Brain aneurysm

Most brain aneurysms only cause symptoms if they rupture. This is a medical emergency. Symptoms may include an excruciating headache, which comes on suddenly and is associated with:

• neck pain
• nausea and/or vomiting
• numbness or weakness in one side of your face and/or body
• dizziness and/or disorientation
• cute sensitivity to light

Your consultant will perform some, or all, of the following tests to confirm a diagnosis:

• MRI scan. This is usually used to detect brain aneurysms that have not ruptured, but is also used to look at the arteries in detail (MR angiogram).
• CT scan. This is usually the preferred type of scan if there is a history suggestive of haemorrhage. CT scans within 3 days of a bleed are very reliable at detecting blood.
• Angiography (digital subtraction — DSA). This involves injecting contrast into the arteries of your brain through a catheter (narrow tube) to give clear pictures of the brain arteries.

• Monitoring with MRI scans at yearly intervals, if the aneurysm has not burst and is considered low-risk (normally under 5mm in diameter).
• Coiling or stenting of the aneurysm using minimally invasive radiology techniques.
• Clipping. Increasingly this is not necessary but sometimes remains the best option for treatment. A titanium spring clip is placed across the ‘neck’ of the aneurysm where it arises from the parent artery, so it can no longer fill, removing the risk of a future bleed.