Mecklenburg Radiology

Aneurysm

A brain aneurysm is an abnormal outpouching of an artery within the brain. Aneurysms form as a result of weakened areas within the walls of arteries in the brain. Aneurysms can be a source of headache. More importantly, these weakened vessels can rupture without warning, which can cause fatal strokes.

 

 

How do we diagnose a Brain Aneurysm?

CT Scan
Computed tomography, or CT scans, can be used to diagnose ruptured brain aneurysms. CT scanners use a series of x-rays and powerful computers to create 2 and 3-dimensional images of the body, including the brain. A related technique called CT angiography, or CTA, adds contrast dye injected through an IV line to highlight the blood vessels within the brain and neck, which allows radiologists and neurosurgeons to better evaluate aneurysms and blood flow within the brain.

MRI
Magnetic resonance imaging, or MRI, is another important tool for diagnosing and following brain aneurysms. MRI uses a powerful magnetic field to produce images of the brain. MRI does not use or produce radiation and therefore is not associated with radiation risks or effects. A special form of MRI known as MR angiography, or MRA, is often used to diagnose or follow known brain aneurysms and allows physicians to better evaluate the arteries within the brain.
Cerebral angiography
Cerebral angiography is the gold standard for the diagnosis of brain aneurysms and is often used in the treatment process. In angiography, a special dye is injected through an IV line, and x-rays of the brain are taken at multiple angles in order to see precise detail of the arteries within the patient’s brain. Angiography is usually performed by a specially trained neuroradiologist or neurosurgeon.

How do we treat a Brain Aneurysm?

Coil embolization
Coil embolization is a minimally invasive procedure to treat an aneurysm by filling it with material that closes off the sac and reduces the risk of bleeding. It is performed from within the artery (endovascular) through a steerable catheter inserted into the blood stream at the groin and guided to the brain. Tiny coils are used to promote clotting and close off the aneurysm. The goal of endovascular coiling is to isolate an aneurysm from the normal circulation without blocking off any small arteries nearby or narrowing the main vessel. These procedures are performed with the use of cerebral angiography.

Balloon-assisted coil embolization
Balloon-assisted coil embolization is a related technique that can be used for aneurysms with unusual or difficult shapes that would ordinarily prevent successful coil embolization. In this procedure, a second catheter containing is inserted through the groin parallel to the catheter containing the coils. The balloon in this second catheter is inserted just prior to the deployment of the coils in an effort to prevent the coils from moving downstream before they can form a stable clot within the aneurysm.

Stent-assisted coil embolization
Like balloon-assisted coil embolization, stent-assisted embolization uses a catheter placed in the groin to deploy a vascular stent within the artery at the level of the aneurysm prior to the coils being placed. This additional surface allows the coils to promote clotting and helps prevent them from moving prematurely.

Pipeline flow diversion                                                                                                                                                                               Pipeline stenting is another minimally invasive procedure performed by neuroradiologists or neurosurgeons to treat large brain aneurysms. In this procedure, a large solid-walled stent is placed endovascularly at the level of the aneurysm. This stent allows blood to completely bypass the aneurysm. These procedures are also performed with the use of cerebral angiography.