Treatment:

Because symptoms often do not appear until bleeding occurs, a ruptured cerebral aneurysm is an emergency condition when it is discovered. The goal of treatment is to control symptoms and prevent further bleeding. Lowering blood pressure can reduce the risk of further bleeding.

Neurosurgery is the primary treatment for cerebral aneurysm. The base of the aneurysm is closed off with clamps, sutures, or other methods that prevent blood flow through the aneurysm. In many cases, special coils or stents can be placed into the aneurysm through the arteries.

This causes a clot to form in the aneurysm and prevents further bleeding. This is considered a less invasive approach than brain surgery, and in the appropriate circumstances, it is regarded as the best form of treatment.

If surgery is not feasible because of the location or size of the aneurysm or the condition of the person, medical treatment is similar to treatment for subarachnoid hemorrhage.

This may include restricting activity (often complete bedrest is advised), treating symptoms such as headache, controlling blood pressure, and prescribing preventive use of antiseizure medications.

Once the aneurysm is repaired, prevention of stroke due to blood vessel spasm may be necessary. This may include intravenous fluids, certain medications, and actually letting one's blood pressure run high.

Expectations (prognosis):

The outcome varies. Patients who are in deep comas after an aneurysm rupture generally do not do as well as those with less severe symptoms.

Ruptured cerebral aneurysms are often deadly. About 25% of people die within 1 day, and another 25% die within about 3 months. Of those who survive, more than half will have some sort of permanent disability.

Complications:

• Subarachnoid hemorrhage
• Stroke
• Seizures, epilepsy
• Paralysis of any part of the body
• Permanent loss of sensation of any part of the face or body
• Other neurologic deficits (such as vision changes, loss of speech ability, cognitive decline)
• Communicating hydrocephalus

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if sudden or severe headache occurs, particularly if you also have nausea, vomiting, seizures, or any other neurological symptoms. Also call if you have a headache that is unusual for you.