Aneurysms are weak “bubbles” on blood vessels, with about 5% of people having brain aneurysms by some estimates. The rupture rate is very low (less than 1 in 2,000 for the smaller, more common aneurysms according to a more recent study). Most unruptured aneurysms are not treated, but observed. Symptoms may include pressure on a nerve to the eye causing increase in the eye’s pupil size, with eyelid drooping or double vision); the “worst headache of your life” due to the bleed in our around the brain (called “subarachnoid hemorrhage”). While most aneurysms can be observed without likelihood of rupture, treatment options (see"Treatments & Testimonials" section) include surgical clipping or coiling through the groin using a catheter. In the rare event that an aneurysm ruptures, roughly 1/3rd die, 1/3rd are permanently impaired, and 1/3rd make a meaningful recovery. In our practice, we evaluate aneurysms on a case-by-case basis – and can offer surgery only if appropriate; many times, we observe with a follow-up MRI/MRA exam.
“Arteriovenous malformations” (AVMs) are tangles of blood vessels present since birth, where blood moves directly from arteries to veins without being slowed down in capillaries. There is about a 4% risk of causing bleeding within the brain due to an AVM, many times in younger people. Treatment options include surgical removal vs. observation vs. highly focused radiation.
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