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Home > Neurosurgery > Brain Aneurysm

Brain Aneurysm

A brain aneurysm is a silent threat a weak bulge in a cerebral artery wall that may sit undetected for years, causing no symptoms, until the moment it ruptures. When it does, the result is a subarachnoid haemorrhage a catastrophic bleed around the brain producing the worst headache of the patient's life. Subarachnoid haemorrhage diagnosis and emergency neurosurgical care within the first hours is the difference between survival with good function and permanent neurological devastation.

At Shree Hospitals, our ruptured brain aneurysm specialists deliver round-the-clock Brain Aneurysm treatment in Mumbai, India from emergency coiling and surgical clipping to unruptured aneurysm management and long-term surveillance with the speed and expertise this life-threatening condition demands.

(24×7 Emergency Care)

1800-268-4000

(24×7 Emergency Care)

1800-268-4000

Our Approach to Managing Brain Aneurysm

Detect before rupture. Intervene before disaster. Rebuild after both.

Brain aneurysm management sits at the intersection of urgency and nuance. A ruptured aneurysm is one of the most time-critical neurological emergencies in medicine - every hour without treatment increases the risk of rebleeding, vasospasm, and death. An unruptured aneurysm discovered incidentally presents an entirely different challenge: balancing the lifetime risk of rupture against the procedural risks of prophylactic treatment, in a decision-making process that requires deep neurovascular expertise and honest patient communication.

At Shree Hospitals, our approach to cerebral aneurysm clipping and coiling in Mumbai encompasses both ends of this spectrum. Our ruptured brain aneurysm specialist team is available 24 hours a day to respond to subarachnoid haemorrhage with immediate diagnostic imaging and same-day aneurysm occlusion. Our elective team applies careful risk stratification and international guidelines to every incidentally discovered unruptured aneurysm - treating when the evidence supports it, watching when it does not.

1. Emergency Diagnosis (Subarachnoid Haemorrhage)

Precise diagnostic classification forms the backbone of effective oncological decision-making. Every patient undergoes advanced imaging and diagnostic evaluation to guide treatment planning:

Immediate non-contrast CT brain, diagnostic for subarachnoid blood in over 95% of cases within 6 hours of rupture
Lumbar puncture when CT is negative but clinical suspicion remains high, where xanthochromia in CSF confirms subarachnoid haemorrhage
CT angiography for rapid, high-resolution aneurysm identification and anatomical characterisation for emergency treatment planning
Digital subtraction angiography (DSA) as the gold-standard aneurysm imaging for treatment planning when CTA findings are complex
Hunt and Hess grading and WFNS grade clinical severity scoring guiding treatment decisions and prognosis communication
Rapid neurosurgical and neurointerventional team activation, initiating treatment within hours of confirmed diagnosis

2. Endovascular Coiling (Minimally Invasive Aneurysm Occlusion)

Intracranial aneurysm endovascular treatment is the preferred approach for most ruptured and many unruptured aneurysms at Shree Hospitals:

Catheter advanced from the femoral artery to the aneurysm under fluoroscopic guidance
Platinum microcoils packed within the aneurysm sac, occluding blood flow and eliminating rupture risk
Flow diverter stents (Pipeline or Surpass devices) for large or wide-neck aneurysms unsuitable for conventional coiling
Intrasaccular flow disruption devices (WEB device) for bifurcation aneurysms with wide necks
Balloon-assisted and stent-assisted coiling for aneurysms requiring additional support to retain coil mass within the sac
Target: complete aneurysm occlusion confirmed on DSA before catheter removal

3. Neurosurgical Clipping

For aneurysms where endovascular treatment is anatomically unsuitable, or in the context of significant intracerebral haematoma requiring evacuation:

Craniotomy and microsurgical clip placement across the aneurysm neck, permanently excluding it from the circulation
Intraoperative angiography or indocyanine green (ICG) video angiography to confirm complete occlusion and parent vessel preservation
Temporary clipping of parent artery during dissection to protect the brain from aneurysm rupture during surgery
Comprehensive cerebral aneurysm clipping and coiling in Mumbai options at Shree Hospitals—both modalities available, selected based on aneurysm anatomy and patient factors
Haematoma evacuation combined with clipping in patients with ruptured aneurysm and significant intracerebral or subdural blood

4. Subarachnoid Haemorrhage Intensive Care

Post-treatment care following rupture is as important as aneurysm occlusion itself:

Dedicated neurovascular ICU monitoring for a minimum of 14 days post-rupture
Vasospasm surveillance - the most dangerous post-haemorrhage complication, occurring days 4 to 14 after rupture
Transcranial Doppler monitoring daily for cerebral blood flow velocity, detecting vasospasm before clinical deterioration
Nimodipine calcium channel blocker administered for 21 days to reduce vasospasm-related cerebral infarction
Triple H therapy (hypertension, hypervolaemia, and haemodilution) for symptomatic vasospasm
Endovascular balloon angioplasty or intra-arterial verapamil for refractory vasospasm

5. Unruptured Aneurysm Management

Incidentally discovered aneurysms require individualised risk-benefit analysis:

PHASES score and UIATS criteria validated tools for rupture risk estimation and treatment decision support
Factors favouring treatment: size above 7 mm, posterior circulation location, irregular morphology, prior SAH from another aneurysm, young patient age
Factors favouring surveillance: small size, anterior circulation, elderly patient, significant treatment risk from comorbidities
Annual MRA or CTA surveillance for aneurysms managed conservatively to detect growth that would shift the treatment decision
Family screening for first-degree relatives of patients with ruptured aneurysm offered cerebrovascular imaging given genetic component

6. Rehabilitation After Subarachnoid Haemorrhage

Continuous longitudinal care to preserve quality of life and handle disease progression promptly:

Early physiotherapy and occupational therapy addressing motor deficits from vasospasm-related infarction
Cognitive rehabilitation - memory, attention, and executive function deficits are common after SAH and frequently underappreciated
Speech and language therapy for aphasia following dominant hemisphere vasospasm infarction
Psychological support, addressing depression and anxiety which are extremely prevalent after SAH and require active management
Structured follow-up at 3, 6, and 12 months with DSA or MRA to confirm durable aneurysm occlusion as part of Brain Aneurysm treatment in Mumbai, India

Happy Patients & Their Case Stories

A 47-year-old woman from Andheri collapsed at home with a sudden thunderclap headache. Rushed to Shree Hospitals, CT confirmed subarachnoid haemorrhage and CTA identified a ruptured middle cerebral artery aneurysm. Emergency coiling was performed within 4 hours. She was discharged neurologically intact 12 days later.

Mrs. Rekha. K

This 55-year-old man underwent MRI for unrelated headaches which incidentally revealed a 9 mm posterior communicating artery aneurysm. Risk analysis guided elective coiling as part of cerebral aneurysm clipping and coiling in Mumbai at Shree Hospitals, preventing a potentially catastrophic rupture before it occurred.

Mr. Avesh. J

How to Identify Brain Aneurysm?

Most unruptured aneurysms cause no symptoms at all - they are silent until they rupture or grow large enough to compress adjacent structures. Knowing both presentations is critical:

Ruptured Aneurysm (Emergency Signs):

Thunderclap headache: The most characteristic symptom; described as the worst headache of the patient's life, reaching maximum intensity within seconds - always a neurological emergency requiring immediate thunderclap headache evaluation.
Sudden vomiting and photophobia: Accompanying the severe headache as blood irritates the meninges.
Loss of consciousness or confusion: Indicating significant haemorrhage with acute brain involvement.
Neck stiffness: Develops hours after rupture as blood breaks down and causes meningeal irritation.
Focal neurological deficit: Arm weakness, speech difficulty, or visual change from vasospasm or direct haematoma effect.

Unruptured Aneurysm (Occasional Warning Signs):

Sentinel headache: A less severe but unusual headache preceding rupture by days to weeks - often a small warning bleed.
Painful third nerve palsy: Sudden painful drooping of the upper eyelid with pupil dilation, from a posterior communicating artery aneurysm expanding and compressing the oculomotor nerve - an emergency warranting immediate aneurysm evaluation.
Visual disturbance: From a large unruptured aneurysm compressing optic structures.
Pulsatile tinnitus: Rarely, from a large aneurysm near the petrous bone.

Any sudden severe headache - particularly if described as "the worst ever," or accompanied by neck stiffness, vomiting, or visual change - requires immediate emergency department attendance and CT brain. For Brain Aneurysm treatment in Mumbai, India, do not wait.

Important FAQs: Brain Aneurysm

What causes a brain aneurysm?

Aneurysms form at points of arterial wall weakness most commonly at vessel bifurcations in the circle of Willis. Contributing factors include hypertension, smoking, family history, connective tissue disorders (Marfan syndrome, polycystic kidney disease), and female sex. Controlling blood pressure and cessation of smoking are the most effective preventive measures available.

Is every brain aneurysm treated?

No. Small unruptured aneurysms in elderly patients or high surgical risk individuals are frequently best managed with surveillance. Treatment is recommended for larger aneurysms, those with unfavourable morphology, in younger patients, or following a previous rupture from a different aneurysm all assessed using validated risk tools by our ruptured brain aneurysm specialist team.

Which is better coiling or clipping?

Both are effective the choice depends on aneurysm anatomy, location, patient age, and surgeon expertise. Intracranial aneurysm endovascular treatment with coiling is less invasive with faster recovery; surgical clipping offers more durable occlusion for certain anatomies. Our team discusses both options at cerebral aneurysm clipping and coiling in Mumbai for every individual patient.

What is a thunderclap headache and why is it an emergency?

A thunderclap headache reaches maximum intensity within 60 seconds mimicking the sensation of being struck on the head. It is the hallmark symptom of subarachnoid haemorrhage from aneurysm rupture. Immediate thunderclap headache evaluation with CT brain is mandatory approximately 10% of patients with this headache pattern have a life-threatening bleed.

Can an aneurysm rebleed after treatment?

Coiling carries a small recanalization and retreatment rate approximately 10 to 15% at five years requiring surveillance angiography. Surgical clipping has extremely low rebleed rates when complete occlusion is confirmed intraoperatively. All treated patients at Shree Hospitals enter a structured Brain Aneurysm treatment in Mumbai, India follow-up programme.

Treatments for Brain Aneurysm at Shree Hospitals

Brain aneurysm treatment focuses on preventing rupture and protecting brain function. Depending on the aneurysm's size, location, and risk, treatment may include minimally invasive endovascular coiling, flow diversion, or microsurgical clipping to achieve the best possible outcome.

Endovascular Coil Embolisation

Catheter-based platinum microcoil packing of the aneurysm sac is the most commonly performed intracranial aneurysm endovascular treatment at Shree Hospitals. Minimally invasive, no craniotomy required, and highly effective for most aneurysm anatomies. Same-day treatment possible for ruptured aneurysms on emergency presentation.

Flow Diverter Stent Implantation

Pipeline or Surpass flow diverter stents redirect blood flow away from the aneurysm, causing progressive aneurysm thrombosis and occlusion over months. Ideal for large or giant fusiform and wide-neck aneurysms unsuitable for coiling as part of cerebral aneurysm clipping and coiling in Mumbai.

Microsurgical Clipping

Open craniotomy with microsurgical clip placement across the aneurysm neck permanently and durably excludes the aneurysm from the circulation. Preferred for certain aneurysm locations, for patients with haematoma requiring evacuation, and when endovascular access is technically impossible.

Vasospasm Management

Post-haemorrhage vasospasm management (nimodipine prophylaxis, transcranial Doppler monitoring, triple H therapy, and endovascular balloon angioplasty for refractory cases) forms the critical second phase of subarachnoid haemorrhage diagnosis and emergency neurosurgical care at Shree Hospitals.