A brain aneurysm is a balloon-like bulge in a weakened artery wall inside the brain. Around 2–3% of people harbour one — most without ever knowing. The danger arises if it ruptures, causing bleeding around the brain (subarachnoid haemorrhage), a life-threatening emergency.
Symptoms of a ruptured aneurysm
- Thunderclap headache — a sudden, explosive, “worst headache of my life”
- Neck stiffness, vomiting, sensitivity to light
- Loss of consciousness or seizure
- Sudden double vision or a drooping eyelid
Any thunderclap headache needs an emergency CT scan — minutes matter.
Unruptured aneurysms: found by chance
Many aneurysms today are discovered incidentally on scans done for other reasons. This is not a death sentence — small aneurysms in low-risk locations are often simply monitored, while larger or irregular ones may be secured electively before they can ever bleed. Risk factors that push toward treatment include size above 7 mm, irregular shape, posterior circulation location, smoking, uncontrolled hypertension and a family history of rupture.
Treatment options
- Microsurgical clipping — a titanium clip placed across the neck of the aneurysm, permanently excluding it. Durable, one-time treatment.
- Endovascular coiling / flow diversion — treated from within the artery via a catheter, suitable for selected aneurysms.
The right choice depends on aneurysm anatomy, age and overall health — and should be made at a centre comfortable with both techniques. Dr. Shyam trained in complex aneurysm and bypass surgery under Prof. Yoko Kato in Japan and offers honest, individualised advice for both ruptured and unruptured aneurysms.
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