Brain Aneurysm

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A brain aneurysm -- a weakened or bulging portion of an artery in the brain -- can be emergent or stable. If a rupture has occurred, our neurosurgeons work quickly to repair damage and reduce the risk of complications like subarachnoid hemorrhages. If your brain aneurysm is stable, small, and has not ruptured, Duke radiologists, neurologists, and neurosurgeons use sophisticated imaging tools to determine whether you will benefit from observation or treatment. We perform open surgery or complex, minimally invasive catheter procedures to repair aneurysms.

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Treatments

Medications

Drugs may be prescribed to reduce blood pressure and symptoms like seizures.

Microsurgical Clipping

Neurosurgeons make an open incision in the back of the skull (a craniotomy) and place one or more small metal clips along the neck of the aneurysm. This blocks blood from entering the aneurysm sac, prevents it from becoming larger, and reduces the risk for future bleeding.

Cerebral Artery Bypass and Coiling

Through an open incision in the skull, neurosurgeons reroute blood flow around the weakened artery using a replacement blood vessel from another part of your body, usually your leg. The new artery bypasses the damaged blood vessels and restores healthy blood flow in the brain. After that, the surgeon inserts small coils into the aneurysm neck to close it.

Endovascular Coiling or Embolization

Using high-resolution images as a guide, neurosurgeons make a small incision and insert a catheter into a major artery (usually the groin). Then, through the catheter, tiny metal coils are placed in the weakened artery to block or reduce blood flow to the aneurysm.

Endovascular Stenting and Flow Diversion

As with embolization or coiling, neurosurgeons thread a catheter through an artery in the groin and to the brain. Then they place a tiny stent in the weakened brain artery to divert blood flow away from the aneurysm. Eventually, the stent will cause the aneurysm to seal itself off.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Tests

MRI or CT Scans

High resolution, 3D images of the brain and its blood vessels are reviewed to analyze the size, shape, and location of the aneurysm, as well as potential bleeding or spasms that may signal an increased risk for stroke. These tests take about 30-60 minutes, and are virtually painless. When MRI or CT scans are used to examine blood vessels (angiograms), they are called MRAs and CTAs.

Cerebral Angiography

Through a small incision, a catheter is inserted into one of your major arteries and threaded through the circulatory system to your neck. Then a contrast dye is injected into the catheter and travels to the brain’s arteries, which highlights the location and severity of the aneurysm. Overall, this test takes about an hour and requires you to lie flat afterward for two to four hours.

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855-855-6484

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Why Choose Duke

Emergency Diagnosis and Response
Many cerebrovascular diseases aren’t diagnosed until after a serious complication occurs. Our team is the region's leading resource for brain health emergencies, including aneurysms.

Advanced Training and Experience
Our neurologists, neurosurgeons, and radiation therapists are trained and experienced in the full range of aneurysm prevention, management, and treatment. Blood-flow disorders in the brain can be difficult to diagnose, but our specialists have the advantage of doing so regularly. From emergency situations in which weak artery walls create immediate risk, to less urgent cases where a comprehensive assessment determines whether surgery is necessary, we ensure you receive the most appropriate treatment for your condition.

Complex Procedures, Successful Outcomes
Unlike some hospitals, we are equipped and trained to perform surgery on large aneurysms, which is an extremely complex and often lifesaving procedure.

Sophisticated Microsurgical Techniques
Our surgeons use powerful microscopes that allow them to see tiny vascular structures in detail and in real time. This makes complex aneurysm surgeries safer and more precise.

Diagnostic and Imaging Expertise
We use the most advanced equipment and procedures to diagnose and treat brain aneurysms, including high-resolution 3D imaging of blood vessels in the brain. These tools enhance our ability to review your medical situation and present the safest and best treatment options.

Best Hospital for Neurology, Neurosurgery in NC

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our neurology and neurosurgery program is nationally ranked, and the highest ranked program in North Carolina by U.S. News & World Report for 2021–2022.

Reviewed: 10/17/2019