Brain aneurysms Q&A

This is the first in a series of articles devoted to Brain Awareness Week. We begin by talking with Kenneth Shea, MD, on brain aneurysms — a condition that impacts a small number of people. But one that poses a major health risk for those affected.

Q: What is an aneurysm?

A: An aneurysm is an outpouching of a blood vessel in the brain from a weakness that forms in the blood vessels. There also is another type of aneurysm where the blood vessel stretches out, which can lead to bleeding in the brain. Only about two to five percent of people have aneurysms and only a small portion of those aneurysms will ever bleed. If this happens, it is a life-threatening emergency.

Q: How do you diagnose aneurysms?

A: Typically, there are no symptoms. Aneurysms are sometimes found by CT or MRI scans that are being done for other reasons. Another scenario would be that a patient had bleeding around the brain and we would perform testing to look at blood vessels. Once an aneurysm is found, we usually go further and perform a conventional angiogram by injecting dye into the blood vessel to get the best picture possible of the aneurysm.

Q: What is Interventional Neurology and how does it treat aneurysms?

A: Interventional Neurology is a sub-specialty of Neurology. I specialize in cerebrovascular diseases. In respect to aneurysms, I am involved in diagnosing aneurysms, finding the location of the aneurysm and characterizing the anatomy of the aneurysm by performing cerebral angiography. I also perform the treatment of the aneurysm inside the blood vessel. I work closely with my neurosurgical colleagues to decide if an aneurysm should be treated from the inside or the outside.

Q: What can you do to prevent aneurysms?

A: There are risk factors for forming aneurysms. Those risk factors include smoking, uncontrolled hypertension and a family history of aneurysms. The best thing a patient can do is to take blood pressure medication and avoid smoking.

Q: What treatments are available at St. Cloud Hospital?

A: If someone is found to have an aneurysm, repeated imaging is taken to make sure the aneurysm is not growing. This is typically done for smaller aneurysms.

Only certain aneurysms need to be treated. One treatment is coil embolization to place coils in the aneurysm to make it clot in the inside. Another option is to place a clip at the neck of the aneurysm to make sure it doesn’t continue to fill with blood. We also offer flow-diversion stent placement, which is a newer form of treatment for aneurysms.

If we’ve decided that we should not treat the aneurysm, then it is very important for the patient to control his/her blood pressure, to not smoke and to maintain an active lifestyle.