Brain Aneurysm

Diagnosis, risk assessment, and treatment of ruptured and unruptured cerebral aneurysms in Lahore, Pakistan

What is a Brain Aneurysm?

A brain aneurysm (cerebral aneurysm), sometimes called dimagh ki rag phulna, is an abnormal bulge or ballooning in the wall of a blood vessel in the brain, caused by a weakness in the vessel wall. Most aneurysms occur at branch points of arteries at the base of the brain, in the network of vessels known as the Circle of Willis.

Many aneurysms remain silent for a person's entire life and are found only incidentally when a scan is done for an unrelated reason. However, if an aneurysm ruptures, blood leaks into the space around the brain — a subarachnoid haemorrhage — which is a neurosurgical emergency with a high risk of death or disability if not treated urgently.

Dr. Waqas Mehdi, FCPS Neurosurgeon at MidCity Hospital Lahore, assesses patients with both incidentally discovered unruptured aneurysms and emergency ruptured aneurysms, guiding them through the appropriate investigation and treatment pathway.

Warning Signs of a Ruptured Aneurysm — Seek Emergency Care Immediately

!Sudden, severe "thunderclap" headache — worst headache of your life
!Neck stiffness
!Nausea and vomiting
!Sensitivity to light (photophobia)
!Blurred or double vision
!Sudden loss of consciousness or seizure
!Drooping eyelid or facial weakness on one side
!Confusion or difficulty speaking

A ruptured brain aneurysm is a life-threatening emergency. Go to the nearest emergency department immediately — do not wait for a scheduled appointment.

Unruptured vs Ruptured Aneurysm

Unruptured Aneurysm

Often found incidentally on a CT/MRI done for headaches, dizziness, or another reason. Usually causes no symptoms unless it is large enough to press on a nearby nerve (e.g. causing a drooping eyelid or double vision). Managed with careful risk assessment — some are monitored, others treated preventively.

Ruptured Aneurysm

Presents as a subarachnoid haemorrhage — sudden severe headache, often with loss of consciousness. This is a medical emergency requiring immediate hospital admission, CT/CT-angiography, and urgent treatment to secure the aneurysm and prevent re-bleeding.

How is a Brain Aneurysm Diagnosed?

CT Scan / CT Angiography (CTA): The first test in suspected rupture — CT quickly identifies bleeding around the brain, and CTA maps the blood vessels to locate the aneurysm.
MRI / MR Angiography (MRA): Used for unruptured aneurysms found incidentally, and for follow-up monitoring of small aneurysms over time.
Digital Subtraction Angiography (DSA): The gold-standard catheter-based test giving the most detailed view of the aneurysm — used to plan clipping or coiling.
Lumbar Puncture: Occasionally used if CT is normal but rupture is still suspected, to check for blood breakdown products in the spinal fluid.

Brain Aneurysm Treatment Options

Observation & Risk Factor Control

  • › For small, incidentally found unruptured aneurysms with low rupture risk
  • › Strict blood pressure control
  • › Smoking cessation — smoking significantly increases rupture risk
  • › Periodic imaging (MRA) to monitor for growth

Microsurgical Clipping

  • › A craniotomy is performed to directly access the aneurysm
  • › A small metal clip is placed across the neck of the aneurysm, permanently excluding it from circulation
  • › Durable, long-term solution with a very low re-treatment rate
  • › Preferred for certain aneurysm shapes/locations not suited to endovascular treatment

Endovascular Coiling / Flow Diversion

  • › A catheter is passed through the groin or wrist artery up to the brain vessel
  • › Platinum coils are packed into the aneurysm to promote clotting and seal it off, or a flow-diverting stent redirects blood flow away from the aneurysm
  • › Minimally invasive — no craniotomy required
  • › Performed jointly with interventional neuroradiology colleagues where indicated

Frequently Asked Questions

What is a brain aneurysm?
A brain aneurysm (cerebral aneurysm) is a weak, bulging spot on the wall of a brain artery, similar to a thin balloon filling with blood. Most are small and never cause symptoms, but if one ruptures it causes bleeding around the brain (subarachnoid haemorrhage) — a life-threatening emergency.
Who is the best neurosurgeon for brain aneurysm treatment in Lahore?
Dr. Waqas Mehdi, FCPS Neurosurgeon and Assistant Professor at King Edward Medical University (KEMU) and Mayo Hospital, Lahore, evaluates and manages patients with both ruptured and unruptured brain aneurysms, coordinating surgical or endovascular treatment as appropriate.
What are the warning signs of a ruptured brain aneurysm?
The classic warning sign is a sudden, severe 'thunderclap' headache — often described as the worst headache of a person's life — along with neck stiffness, vomiting, blurred or double vision, sensitivity to light, and sometimes loss of consciousness. This is a medical emergency requiring immediate hospital care.
Are all brain aneurysms dangerous?
No. Many small, unruptured aneurysms are discovered incidentally on brain scans done for other reasons and carry a low annual risk of rupture. The decision to treat or simply monitor depends on the aneurysm's size, location, shape, and the patient's age and risk factors — this requires individual specialist assessment.
How is a brain aneurysm treated?
Treatment options include microsurgical clipping (a craniotomy to place a metal clip across the aneurysm's neck) or endovascular coiling/flow diversion (a catheter-based procedure through the groin or wrist). The best option depends on the aneurysm's size, shape, location, and the patient's overall condition.

Concerned About a Brain Aneurysm?

If you have been told you have a brain aneurysm, or are experiencing a sudden severe headache, seek immediate medical attention. For non-emergency evaluation and second opinions, consult Dr. Waqas Mehdi at MidCity Hospital, Lahore.

Call: 0300-8482624Book Appointment

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