An unruptured brain aneurysm is a bulge in an arterial wall that has not yet broken. Most unruptured aneurysms cause no symptoms and are discovered incidentally on brain imaging. Management depends on the aneurysm's size, location, shape, and the patient's overall health, and ranges from watchful surveillance to endovascular coiling or surgical clipping. A ruptured aneurysm has burst, releasing blood into the subarachnoid space around the brain. This produces a thunderclap headache, described as the worst headache of a patient's life, of sudden explosive onset, often with nausea, vomiting, neck stiffness, and in severe cases loss of consciousness. A ruptured aneurysm is a medical emergency requiring immediate hospital attention and imaging. Treatment to secure the ruptured aneurysm, either by coiling or clipping, is carried out as soon as the patient is stable enough to undergo the procedure.
Written by Dr Robin Gupta, MBBS, MS General Surgery, MCh Neurosurgery (GB Pant Hospital and Maulana Azad Medical College, New Delhi), Consultant Neurosurgeon and Stroke Specialist, Neuroendovascular Surgeon, SPARSH Hospital, Infantry Road, Vasanth Nagar, Bengaluru.
