneurysms?


When was coil embolisation first performed in South East Asia?


How are stents used  in the treatment of patients with brain aneurysms?


How do brain aneurysms form?


What are the risk factors for developing aneurysms?

 

What are brain aneurysms?

Aneurysms are swellings on the walls of blood vessels. They are like balloons with thin walls. They can grow larger and rupture, spilling out blood into the brain at high pressure. Some aneurysms produce effects such as weakness and numbness as a result of compression of the adjacent brain and nerves.

                                                                                                              
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What happens when an aneurysm ruptures inside the brain?

Bleeding inside the brain is the most devastating complication of an aneurysm. This is diagnosed with a Computed Tomography (CT) scan. About 15% of patients with bleeding due to a ruptured aneurysm do not survive to reach the hospital. About 40% will not survive over the next 6 months due to complications from the initial bleed.
                                                                                   
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CT scan of normal person


CT scan of patient with brain haemorrhage from rupture of an aneurysm. (Red arrow points to thick layers of white substance representing acute bleeding.)

What is coil treatment for brain aneurysms?

Brain aneurysms can be treated by open surgery or by inserting fine platinum coils into the aneurysm itself. Coil treatment is a minimally invasive technique of reliably treating brain aneurysms through a small puncture  of an artery in the groin. From there, a fine tube (microcatheter) is pushed within the blood vessels and navigated into the aneurysm. Extremely soft, flexible platinum coils are then deposited within the aneurysm. The final result is filling of the aneurysm sac with clots mixed with coils.

This was made possible through the invention of an electrolytically detachable coil device invented by an Italian neuroscientist in the University of California Los Angeles. The coil, named as the Guglielmi Detachable Coil (GDC) after its inventor revolutionised treatment of brain aneurysms after it was introduced in 1992.

In September 1995, this device was approved by the FDA for use in treatment of brain aneurysms. Now, there are several different types of coils from various companies that can be used to treat aneurysms in this manner.
                                                                                  
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When was coil embolisation first performed in South East Asia?

The first case of a patient with a brain aneurysm treated by this coil technique in South East Asia was a 56 year old Indian man with a ruptured basilar artery aneurysm which presented with subarachnoid haemorrhage. This was carried out in February 1996.
                                                                                  
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How are stents used in the treatment of patients with brain aneurysms?

In some patients, the aneurysm has a wide opening into the main artery. Coils deposited within such aneurysms can fall back into the main artery. A stent can be placed across the opening of the aneurysm to prevent the coils from any shift in position.
                                                                                  
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A stent is meant to prevent the coils from falling into the main artery in  cases where the opening of the aneurysm is too wide.
How do brain aneurysms form?

Aneurysms usually form as a result of a weakness of the wall of the brain artery. This is especially likely at the site of branching of a major brain artery. It starts as a small blister and then grow into a balloon like structure. The walls of the aneurysm are very thin, making them prone to rupture.
                                                                                   
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What are the risk factors for developing aneurysms?

High blood pressure, smoking and certain pre-existing blood vessel diseases of the brain are risk factors favouring the development of an aneurysm. Aneurysms are also more likely to develop in the elderly. In many patients, however, it can form even when no risk factors are present.
                                                                                  
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