Brain Aneurysms: What to Watch for and When to Refer
Brain aneurysms are relatively common – unruptured intracranial aneurysms and subarachnoid hemorrhage have respective incidences of 15.6 and 7.7 per 100,000 people – and a rupture can have devastating consequences. Here’s a brief Q&A with two of our physicians – interventional neurologist Asif Khan, MD and endovascular neurosurgeon Dustin Hayward, MD – to help you know what to watch for and when to consider referring a patient for specialty care.
When Does a Headache Signal a Potential Brain Aneurysm?
While most headaches are benign, they’re also one of the most common presentations of a brain aneurysm. When a patient has a headache that’s related to aneurysm, they’ll often report that the headache feels very unusual – that “it’s not like a normal headache.” These headaches may come on very suddenly, cause severe pain and be in a location that seems unusual.
Which Other Brain Aneurysm Symptoms Should Providers Be Aware Of?
Not all aneurysms cause headaches. Other symptoms can include:
A drooping eyelid or dilated pupil
Sensitivity to light
Feeling disoriented or confused
Vision problems, including blurriness and/or double vision
If a patient reports these symptoms, immediate medical attention should be considered.
Which Brain Aneurysm Risk Factors are Noteworthy?
Brain aneurysms are often asymptomatic, making it important to be aware of risk factors that predispose people to aneurysms and to rupture. Fortunately, screening can help identify an aneurysm before it ruptures. Risk factors include:
A family history of brain aneurysms
A history of smoking
High levels of alcohol consumption
Collagen vascular diseases such as Ehlers-Danos disease
If you see a patient that has these risk factors, you should consider ordering a non-invasive screening study such as an MR angiogram to evaluate for unruptured cerebral aneurysms.
How Does the Eastside Neuroscience Institute Approach Brain Aneurysm Monitoring and Treatment?
Our care starts with state-of-the-art neuroimaging to evaluate the aneurysm and assess the risk of rupture. Then a multidisciplinary group of physicians – including a neurologist or neurosurgeon who is fellowship-trained in neurointerventional techniques – reviews the patient’s imaging, medical history and risk factors.
Many small aneurysms don’t require immediate intervention. If the aneurysm is small and non-threatening, we may determine monitoring is the safest course of action. We will typically monitor a patient annually for at least three-to-five years. If the aneurysm does not change in size, treatment may not be required.
If intervention is needed, we offer a range of options including minimally invasive endovascular aneurysm coiling and stenting using biplane fluoroscopy as well as open microsurgical aneurysm clipping. Our team works together to determine which treatment approach best matches the patient’s situation and individual anatomy. We also use a patient-centered approach that prioritizes building relationships with each and every patient, so we can understand their lifestyle and goals, answer their questions and put them on track toward the best possible outcome.
The Eastside Neuroscience Institute is a growing practice and is accepting patients from across our region.