Cerebral Aneurysm

Diagnosis

Diagnosis of Ruptured Cerebral Aneurysm

A ruptured cerebral aneurysm leads to bleeding within the brain, causing sudden onset of extremely severe headaches, loss of consciousness, stiff neck or seizures. Two tests are the main tools used to diagnose a ruptured cerebral aneurysm:

• Computed tomography (CT) An X-ray technique that produces detailed images of the brain in cross-sectional slices. CT scans are very sensitive in detecting blood in the subarachnoid space from a ruptured aneurysm. The scan reveals the distribution of blood in the brain, providing important clues regarding the aneurysm's location.
• A cerebrospinal fluid examination (CSF) In some cases, the physician may suspect a subarachnoid hemorrhage, but the hemorrhage is not revealed on a CT scan. The CSF can help confirm a ruptured aneurysm by detecting blood in the cerebrospinal fluid. A needle is inserted into the lower back to withdraw a small amount of spinal fluid.

Diagnosis of Unruptured Aneurysm

Unruptured aneurysm patients experience headaches or localized abnormalities in brain function. Physicians use magnetic resonance imaging (MRI), magnetic resonance angiography (MRA) and computed tomography angiography (CTA) to diagnosis this condition.

If an aneurysm or subarachnoid hemorrhage is found, the physician may perform a diagnostic test known as a cerebral angiogram to pinpoint the aneurysm's location. A catheter (thin tube) is inserted into an artery in the leg and guided through the bloodstream to the arteries in the neck that lead to the brain. Dye is injected into the arteries as X-rays are taken. These images provide a map of the arteries. MRI, MRA and CTA scanning also can be used to find an aneurysm, but a cerebral angiogram usually provides more definitive information.

Screening for cerebral aneurysms using MRI, MRA or CTA is recommended for people at high risk, including those with a significant family history of cerebral aneurysms and those with a disease called autosomal dominant polycystic kidney disease.