Aneurysm

Henry Ford’s Cerebrovascular Center is a leader in Michigan for the treatment of cerebral aneurysm – also known as intracranial aneurysm or brain aneurysm.

Our patients benefit from neurosurgeons and endovascular surgeons with decades of experience treating aneurysms, as well as our collaborative process of determining the best course of treatment for each patient.

The Henry Ford Neuroscience Institute offers the latest in surgical and diagnostic technology to quickly and accurately diagnose and treat aneurysm.

Rapid aneurysm treatment at Henry Ford

Henry Ford’s physicians are exceptionally skilled at treating patients with cerebral aneurysms surgically and non-surgically.

Aneurysm care is available on a 24/7 basis for emergency and non-emergency cases. Specific treatments depend upon the size and location of the aneurysm, whether it has ruptured, and how likely it is to rupture in the future.

Other reasons we excel at aneurysm care include:

• Comprehensive team approach: Physicians at Henry Ford bring each case, especially very complex ones, to our multidisciplinary aneurysm board, where a team of neurologists, neurosurgeons, endovascular surgeons and neuroradiologists discuss the case in a collaborative, cooperative environment. This means that each Henry Ford patient benefits from the experience of expert physicians who care for some 200 aneurysm patients every year. This consensus approach to treatment plans assures our patients that their care is the top priority of all of our Cerebrovascular Center physicians.
• Advanced technology: We access the latest technology to assist in treating cerebral aneurysm. For example, our surgeons now can produce a 3D-printed model of a patient’s aneurysm, based on the CT scan, to form an even clearer understanding of the aneurysm’s anatomy and location prior to surgery – a development that improves surgical planning for patients and physicians.

What is an aneurysm?

An aneurysm is a damaged, blocked or weakened blood vessel that swells, building up pressure inside the vessel. Aneurysms are very dangerous if they rupture. A burst aneurysm can cause severe hemorrhage (internal bleeding), stroke and other complications, including sudden death.

• Aneurysms can happen in any part of the body. Most commonly, they occur in the aorta (the large artery carrying blood from the heart) or in the brain.
• Aneurysms can occur in people of any age, but they are more common in people over age 65.
• Aneurysms in general happen more frequently in men, but intracranial aneurysms and subarachnoid hemorrhage (bleeding into the spaces around the brain) are more common in women.

Signs and symptoms of intracranial aneurysm

Small brain aneurysms often cause no symptoms, and may go unnoticed. These cerebral aneurysms may be detected during other testing or scans.

Occasionally, an aneurysm near the skin surface of the skin may be painful. This type of aneurysm may cause swelling or even throb visibly. A large intracranial aneurysm may cause pressure on nerves within the brain, which can cause vision problems or facial numbness.

An aneurysm that ruptures or suddenly expands may cause sudden, severe symptoms including:

• Very severe, sudden headache
• Clammy skin
• Nausea and vomiting
• Rapid heart rate
• Low blood pressure
• Shock
• Vision problems or sensitivity to light
• Seizures (fits), dizziness or fainting
• Confusion
• A drooping eyelid
• A stiff neck

If you think someone may be experiencing a ruptured aneurysm, call 911.

Aortic aneurysms have other symptoms, such as back or abdominal pain and coughing. Henry Ford’s cardiac surgeons and vascular surgeons treat aortic, thoracic and abdominal aneurysms.

What causes intracranial aneurysm?

Intracranial aneurysms can be caused by disease or injury. Sometimes, people may be born with an aneurysm or with weakened arteries that are vulnerable to aneurysm.

Other potential causes of brain aneurysm include:

• Family history of aneurysm
• Having had a previous aneurysm
• Weakness in walls of the artery, usually congenital (present from birth)
• High blood pressure (hypertension)
• Hardening of the arteries (arteriosclerosis/atherosclerosis)
• Ethnicity (aneurysm and subarachnoid hemorrhage are more common in African-American people than in Caucasian people)
• Smoking cigarettes, which not only increases blood pressure, but makes it more likely that an aneurysm will rupture

Diagnosis of brain aneurysm at Henry Ford

Patients who come to Henry Ford with symptoms of a possible aneurysm or stroke receive leading-edge diagnosis and testing in the Henry Ford Stroke and Neurovascular Center.

We provide the most advanced imaging diagnostic studies available, including the 64-slice helical CT scanner. We are one of only a few institutions in the world with this technology.

If an intracranial aneurysm is detected, physicians in the Henry Ford Cerebrovascular Center will conduct additional diagnostic testing and imaging. These tests might include:

• CT (computerized tomography) or MRI (magnetic resonance imaging) scan to create a three-dimensional picture of the ruptured aneurysm
• Computed tomography angiogram (CTA) scan to evaluate blood vessels in the area of the aneurysm
• Magnetic resonance angiography (MRA) to provide pictures of blood vessels inside the body
• A cerebrospinal fluid test (also called spinal tap or lumbar puncture) to determine whether subarachnoid hemorrhage has occurred
• Cerebral arteriogram or cerebral angiogram to provide a visual, using injected dye, about the condition of the arteries and the site of a ruptured aneurysm

Treatment for unruptured brain aneurysm

An aneurysm that has not ruptured may be treated with a “watch and wait” philosophy (especially if the aneurysm is small – 5mm in diameter or less). Alternatively, physicians may decide to seal the aneurysm off using clipping (a surgical procedure) or coiling via an endovascular procedure.

Henry Ford’s neurosurgeons determine a course of treatment based on factors including:

• The aneurysm’s location, size and symptoms
• The patient’s age
• The patient’s health and medical history (such as congenital conditions that might indicate a higher risk of the aneurysm’s rupturing)
• Any family history of ruptured aneurysms

Treatment for ruptured brain aneurysm

If a brain aneurysm has ruptured, the physicians at Henry Ford will recommend surgical or endovascular treatment options. The most common treatments include:

• Surgical clipping: The surgeon temporarily opens the skull and uses clips to seal off the aneurysm to stop any bleeding. Our neurosurgeons can rely on Henry Ford’s intraoperative angiography, videography and MRI to reduce the likelihood of needing additional procedures.
• Endovascular coiling: An endovascular surgeon inserts a catheter from the groin, through the blood vessels into the cerebral aneurysm. Soft wire coils inserted into the aneurysm cause the blood flow to clot, sealing the aneurysm and halting additional bleeding.

Additional cerebral aneurysm treatments can relieve symptoms (whether for a ruptured aneurysm or an unruptured aneurysm) and prevent further complications:

• Painkillers to relieve aneurysm-related headache
• Anti-seizure drugs to control seizures that occur after an aneurysm has ruptured
• A ventricular catheter to reduce the pressure on the brain caused by excessive fluid in the brain (hydrocephalus)
• Calcium channel blockers to prevent calcium from entering the cells of the blood vessels, thereby reducing changes in the width of blood vessels that may result from a ruptured aneurysm
• Injected vasopressor drugs to raise blood pressure in order to widen narrowed blood vessels and prevent stroke
• Rehabilitation for brain damage that can be caused by a subarachnoid hemorrhage, such as impaired speech and bodily movements