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Cerebral Aneurysm (Brain Aneurysm)

A weak or thin spot on a blood vessel in the brain that balloons out and fills with blood. An aneurysm can press on a nerve or surrounding tissue, and also leak or burst, which lets blood spill into surrounding tissues (called a hemorrhage).

PubMed Health Glossary
(Source: NIH - National Institute of Neurological Disorders and Stroke)

About Cerebral Aneurysm

A cerebral aneurysm (also known as an intracranial or intracerebral aneurysm) is a weak or thin spot on a blood vessel in the brain that balloons out and fills with blood. The bulging aneurysm can put pressure on a nerve or surrounding brain tissue. It may also leak or rupture, spilling blood into the surrounding tissue (called a hemorrhage). Some cerebral aneurysms, particularly those that are very small, do not bleed or cause other problems. Cerebral aneurysms can occur anywhere in the brain, but most are located along a loop of arteries that run between the underside of the brain and the base of the skull.

What causes a cerebral aneurysm?

Cerebral aneurysms can be congenital, resulting from an inborn abnormality 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, and certain circulatory...Read more about Cerebral Aneurysms NIH - National Institute of Neurological Disorders and Stroke

What works? Research summarized

Evidence reviews

Cooling the brain during surgery to prevent death or severe disability in people with brain aneurysms

We reviewed the evidence about the effect of cooling the brain during surgery for brain aneurysms. We found three studies of acceptable quality and analysed the results to see if cooling the brain during open‐skull surgery for brain aneurysms prevents death or severe disability.

Drugs for preventing blood clot dissolution (antifibrinolytic therapy) to reduce the occurrence of rebleeding in aneurysmal subarachnoid haemorrhage

A subarachnoid haemorrhage (SAH) is a bleed into the small space between the brain and skull that contains blood vessels that supply the brain (the subarachnoid space). The cause of a bleeding here is usually a rupture of a weak spot in one of these vessels. A SAH is a relatively uncommon type of stroke, but it often occurs at a young age (half the patients are younger than 50 years). The outcome of SAH is often poor: one‐third of people die after the haemorrhage and of those who survive, one‐fifth will require help for everyday activities. An important cause of poor recovery after SAH is a second bleed from the weakened vessel (rebleeding). This is thought to be caused by the dissolving of the blood clot at the original bleeding site that results from natural blood clot dissolving (fibrinolytic) activity. Antifibrinolytic therapy that reduces this activity was introduced as a treatment for reducing rebleeding and therefore for improving recovery after SAH. This review included 10 trials, totaling 1904 participants that investigated the effect of these drugs in people with SAH. Antifibrinolytic treatment does indeed reduce the risk of rebleeding, but does not improve survival or the chance of being independent in everyday activities. This may be due to an increase in one of the other common complications of SAH. We conclude that antifibrinolytic treatment should not routinely be given to people with SAH, but new randomised trials are needed to establish if short‐term treatment might be beneficial.

Corticosteroids for aneurysmal subarachnoid haemorrhage and primary intracerebral haemorrhage

There is no evidence of benefit from corticosteroids for patients with stroke due to bleeding. About one fifth of all strokes are due to bursting of an artery. The burst artery causes bleeding into the brain itself (called intracerebral haemorrhage) or into the space around the brain (called subarachnoid haemorrhage). After either type of bleed the brain tissue may become swollen. The swelling causes a rise in pressure which can cause further brain damage or even death. Corticosteroids could reduce swelling after brain haemorrhage and so improve the chances of the patient recovering. However, corticosteroids can also have important adverse effects such as increased blood sugars, infection, and gastrointestinal bleeding. The trials included in this review had too few participants to provide reliable evidence on any benefits weighed against harms of this treatment for patients with stroke due to bleeding in the brain.

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Summaries for consumers

Cooling the brain during surgery to prevent death or severe disability in people with brain aneurysms

We reviewed the evidence about the effect of cooling the brain during surgery for brain aneurysms. We found three studies of acceptable quality and analysed the results to see if cooling the brain during open‐skull surgery for brain aneurysms prevents death or severe disability.

Drugs for preventing blood clot dissolution (antifibrinolytic therapy) to reduce the occurrence of rebleeding in aneurysmal subarachnoid haemorrhage

A subarachnoid haemorrhage (SAH) is a bleed into the small space between the brain and skull that contains blood vessels that supply the brain (the subarachnoid space). The cause of a bleeding here is usually a rupture of a weak spot in one of these vessels. A SAH is a relatively uncommon type of stroke, but it often occurs at a young age (half the patients are younger than 50 years). The outcome of SAH is often poor: one‐third of people die after the haemorrhage and of those who survive, one‐fifth will require help for everyday activities. An important cause of poor recovery after SAH is a second bleed from the weakened vessel (rebleeding). This is thought to be caused by the dissolving of the blood clot at the original bleeding site that results from natural blood clot dissolving (fibrinolytic) activity. Antifibrinolytic therapy that reduces this activity was introduced as a treatment for reducing rebleeding and therefore for improving recovery after SAH. This review included 10 trials, totaling 1904 participants that investigated the effect of these drugs in people with SAH. Antifibrinolytic treatment does indeed reduce the risk of rebleeding, but does not improve survival or the chance of being independent in everyday activities. This may be due to an increase in one of the other common complications of SAH. We conclude that antifibrinolytic treatment should not routinely be given to people with SAH, but new randomised trials are needed to establish if short‐term treatment might be beneficial.

Corticosteroids for aneurysmal subarachnoid haemorrhage and primary intracerebral haemorrhage

There is no evidence of benefit from corticosteroids for patients with stroke due to bleeding. About one fifth of all strokes are due to bursting of an artery. The burst artery causes bleeding into the brain itself (called intracerebral haemorrhage) or into the space around the brain (called subarachnoid haemorrhage). After either type of bleed the brain tissue may become swollen. The swelling causes a rise in pressure which can cause further brain damage or even death. Corticosteroids could reduce swelling after brain haemorrhage and so improve the chances of the patient recovering. However, corticosteroids can also have important adverse effects such as increased blood sugars, infection, and gastrointestinal bleeding. The trials included in this review had too few participants to provide reliable evidence on any benefits weighed against harms of this treatment for patients with stroke due to bleeding in the brain.

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Terms to know

Aneurysm
Balloon-like bulge in the wall of a blood vessel. A ruptured aneurysm can lead to bleeding. Aneurysms are a result of a weakened blood vessel wall.
Blood Vessels
Tubes that carry blood to and from all parts of the body. The three main types of blood vessels are arteries, capillaries, and veins.
Brain
The part of the central nervous system that is contained within the skull (cranium).
Hemorrhage
In medicine, loss of blood from damaged blood vessels. A hemorrhage may be internal or external, and usually involves a lot of bleeding in a short time.
Stroke (Cerebrovascular Accident)
A stroke occurs if the flow of oxygen-rich blood to a portion of the brain is blocked. Without oxygen, brain cells start to die after a few minutes. Sudden bleeding in the brain also can cause a stroke if it damages brain cells.

More about Cerebral Aneurysm

Photo of an adult woman

Also called: Intracranial aneurysm, Intracerebral aneurysm, Berry aneurysm

Other terms to know: See all 5
Aneurysm, Blood Vessels, Brain

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