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A brain aneurysm is a bulge or ballooning of the wall of a blood vessel in the brain. As blood flows through the vessels, it passes by the bulging wall and over time, the pressure can weaken it. Though rare, the steady pressure can cause the aneurysm to rupture. Brain aneurysms affect mostly adults between the ages of 40 to 60, with a higher prevalence in women. The cause of most aneurysms is unknown, although there's evidence they may be inherited.
Our team has many different health care practitioners who can diagnose a brain aneurysm and determine the best course of treatment. The first step is to get a visual picture of your brain, the blood vessels and the aneurysm. After the tests are completed, a member of the team will discuss with you and your family or caregiver your treatment options.
A treatment for an aneurysm depends on a variety of factors, including your age, overall health, if the aneurysm is producing symptoms, and the size, location and shape. Some aneurysms require a single treatment, while others are complicated because of their location, shape or size. They may require more than one treatment type. The health care practitioner will provide your options to you during your clinic visit. The role of treatment is to prevent the risk of a rupture, but keep in mind – the rate of rupture is very low.
An aneurysm that's less than 5 mm in size or one without symptoms is considered too small to treat, and its potential to rupture is extremely unlikely. A periodic test, such as a CT Angiography, may be recommended to check whether it's grown in size.
Endovascular TreatmentThis treatment uses a platinum coil sent through an artery in the groin to the aneurysm to pack it off. Sometimes a wire mesh is placed into the aneurysm to change its shape.
Surgical TreatmentThis kind of treatment includes "clipping" the aneurysm with a small titanium clip that looks like a small set of tweezers. It's placed on the "neck" of the aneurysm or the area where it bubbles out from the artery. If the situation is complicated, the surgeon can create a detour for the blood and a small artery or vein is sewn around the aneurysm.
For more information, please see the videos in the section "Treatment" and click on which video you want to watch.
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The Krembil Neuroscience Centre was the first facility in Canada to perform surgery with a procedure called ELANA (Excimer Laser Assisted Non-occlusive Anastomosis). It uses a laser to treat complex brain aneurysms and blocked arteries to the brain.
The ELANA technique allows neurosurgeons to avoid using regular bypass surgery, which involves clamping an artery to create a new source of blood flow. In the conventional operation, the clamps may have to stay on for a half-hour or even an hour, and that's where the risk comes in – cutting off blood flow to the brain can cause a stroke that may leave permanent damage. This also leaves surgeons with an extremely small window of time to complete the bypass. But by using this revolutionary laser technique, a neurosurgeon can maintain blood flow at all times.
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There are a few different tests that can provide the team with the necessary information needed. A health care practitioner may order more than one. Some of these tests can be completed by your family doctor before your first clinic visit.
See how new research at the Krembil Neuroscience Centre is improving the way we treat patients with aneurysms.