What is an aneurysm?

There are two main types of aneurysms fusiform and saccular (or berry aneurysms).  Fusiform aneurysms are defined as abnormal enlargement of an artery 1.5 times the normal diameter. Saccular (or berry) aneurysms are a focal bulge in an artery.  They can have a wide or narrow neck, which can affect treatment options. 

Cerebral Aneurism


Where can aneurysms occur?

Aneurysms can form in any artery throughout the body from the largest artery (aorta) to some of the smallest in the brain (cerebral aneurysm).  Other common locations are carotid (artery in the neck), popliteal (behind the knee), mesenteric (intestinal arteries) or splenic artery.


Do aneurysms run in families?

While there are general risk factors for aneurysms like cigarette smoking, high blood pressure (hypertension), and estrogen deficiency (menopause), there are also associations with some syndromes and genetic factors.  There is an increased risk of cerebral aneurysms with coarctation of the aorta, Ehlers-Danlos, polycystic kidney disease, and moyamoya syndrome as well as an increased risk if a family member has a brain aneurysm, even without the diagnosis of a specific disease or syndrome. 

Please visit the Brain Aneurysm Foundation for more information and family support: https://www.bafound.org/


How are aneurysms treated?

Deciding between surgical or endovascular repair of an un-ruptured cerebral aneurysm requires careful consideration of aneurysm size, location, are morphologic features.  Surgical management involves temporarily removing a portion of your skull and placing a metallic clip across the aneurysm neck, excluding the aneurysm from blood flow and decreasing the risk of rupture. Endovascular repair uses a series of catheters (small tubes) starting from an artery in the groin and gaining access to the aneurysm from inside the blood vessel.  From there a neuro interventionalist can deploy platinum coils which fill up the aneurysm sack excluding it from blood flow and decreasing the risk of rupture. Newer devices and techniques have increased the options for endovascular treatments including stent-assisted coiling, balloon-assisted coiling, flow diverters, and embolic liquids.   


What happens if an aneurysm isn’t treated?

Cerebral aneurysms less than 7 mm have low rupture rates with increasing annual incidence of rupture as the size increases.  There are similar cutoffs for other aneurysms, with increasing rupture risk as they increase in size. When an aneurysm ruptures blood leaks out of the artery into a space that shouldn’t contain blood, with different consequences based on location.  In the brain, those consequences are particularly severe given the pressure the blood can have on the brain.   Ruptured brain aneurysms are fatal in 50% of cases. Of those that survive, 66% suffer a permanent brain injury.


Where is the best place to go if I need coil embolization of an aneurysm?

As a patient, it's important to know that you are going to a hospital that can provide you with the best care possible. The Joint Commission along with the American Heart Association has given a Gold Seal of Approval for Advanced Comprehensive Stroke Centers to select hospitals in the United States. In order to receive this award, a hospital must be able to provide excellent 24/7 stroke care as well as have the facilities and staff available to coil cerebral aneurysms. You can search for Comprehensive Stroke Centers near you by clicking on this link (https://www.qualitycheck.org) and searching your state.


How is aneurysm volume calculated?  How is percent packing volume calculated?

Calculating aneurysm volume is an important part of aneurysm surveillance, treatment, and follow-up. After coil embolization of a cerebral aneurysm, calculating percent packing volume can help predict the risk of aneurysm recurrence.  The AngioCalc Background page covers this information.(See Link)


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