What medical tests are needed to diagnose a brain aneurysm?

The article is professionally consulted by Master, Doctor Nguyen Thanh Nam - Radiologist - Department of Diagnostic Imaging - Vinmec Danang International General Hospital. The doctor has over 10 years of experience in the fields of Diagnostic Imaging.

When the patient suddenly has a severe headache, or some symptoms such as nausea and vomiting, blurred or double vision, convulsions, loss of consciousness... will be indicated for CT scan, brain MRI... to diagnosis of cerebral aneurysm.

A brain aneurysm is a condition in which a blood vessel becomes enlarged in the brain. A brain aneurysm can cause a brain vessel to leak or burst, leading to a brain hemorrhage. Most cerebrovascular aneurysms rupture at meningeal or middle cerebral artery sites. The disease is very dangerous, can be life-threatening, because when a brain artery burst, it can lead to brain damage, stroke, and more dangerously, death if not treated promptly.
The location of the brain aneurysm is usually at the branching points of the vascular system, it tends to grow bigger gradually. The weaker the wall of the aneurysm, the greater the risk of rupture. In some cases, cerebral aneurysm may also be associated with some congenital pathology due to a genetic abnormality, then the disease is thought to be familial. Some risk factors for residual brain aneurysms are high blood pressure, smoking, alcoholism, drug abuse, sepsis, and traumatic brain injury.
Once the aneurysm bursts, the blood will flow causing the surrounding cells to be damaged or die. In addition, rupture of an aneurysm can cause pressure inside the skull to increase. If this pressure is too high, blood and oxygen to the brain can be cut off, leading to coma or even death. Some complications that can occur after a brain aneurysm rupture include:
Re-bleeding: When an aneurysm ruptures or leaks, there is a risk of re-bleeding. Re-bleeding causes more severe brain cell damage; Complications of vasospasm: In the case after the aneurysm bursts, the cerebral blood vessels may be erratically narrow. This erratic contraction will reduce blood flow to the brain cells, which in turn leads to damage or death of brain cells; Hydrocephalus: Complications of hydrocephalus occur when aneurysms burst, leading to bleeding into the subarachnoid space, blocking the flow of cerebrospinal fluid. This complication is very common, blood can block the flow of blood around the brain and spinal cord, causing an excess of cerebrospinal fluid that increases pressure on the brain and damages brain tissues; Hyponatremia: An imbalance of sodium in the blood can be caused by damage to the hypothalamus, which is an area near the base of the brain. When blood sodium drops rapidly, it can cause brain cells to swell, leading to permanent brain damage.

The diagnosis of a brain aneurysm will be based on information gathered from a number of tests. Therefore, when the patient suddenly has a severe headache, or some symptoms such as nausea and vomiting; blurred or double vision; convulsions; Loss of consciousness, ... then the patient will be tested to diagnose brain aneurysm. Those tests include:
CT scan: CT scan is considered a crazy head test to identify intracranial bleeding. Using this technique, images are created that are three-dimensional slices of the brain; Cerebrospinal fluid test: In cases of subarachnoid hemorrhage, there are usually red blood cells in the fluid surrounding the brain and spinal cord. Therefore, CSF testing is necessary if the patient has symptoms of a ruptured aneurysm but CT scans show no evidence of bleeding; Magnetic Resonance Imaging (MRI): An MRI scan uses a strong magnetic field and radio waves to take detailed pictures of the brain. Compared with the CT scan method, this brain aneurysm diagnosis technique can give a clearer picture; Digital brain angiography erasing background: With this method, the doctor will insert a catheter into the cerebral blood vessels and record the brain vessels to survey the condition of the blood vessels and the rupture point of the aneurysm. This invasive approach should be used when other imaging tests do not provide sufficient information.

Currently, there are two methods of treating brain aneurysms, which are endovascular treatment of the aneurysm with a metal coil or stent and surgical clamping of the aneurysm. Specifically:
Surgical method: The patient will be anesthetized, the surgeon opens the patient's skull to find and clamp the aneurysm neck with a metal clip; Intravascular aneurysm treatment: By digital angiography technique, under the guidance of television lighting to put material into the aneurysm position causing blockage of the ruptured vessel. The advantage of this method of treatment is that it is non-surgical and can be performed in difficult cases. However, in cases where the aneurysm is small, has not ruptured, and has no symptoms, it does not require immediate treatment. Patients only need to be monitored periodically, if there are signs of an aneurysm increasing in size, causing symptoms or suddenly bursting, it should be treated immediately. In addition, if the patient has other diseases such as high blood pressure, heart disease, etc., it is also necessary to monitor and treat because these are risk factors for brain aneurysms.

To prevent rupture of a brain aneurysm, the patient can reduce the risk by making the following lifestyle changes:
Avoid smoking as well as secondhand smoke and use of hallucinogens or drugs. Because those stimulants will increase the risk of rupture of brain aneurysms. So, if you are on these medications, talk to your doctor about how to quit smoking; Have a healthy diet and lifestyle and exercise. Because these things can help balance blood pressure; Limit the intake of stimulant drinks such as alcohol, beer, coffee. Because these stimulants can increase blood pressure suddenly, thereby leading to the risk of rupture of brain aneurysms; Do not exert yourself too much, or exert yourself suddenly because it can cause blood pressure to rise suddenly. Therefore, you should only exercise and work at a moderate level; Patients should be cautious when taking aspirin or other blood-thinning medications, as it will cause more bleeding if the aneurysm ruptures. In addition, people with brain aneurysms should have regular check-ups as prescribed by their doctor. As for those who have sudden headache symptoms and symptoms that are suspicious for this disease, it is necessary to see a specialist facility for timely diagnosis and treatment of brain aneurysms. Currently, Vinmec International General Hospital is one of the leading prestigious hospitals in the country, trusted by a large number of patients for medical examination and treatment. Not only the physical system, modern equipment Vinmec is also the place to gather a team of leading medical experts. In particular, with a space designed according to 5-star hotel standards, Vinmec ensures to bring the patient the most comfort, friendliness and peace of mind.