How to Detect and Treat an Aneurysm

Dustin Hayward, MD, with EvergreenHealth Neurosurgery, part of the Eastside Neuroscience Institute, specializes in cerebral aneurysms and vulnerable spots in the wall of your blood vessel. He shares everything you need to know about an aneurysm and how you doctor can monitor and treat one.

What is an Aneurysm?

Cerebral aneurysms are generally located off one of the four major vessels that travel into your brain. When an aneurysm forms in one of these four vessels' walls, it is almost like a balloon forming along that wall.

This ballooning can potentially cause the aneurysm to rupture, which can cause a very severe "thunderclap" headache and lethargy. A ruptured aneurysm can also be life threatening or lead to a loss of consciousness.

What Causes an Aneurysm?

Dr. Hayward says aneurysms are caused by a combination of "nature and nurture," meaning that they can be caused by both hereditary factors as well as modifiable risk factors.

You are more at-risk of developing a cerebral aneurysm if you have an immediate relative who has experienced a cerebral aneurysm. So, staying up to date with your family's health history can help you and your doctor know whether or not you should be screened for an aneurysm.

Modifiable risk factors that could lead to a higher chance of developing an aneurysm include smoking and high blood pressure. There are a number of ways that you can work to manage your blood pressure, including exercise, a healthy diet and medications, if necessary.

There are also a number of strategies and programs to help you quit smoking, including the EvergreenHealth Smoking Cessation Program.

How Do You Detect an Aneurysm?

Generally speaking, aneurysms don't cause any symptoms, according to Dr. Hayward. In certain cases, an aneurysm may cause symptoms impacting your eyes. For instance, a single pupil may be dilating or one eye may be pointing down and away due to how the aneurysm is impacting the muscles that control eye movement.

Because aneurysms don't typically cause symptoms, they are often found incidentally during an MRI or a CT scan of the head that is being done for another reason.

Can You Treat an Aneurysm?

With the advanced techniques and leading-edge technology available through the Eastside Neuroscience Institute, there are treatment options available that suit everyone's needs.

Dr. Hayward explains that there are essentially three main strategies for treating an aneurysm:

• Traditional Clipping: This technique involves open surgery during which your surgeon performs a craniotomy, which means a portion of your bone would be removed, so that they can dissect through the planes of the brain to reach the aneurysm. At this point a clip (similar to small clothespin) would be placed between the aneurysm and the rest of your blood vessel.
• Coil Embolization: This procedure, similar to how a cardiologist might place a stent to support the heart, involves entering the blood vessel through another artery and going up to the brain with a very small catheter (a tube). Once your doctor reaches the aneurysm, they can then place coils, which are small platinum pieces of thread that are rounded and fill the aneurysm.
• Flow Diverting Technology: This process involves placing a stent within the blood vessel to divert blood flow away from the aneurysm. This allows the aneurysm to clot and become solid while the stent then is incorporated as the wall of your blood vessel.
  Depending on the location of cerebral aneurysms, there are risks associated with treatment that may be greater than the risks associated with leaving the aneurysm alone and monitoring it.

If treatment is determined to be riskier than leaving an aneurysm alone, doctors can monitor the aneurysm using surveillance imaging like an annual angiogram. They'll look for changes in the aneurysm's size or configuration to determine when or if there is ever a time to move forward with treatment.

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