MU neurosurgeon uses microsurgical approach to treat brain aneurysms

MU neurosurgeon uses microsurgical approach to treat brain aneurysms

According to the American Association of Neurological Surgeons, an estimated 30,000 people in the United States experience a ruptured cerebral aneurysm each year, and up to six percent of the population may be living with an un-ruptured aneurysm.

“An aneurysm is a weakness of the blood vessel, specifically the artery,” said David Hasan, M.D., a neurosurgeon at University Hospital. “The weakened area bulges or balloons out, and under the hemodynamic stress of blood circulating through the artery, can rupture.”

If the aneurysm ruptures, it is a life-threatening event that could result in death.

“Aneurysms are very dangerous,” said Hasan. “Approximately 50 percent of the people who experience ruptured aneurysms die before reaching the hospital. Of those who do make it to the hospital, about half will experience life-threatening complications due to the ruptured vessel.”

Warning signs of a ruptured aneurysm include:

The rapid formation of an extremely painful headache
Nausea and vomiting
Stiff neck
Blurred or double vision
Sensitivity to light (photophobia)
Loss of sensation

Brain aneurysms occur in all age groups; however, they are most prevalent in people ages 50 to 60, with women more at risk than men. Additional risk factors for aneurysms also include smoking, high blood pressure, high cholesterol, and in some cases, a genetic predisposition.

If found before rupturing, a brain aneurysm may be treated through observation, medication or surgery based on its size. However most are found incidentally, due to an unrelated screening or test, so that treatment usually involves a surgical procedure such as “coiling” or “clipping.”

“Microsurgical clipping of the aneurysm involves making a minimal incision behind the patient’s hairline and then making an opening in the skull, approximately two inches in diameter,” said Hasan. “We then shave more bone off the skull so that there is room to work underneath the brain with minimal manipulation of the tissue in order to reach the aneurysm. We then dissect the aneurysm and apply a clip on it to prevent the weakened area of the vessel from ever rupturing again.”

Endovascular coiling may also be a viable option for neutralizing an aneurysm. The coils are deployed into the aneurysm via a catheter that is inserted into an artery in the groin and carefully advanced into the brain. The coils alter the blood flow within the weakened area and close the aneurysm. Although endovascular clipping is a less invasive option, long-term durability is unknown, and not all aneurysms are suitable for coiling.

“Making the best decision about the method of treating an aneurysm is very important,” said Hasan. “But it is also important to address the factors that increase the instance of brain aneurysm, such as quitting smoking, exercising regularly, maintaining a proper diet, and managing both high blood pressure and cholesterol.”

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