Aneurysms of the brain, also known as cerebral or intracranial aneurysms are a bulging of an artery within the brain. Cerebral aneurysms are more common in middle-aged adults and slightly more common in women than men. Many people live with cerebral aneurysms that never require surgery. The location and size of the aneurysm and the individual patient’s risk factors are key components in identifying which patients should have surgery, and which patients can be medically managed.

Who is at risk?

Cerebral aneurysms occur in 10 of every 100,000 individuals annually. Although anyone can develop an aneurysm of the brain, individuals with a family history have a slightly higher risk.

Most cerebral aneurysms are congenital, resulting from an inborn abnormality or malformation in an artery wall. Cerebral aneurysms are also more common in people with certain genetic diseases, such as connective tissue disorders and polycystic kidney disease.

Other causes include trauma or injury to the head, high blood pressure, infection, tumors, atherosclerosis (a blood vessel disease in which fats build up on the inside of artery walls), and cigarette smoking. Drug abuse, particularly the habitual use of cocaine, can inflame blood vessels and lead to the development of aneurysms. There is also some speculation that oral contraceptives may increase the risk of developing aneurysms within the brain.

Diagnosis

Unruptured aneurysms are commonly detected during magnetic resonance angiography (MRA) or a computed tomography angiogram (CTA). These diagnostic tests are increasingly being utilized to screen patients with suspicious headaches or a family history of intracranial aneurysm.

Three-dimensional angiography (cerebral angiogram) is another more invasive exam which provides excellent visualization of the cerebral aneurysm. In this procedure, a thin catheter is inserted into an artery in the groin and then guided to the location of the aneurysm. Contrast is then injected through the catheter, allowing the neurosurgeon to obtain accurate images of the aneurysm size, shape, and location.