Intracranieel aneurysma

Intracranial aneurysms are balloon-like localized bulges of an artery that develop in the majority of cases due to congenital weakness of the vascular wall.

These lesions can be seen on special angiographic sequences in CT or MRI. For detailed evaluation of anatomy and treatment options a conventional catheter angiography is performed.

Aneurysms usually produce no symptoms and are discovered if they rupture and cause subarachnoid hemorrhage or they are detected “incidentally”. This means that a CT or MRI was done for another purpose and the aneurysm was seen by chance. If an aneurysm is discovered as an incidental finding, the risks of treatment compared with those of the expected spontaneous course must be weighed.

In the Universitair Ziekenhuis Brussels we have both available treatment options for intracranial aneurysms: Microsurgical clipping and endovascular coil embolization. The optimal treatment for the patient is discussed on our Neurovascular board meetings for incidental aneurysms and by direct communication between Neurosurgeon and interventional Neuroradiologist in the emergency case of ruptured aneurysms.

Microsurgical clipping means opening of the skull (craniotomy) under the microscope and excluding the aneurysm from the circulation by placing a titanium clip on its basis (BEELD).

Coil embolization is also performed under general anesthesia. A catheter is inserted into the femoral artery and advanced under fluoroscopic control into the head. Subsequently, the aneurysm is filled with platinum coils.