DIAGNOSTICS, TREATMENT OPTIONS
congenital, or come from pre-existing conditions like hypertension or atherosclerosis (fatty deposits in
the arteries), or very rarely from head injury.
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The outlook after rupture of a cerebral aneurysm depends on the size and location of the aneurysm, the person's age,
general health, and neurological condition after haemorrhage. Many patients (probably over 40%) die from the initial
bleeding or later complications, and others eventually recover with little or no permanent disability. Early diagnosis and
treatment are vital, to reduce the risk of further bleeding.
Emergency treatment for individuals with a ruptured cerebral aneurysm includes strict bedrest and painkillers.
Unconscious patients may need treatment to restore deteriorating breathing and to reduce raised pressure in the head.
Surgery is usually performed within the first 3 days to clip the ruptured aneurysm and thus eliminate the risk of rebleeding.
Emergency operation may be needed if there is a large blood clot. Other treatments include drugs or hypertensive-
hypervolaemic therapy (artificially increasing blood volume and blood pressure) to control vasospasm. In patients for whom
surgery is considered too risky, and in an increasing proportion overall, microcoil thrombosis or balloon embolisation may be
performed.
Surgery or minimally-invasive endovascular coiling techniques can be used in the treatment of brain aneurysms. It is
important to note, however, that not all aneurysms are treated at the time of diagnosis or are amenable to both forms of
treatment. Patients need to consult a neurovascular specialist to determine if they are candidates for either treatment.
To get to the aneurysm, surgeons must first remove a section of the skull, a procedure called a craniotomy. The surgeon
then spreads the brain tissue apart and places a tiny metal clip across the neck to stop blood flow into the aneurysm. After
clipping the aneurysm, the bone is secured in its original place, and the wound is closed.
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