A brain aneurysm (cerebral aneurysm, intracranial aneurysm) is a type of aneurysms in which one of the cerebral arteries is affected. The term "aneurysm" itself refers to the expansion of the arterial wall. The incidence of cerebral aneurysms among the general population is about 5%.
A brain aneurysm is a pathological local protrusion of the artery wall.
Depending on the size of the protrusion, there are:
- regular-sized brain aneurysms (up to 15 mm)
- large brain aneurysms (up to 25 mm)
- gigantic brain aneurysms (more than 25 mm)
The larger the aneurysm, the more it compresses the brain tissues and causes a more pronounced neurological picture. Protrusions can also be single or multiple, congenital, or acquired.
The disease often affects the vessels, inside which blood is flowing under high pressure. Such changes in the vessel wall leading to an increase in its size and accumulation of the pressure on the surrounding brain structures, disrupting the functions of the central nervous system.
However, a brain aneurysm is often manifested by an aneurysm rupture (in 50% of cases). If the aneurysm is unruptured, but simply increases in size, then it can manifest itself as a tumor (press on the surrounding brain tissues, causing certain neurological disorders). In terms of the outcomes of rupture of brain aneurysms, the statistics are quite harsh: 25% of patients die immediately or in a long-term period, 25% become severely disabled, 25% have a moderate disability, and only 25% are left without consequences for their health.
It is not yet clear why aneurysms occur in some people and not in others. Among the causes of a cerebral aneurysm, in the first place are congenital disorders of the structure of the vascular wall and atherosclerosis. Sometimes cerebral aneurysms occur as a result of inflammatory processes in the walls of an artery. This is usually due to blockage of the vessel lumen by an infected blood clot.
Brain aneurysms are dangerous for the patients due to the high risk of rupture of the aneurysm with hemorrhage into the brain tissue. Besides, the disease is often asymptomatic in the early stages of its development, which significantly complicates timely diagnosis.
If a brain aneurysm is detected, it is necessary to immediately contact a neurosurgeon. The specificity of this pathology is rather narrow; therefore not every neurosurgeon can give an adequate assessment of the patient.
The danger of arterial wall protrusions lies in their "quiet" development. In the early stages, the patient may not even be aware of a serious problem, since small aneurysms practically do not compress the brain tissue and do not cause discomfort.
The clinical picture manifests itself in the later stages of the disease. The first signals of a problem can be:
- Impaired vision, pain in the eyes and head
- Changes in the motor functions of the limbs – the patient can suddenly "forget" how to hold a spoon or his handwriting deteriorates largely
- Violation of tactile and pain sensitivity of the legs
- Numbness of the muscles of the face, inability to smile, sudden impairment of speech
These signs indicate compression of the brain tissue. A neurological deficit develops, which should become an urgent reason for seeking help from a neurologist.
As the disease progresses, the aneurysm can rupture. This condition is threatening to the patient's life. The symptoms of rupture are:
- Intense headache that does not respond well to medication
- Nausea, vomiting
- Double vision
- Loss of consciousness
- Intense cramps
If a person develops the described symptoms, an ambulance team should be called.
Identifying pathological protrusions of the arteries of the brain is not always an easy task, especially if the patient does not feel any discomfort. In such cases, the diagnosis is suspected during preventive examinations.
To identify an aneurysm, a neurologist may prescribe the following instrumental diagnostic methods:
The procedure is more often used to determine the already ruptured aneurysm with a formed hemorrhage in the brain tissue.
- Magnetic resonance imaging (MRI)
- Angiography of cerebral vessels
The method allows doctors to evaluate the size, localization, and structural features of the pathological protrusion.
If a ruptured aneurysm is suspected, the neurologist also performs a lumbar puncture to assess the condition of the cerebrospinal fluid.
Surgery is the only effective treatment for cerebral aneurysm treatment. Having received the results of the patient's examination, the surgeon decides on the appropriateness of the surgical operation. Since the consequences of a ruptured cerebral aneurysm, unlike an unruptured aneurysm, are lethal, surgical intervention can save the patient's life.
There are two methods of brain aneurysms treatments: surgical clipping of the aneurysm neck (surgery with opening the skull) or neuroradiological surgery that does not require opening the skull – endovascular embolization that is, filling the aneurysm with coils through a catheter, which is inserted through the femoral artery in the groin. The decision on the method of treatment is made by the medical council together with the patient; the council includes a neurosurgeon and an interventional radiologist. When choosing one of the two methods described above, the medical consultation takes into account many factors, such as the location of the aneurysm, its size, shape, width, and the conditions of adjacent vessels.
Endovascular treatment (performed by an interventional neuroradiologist) consists of cutting off the aneurysm from the blood supply by filling its lumen with special coils (coils are made of platinum). A cerebral aneurysm is approached with a very thin tube – a catheter, which is inserted through a small incision in the groin and then propelled through the blood vessels. All this time, the location of the catheter is tracked using a special X-ray machine. This is a method based on an advanced technique designed for minimally invasive closure of cerebral vascular defects, including aneurysms.
Endovascular embolization with coils is one of the most frequently used operations used in the world for the treatment of cerebral aneurysms. As with clipping, the purpose of the operation is to exclude it from the general bloodstream, which is necessary to prevent re-rupture.
Embolization of an aneurysm is one of the most common methods of treating disease. In most cases, endovascular embolization is the least invasive method aneurysms treated with today. If it is impossible to carry out intravascular embolization or stenting, the usual neurosurgical operation of vessel stenting or aneurysm clearing can be performed.
How the endovascular embolization is carried out?
Firstly, the surgeon, together with the patient, discusses the possible risks and outcomes of treatment and determines the appropriate treatment method. The size of the aneurysm is extremely important in the course of the disease and prognosis of the outcomes when deciding on treatment planning. The risk of rupture of an aneurysm with a diameter of up to 10 mm is estimated at 0–4% and, accordingly, is higher for larger aneurysms. Also, it should be remembered that their size is not constant – aneurysms can increase, therefore, when choosing a conservative treatment, it is recommended to periodically perform control imaging studies to assess the size of the aneurysm.
The operation is performed by access through the femoral artery – the only skin puncture in the groin area. Along the vascular region, catheters are sequentially inserted into the vessels of the neck, cerebral arteries, and directly into the aneurysm cavity.
Embolization of an aneurysm results in the cessation of blood flow in the aneurysm (bulge), maintaining normal blood flow in the cerebral artery. In the process of embolization, a catheter is inserted through convenient vascular access (usually inguinal) under radiological control and held up to the aneurysm. Then a thinner micro-catheter with a micro-wire coiled inside it is inserted into the catheter and inserted into the aneurysm cavity.
Through the catheter, platinum coils are inserted into the aneurysm, which fills the aneurysm cavity and blocks the flow of blood into it from the common vascular bed. A low voltage electric current is used to separate the micro spirals from the carrier conductor.
As soon as the tip of the catheter is in the aneurysm cavity, coils are released from the catheter, which changes its shape, and in the form of a random coil of wire occupies the aneurysm cavity. For large aneurysms, several coils may be needed. An aneurysm filled with a wire spiral is turned off from the bloodstream and gradually overgrows with connective tissue, that is, the possibility of its rupture is excluded. Subsequently, the blood flow in the aneurysm stops, the aneurysm is completely thrombosed, and it no longer poses a threat of rupture.
The postoperative period after embolization is minimal. In the absence of hemorrhage or other conditions, discharge from the hospital usually occurs on days 2-3 after the surgical intervention.
Where can I undergo partial resection and coil embolization treatment abroad?
Health tourism becomes more and more popular these days, as medicine abroad, often ensures a much better quality of partial resection and coil embolization treatment.
The following hospitals show the best success rates in partial resection and coil embolization treatment:
- Charite University Hospital Berlin, Germany
- Memorial Bahcelievler Hospital Istanbul, Turkey
- University Hospital HM Monteprincipe Madrid, Spain
- Beta Klinik Bonn, Germany
- University Hospital for Neurosurgery Salzburg, Austria
You can find more information about the hospitals on the Booking Health website.
The cost of treatment abroad
The prices in hospitals listed on Booking Health are relatively low. With Booking Health, you can undergo partial resection and coil embolization treatment at an affordable price.
The cost of treatment varies, as the price depends on the hospital, the specifics of the disease, and the complexity of its treatment.
The cost of treatment with partial resection and coil embolization in Germany is 22,087 – 38,216 EUR.
The cost of treatment with partial resection and coil embolization in Turkey is 16,096 – 19,867 EUR.
The cost of treatment with partial resection and coil embolization in Spain is approximately 13,285 EUR.
The cost of treatment with partial resection and coil embolization in Austria is approximately 28,087 EUR.
You might want to consider the cost of possible additional procedures and follow-up care. Therefore, the ultimate cost of treatment may differ from the initial price.
To make sure that the overall cost of treatment is suitable for you, contact us by leaving the request on the Booking Health website.
How can I undergo partial resection and coil embolization treatment abroad?
It is not easy to self-organize any treatment abroad. It takes certain knowledge and expertise. Thus, it is safer, easier, and less stressful to use the services of a medical tourism agency.
As the largest and most transparent medical tourism agency in the world, Booking Health has up-to-date information about partial resection and coil embolization treatment in the best hospitals in the world. We will help you select the right clinic taking into account your wishes for treatment.
We want to help you and take on all the troubles. You can be free of unnecessary stress, while Booking Health takes care of all organizational issues regarding the treatment. Our services aimed at you safely and successfully undergoing partial resection and coil embolization treatment.
Medical tourism can be easy!
All you need to do is to leave a request on the Booking Health website and our manager will contact you shortly.