A brain aneurysm is a weak spot in a brain blood vessel wall, similar to a small balloon that bulges on one side. This bulge can sometimes extend along the entire vessel.
Often, brain aneurysms do not present symptoms or health issues. However, if they enlarge significantly, leak, or rupture, they can lead to serious problems requiring immediate medical attention.
Regular consultation with a qualified healthcare provider is essential for monitoring, managing, and treating the aneurysm early, ideally before rupture. Dr. Sabareesh Natarajan brings over 20 years of experience in treating brain aneurysms, having operated on thousands of patients and managed many others non-surgically. He is skilled in both open and minimally invasive catheter-based procedures, offering a rare level of expertise in the San Diego area.
For more information about brain aneurysms and treatment options, or to schedule a visit, call our office at (619)-984-6969.
Signs & Symptoms of Brain Aneurysms
Aneurysms are frequently found incidentally during brain scans conducted for other neurological issues such as headaches. Occasionally, patients presenting with neurological symptoms like suspected strokes, visual problems, or headaches undergo scans that reveal an aneurysm.
Ruptured aneurysms cause more severe symptoms. For example, you might experience the “worst headache of your life,” a sudden, intensely severe headache. Other signs of aneurysms include:
- Nausea and vomiting
- A stiff neck
- Blurred or double vision
- Light sensitivity
- Seizures
- Loss of consciousness
- Confusion
If you notice these symptoms, seek medical care IMMEDIATELY.
Risk Factors for Brain Aneurysms
While preventing a brain aneurysm isn’t possible, certain risk factors should be acknowledged:
- Family history: Individuals with relatives who have aneurysms are at higher risk.
- Gender: Women are more prone to developing brain aneurysms than men.
- Blood pressure: Elevated blood pressure increases the likelihood of developing and rupturing aneurysms.
- Smoking: Smokers face a greater risk of aneurysm formation and rupture.
If a brain aneurysm occurs, managing blood pressure and quitting smoking can help lower the risk of rupture.
Treating Brain Aneurysms
Dr. Natarajan stresses the importance of early intervention in managing brain aneurysms to prevent rupture. Since 20-50% of patients die before they reach the hospital after rupture, and 30-40% of survivors are left with lasting effects, addressing the issue proactively is crucial. Not all brain aneurysms demand surgery; Dr. Natarajan assesses each case individually to determine the most appropriate treatment.
Usually, the treatment process includes the following steps:
Evaluation
MRIs and CT scans help identify the size and location of an aneurysm, enabling Dr. Natarajan to determine the best treatment approach. The most accurate method for evaluating a brain aneurysm is a diagnostic cerebral angiogram. This outpatient procedure is performed in a state-of-the-art biplane angiography suite equipped with 3D high-resolution imaging.
The procedure is done under sedation, with the patient awake. After applying local anesthesia, Dr. Natarajan carefully inserts a thin catheter, about the width of a hair,into a blood vessel in the wrist or groin, then threads it to the neck. Contrast dye is injected into the brain blood vessels to produce detailed 3D images of the aneurysm and surrounding vessels. The procedure typically lasts about 45 minutes, and patients can go home 2-3 hours afterward, resuming normal activities the next day.
The angiogram helps Dr. Natarajan formulate an individualized treatment plan by assessing not only the aneurysm’s size but also the size and accessibility of the affected blood vessel. Factors such as location, shape irregularities, growth, surrounding vessels, and patient age influence the decision to treat. For instance, a 4mm aneurysm in a 4mm vessel might not need surgery, whereas the same size in a 1mm vessel might require intervention to prevent rupture.
Treatment options are tailored to each case, requiring an expert like Dr. Natarajan to evaluate all factors and determine the best course of action.
Annual Check-Ups
If the brain aneurysm isn’t causing serious problems and doesn’t seem at high risk of rupturing, Dr. Natarajan will suggest yearly check-ups with an MRI or CT scan to monitor whether the aneurysm is growing or showing any changes in configuration.
Surgery for Brain Aneurysms
If the aneurysm is enlarging or presents a higher risk of rupture, Dr. Natarajan will generally recommend surgical intervention. Usually, a minimally invasive procedure is preferred, but Dr. Natarajan is among the few surgeons in San Diego with expertise in both minimally invasive and open surgeries. This enables him to choose the most appropriate approach for each patient.
Minimally Invasive Catheter-Based Approach
When feasible, Dr. Natarajan prefers this method. It involves inserting a catheter through a 2mm incision in the groin or wrist, then guiding it to the brain’s arteries to treat the aneurysm. These procedures are performed in a modern biplane angiography suite, providing high-resolution 3D imaging of brain blood vessels and precise navigation of devices into the arteries to treat the aneurysm without opening the patient’s head.
Dr. Natarajan has been at the forefront of using and developing various catheter-based technologies, including flow-diverting stents, Web devices, stent-assisted coiling, and simple coiling.
Open Surgery
In some cases, open surgery may be the best option. This involves making an incision behind the hairline or in the back of the head, with removal of a small portion of skull. Dr. Natarajan approaches the aneurysm through the space between the skull and brain tissue under high magnification with a surgical microscope, then applies a clip to seal it off. Advanced operating room technologies, such as computerized navigation, neuromonitoring, Doppler ultrasound, and ICG angiography, are used to ensure the procedure is safe, quick, and effective.
Surgery is done under general anesthesia and typically takes about an hour and a half to complete. The majority of patients are able to go home the same day or the next day and resume normal life within a few days.
Brain Aneurysm Treatment in the San Diego Bay Area
Dr. Sabareesh Natarajan brings over 20 years of experience in treating brain aneurysms with both catheter-based and open surgical methods. He is one of the few surgeons in the San Diego area with such comprehensive expertise. Dr. Natarajan assesses each patient individually and recommends the most suitable treatment plan.
To schedule an appointment at one of our four San Diego offices, please call (619)-984-6969 or complete our appointment request form.
