At Cleveland Clinic's Cerebrovascular Center we treat many manners of brain hemorrhage, including intracerebral brain hemorrhage and more. Some of the types of brain hemorrhage include:
- Unruptured cerebral aneurysms, including giant aneurysms
- Vascular malformations and AVMs
- Subarachnoid or parenchymal hemorrhage due to aneurysmal or AVM rupture
- Intracerebral hemorrhage
- Hemorrhagic strokes in children and young adults
- Cavernous angioma and other vascular malformations
What is a brain aneurysm?
A brain aneurysm is an abnormal bulge in a brain artery that develops where the blood vessel wall is weakened. Visualize the artery as a garden hose. If the rubber in a section of the hose becomes thinner, the hose will develop a balloon-like bulge at that point. While the hose may still work, water pressure could cause leaks in the stretched-out hose wall or even cause the hose to burst. Similarly, a brain aneurysm may allow blood to leak into the subarachnoid space around the brain, causing damage to brain cells. The brain aneurysm also may rupture, causing a serious and perhaps fatal stroke.
Why does a brain aneurysm form?
It’s not clear why a brain aneurysm forms, but researchers believe these factors contribute to their development:
- Severe traumatic head injury
- Family history
- Ehlers-Danlos syndrome, polycystic kidney disease, Marfan’s syndrome
- Hypertension (elevated blood pressure)
How is a brain aneurysm detected?
The size, shape and location of brain aneurysms can be detected using imaging tests such as:
- MRI (magnetic resonance imaging)
- CT (computed tomography)
- Cerebral Angiogram MRA (magnetic resonance angiography)
- CTA (computed tomography angiography)
Many brain aneurysms are discovered only after they rupture, because people with unruptured brain aneurysms often have no symptoms. Aneurysms may be detected after a patient reports a traumatic head injury, vision problems or headaches.
Is a brain aneurysm a serious health risk?
The biggest risk is that the brain aneurysm will rupture and leak blood into the space surrounding the brain, causing a stroke called a subarachnoid hemorrhage. A ruptured brain aneurysm requires emergency medical treatment as the likelihood of death or disability is high.
Ten to 20 percent of those who have a subarachnoid hemorrhage will die before getting to a hospital. Of those who survive, approximately 30 percent will have moderate to severe disabilities. Though not all brain aneurysms rupture, it is impossible to predict whether or when a rupture may occur.
What are brain aneurysm treatment options?
A patient’s age, overall health, hemorrhage risk and location of the brain aneurysm are considered in determining treatment options. For some patients, the risks of treatment outweigh the potential benefits, and treatment is not recommended.
Current brain aneurysm treatment options include:
- Open surgery, also referred to as craniotomy, performed through a surgical opening in the skull. Using an operating microscope and tiny instruments, the surgeon attaches a small metal clip at the base of the aneurysm. (Think of it as the end of a balloon being secured by a twist-tie.) Because blood is prevented from flowing into the aneurysm, the chances of it rupturing are greatly reduced. Recovery time typically is four to six weeks.
- Endovascular surgery, performed through a catheter (a flexible tube) threaded through the blood vessels. Thin platinum wires are pushed into the aneurysm, where they coil into a mesh ball. (Think of it as a balloon being filled with a tangle of yarn.) Because blood clots form around the coils, the chances of it rupturing are greatly reduced. Recovery time typically is two to four days.
Look for a physician or team of physicians, like those in the Cerebrovascular Center, who are trained in both types of brain aneurysm treatment.
What are signs of a ruptured brain aneurysm?
A ruptured brain aneurysm is a life-threatening event requiring emergency medical treatment.
How can a brain aneurysm be prevented?
Lifestyle changes that may be beneficial in preventing a brain aneurysm include:
- Not smoking
- Exercising regularly
- Eating a balanced, low-fat diet
- Getting help for alcohol and/or drug abuse
- Controlling high blood pressure
Cleveland Clinic: pioneering advances
For decades, Cleveland Clinic physicians and scientists have gained recognition for major contributions to the understanding of aneurysms and cerebrovascular disease. Most recently, a Cleveland Clinic neurosurgeon pioneered an endovascular surgical technique to treat aneurysms that occur where blood vessels branch off. Two flexible stents (devices used to support tissue as it heals) are joined in a Y-configuration, which allows blood to continue to flow through both arms of the blood vessel. Previously, this type of aneurysm was treatable only by open surgery.