Cerebral aneurysm

Cerebral aneurysms are typically asymptomatic until ruptured, resulting in a subarachnoid haemorrhage.

Head CT usually confirms the diagnosis of subarachnoid haemorrhage if performed within 6 hours of symptom onset, but lumbar puncture is indicated if the CT is negative after 6 hours and suspicion persists.

Cerebral angiogram is the definitive investigation. CT angiography or magnetic resonance angiography may also be used.

Definitive treatment aims to obliterate the aneurysm from the cerebral circulation. Options include microsurgical clipping or endovascular techniques.

Screening with non-invasive neuroangiography is recommended for at-risk populations.

A cerebral aneurysm is a focal abnormal dilation of the wall of an artery in the brain. Intra-cranial aneurysms are most commonly located at branching points of the major arteries at the base of the brain, which course through the subarachnoid space. Cerebral aneurysms can, by nature of their size, compress neighbouring nerves or brain tissue or, more devastatingly, rupture and cause significant morbidity and mortality.