An aneurysm is a weak spot in the blood vessel in the brain and over time it starts to balloon out and has the potential to rupture. Ahsan Sattar, M.D., Medical Director of Neuroendovascular Surgery and Stroke at Mountainside Medical Center, states the aneurysm cause is multifactorial; high blood pressure, smoking, family history of brain aneurysms, natural aging, and genetics. Dr. Sattar does add that often there are no warning signs of a brain aneurysm prior to a rupture, naming it a “silent killer.” Patients will often experience the “worst headache of their life and should report to the nearest appropriate emergency room,” said Dr. Sattar. Mountainside Medical Center’s Neuroscience Institute offers a special MRI called a MR Angiogram (MRA), which evaluates the blood vessels in the brain in great detail - the best screening tool for aneurysms. This test is preferred since it is quick and does not expose the patient to any radiation. A CT Angiogram (CTA) can also be performed if the patient is not able to safely undergo a MRI.
Dr. Sattar explains that treatment options have been rapidly evolving over the last 15-20 years, from open brain surgery using surgical clips to minimally invasive options with catheters and modern devices. Currently, the gold standard treatments can include minimally invasive surgery through the radial artery in the wrist or femoral artery in the groin. These techniques safely and skillfully repair the aneurysm from the inside using stents, coils, or a combination, with minimal downtime for recovery. “Although, there are still some aneurysms that need to be repair via open techniques,” said Dr. Sattar. “Every patient is different, therefore the treatment plan is highly individualized for each patient based on age, co-morbidities, as well as aneurysm size, location, and morphology.” Dr. Sattar likes to take his time with each patient and their family or care providers to discuss highly individualized treatment options best suitable for them.
“Aneurysm rupture can occur at any age, but the chance of ruptures are affected by uncontrolled hypertension, smoking, large aneurysms, and atypical shape of aneurysms,” said Dr. Sattar. Patients with one brain aneurysm have about a 20% chance of developing a second aneurysm. Additionally, if a patient has two immediate family members with a history of a brain aneurysms, he or she is at an increased risk, and therefore should visit a neuroendovascular specialist for a routine workup.
Dr. Sattar advises that patients with a known brain aneurysm should go on to live their lives. However, he does encourage his patients to avoid excessive exercise, such a weight lifting over 150-200 pounds which can increase intracranial pressure, and to avoid sports with trauma to the head such as boxing.
Patients with aneurysm risk factors should make an appointment with a neurologist or neuroendovascular surgeon who are highly trained in diagnosing and treating vascular abnormalities of the brain. Dr. Sattar explains, “Just because you make an appointment with a surgeon, does not mean surgery is the only treatment option. Neuroendovascular physicians are trained and skilled at evaluating brain vessel imaging, and closely monitoring these unique aneurysms over time.”
Learn about the Montclair Neuroscience Insitute at Mountainside Medical Center by visiting mountainsidehosp.com/services/neuroscience-institute. To schedule an appointment at our office call 973-429-6770.