Brain Aneurysm Treatment
Harvard-trained expertise with over 500 brain aneurysms treated using the most advanced techniques available
Understanding Brain Aneurysms
A brain aneurysm is a weak, bulging area in the wall of an artery that supplies blood to the brain. These abnormalities can occur in anyone but are more common in adults between the ages of 30 and 60, with women affected slightly more often than men.
While the word "aneurysm" can be frightening, it's important to understand that many people live their entire lives with unruptured aneurysms that never cause problems. However, when an aneurysm does rupture, it can cause life-threatening bleeding in the brain called a subarachnoid hemorrhage, which requires immediate medical attention.
My Approach to Brain Aneurysm Treatment
Having treated over 500 brain aneurysms throughout my career, I bring extensive experience and expertise to each patient's care. My training at Harvard Medical School and Massachusetts General Hospital, combined with specialized fellowships in both open neurovascular surgery (UCSF) and endovascular techniques (USC), allows me to offer the full spectrum of treatment options.
I believe in a personalized approach to aneurysm treatment. Not every aneurysm requires intervention, and when treatment is needed, the best approach depends on many factors including the aneurysm's size, location, shape, and the patient's overall health and preferences.
Treatment Options
Observation and Monitoring
Small, unruptured aneurysms may be safely monitored with periodic imaging studies. I work closely with patients to manage risk factors and establish an appropriate surveillance schedule.
Endovascular Coiling
This minimally invasive procedure involves threading a catheter through an artery in the leg to reach the brain. Soft platinum coils are then placed inside the aneurysm to promote clotting and prevent rupture. This approach typically offers shorter recovery times compared to open surgery.
Flow Diversion
Flow diverting stents represent one of the most significant advances in aneurysm treatment. The device is placed in the parent artery and redirects blood flow away from the aneurysm, allowing it to gradually heal. I am certified in the Pipeline Embolization Device, the leading flow diverter technology, and have extensive experience treating complex aneurysms with this approach.
Intrasaccular Devices
Intrasaccular devices, including the Woven EndoBridge (WEB) device, represent what many consider a "fourth pillar" in aneurysm treatment alongside coiling, clipping, and flow diversion. These mesh devices are placed inside the aneurysm sac to disrupt blood flow and promote healing. They can be particularly useful for wide-necked bifurcation aneurysms that may be challenging to treat with other methods.
Microsurgical Clipping
In some cases, traditional open surgery remains the best option. This involves a craniotomy (opening in the skull) to directly visualize the aneurysm and place a tiny titanium clip at its base, excluding it from the circulation. My fellowship training in skull base and cerebrovascular surgery at UCSF ensures I can safely perform even the most complex surgical cases.
Liquid Embolic Agents
In select cases, liquid embolic materials can be used alone or in combination with other techniques to treat aneurysms. This approach is particularly useful for certain aneurysm configurations.
Symptoms of Brain Aneurysm
Most unruptured brain aneurysms cause no symptoms and are discovered incidentally during imaging for other conditions. However, larger unruptured aneurysms may cause:
- Pain above and behind the eye
- A dilated pupil
- Vision changes or double vision
- Numbness or weakness on one side of the face
A ruptured aneurysm is a medical emergency. Symptoms include:
- Sudden, severe headache (often described as "the worst headache of my life")
- Nausea and vomiting
- Stiff neck
- Blurred or double vision
- Sensitivity to light
- Seizure
- Loss of consciousness
If you experience these symptoms, call 911 immediately.
Why Choose Dr. Walcott for Brain Aneurysm Treatment?
- Extensive Experience: Over 500 brain aneurysms treated throughout my career
- Harvard Training: Residency at Massachusetts General Hospital/Harvard Medical School, one of the nation's premier neurosurgical programs
- Dual Fellowship Training: Both open surgical (UCSF) and endovascular (USC) approaches, allowing me to offer the full spectrum of treatments
- Advanced Certifications: Pipeline Embolization Device certified
- Academic Excellence: Author of over 160 peer-reviewed publications, including research on aneurysm treatment advances
- Comprehensive Stroke Center: Practice at Santa Barbara Cottage Hospital, ensuring rapid access to emergency care if needed
Frequently Asked Questions
A brain aneurysm is a weak, bulging area in the wall of an artery that supplies blood to the brain. Think of it like a balloon that forms on the side of a blood vessel. While many aneurysms never cause problems, some can rupture and cause life-threatening bleeding.
Brain aneurysms are more common than many people realize. Studies suggest that 3-5% of the population may have an unruptured brain aneurysm. However, only a small percentage of these will ever rupture. The annual rupture rate for small aneurysms is quite low, which is why careful observation is appropriate for many patients.
Flow diversion uses a specialized stent placed in the parent artery to redirect blood flow away from the aneurysm. Over time, this allows the aneurysm to heal and shrink as new tissue grows across the stent. It's particularly effective for large or wide-necked aneurysms that may be difficult to treat with coiling alone.
Recovery varies depending on the treatment approach and whether the aneurysm was ruptured or unruptured. For elective endovascular procedures, most patients spend 1-2 nights in the hospital and return to normal activities within 1-2 weeks. Open surgical procedures typically require a longer hospital stay and recovery period. I provide detailed, personalized recovery guidance for each patient.
No, not all brain aneurysms require treatment. The decision depends on many factors including the aneurysm's size, location, and shape, as well as the patient's age, health, and family history. Small aneurysms with a low rupture risk may be safely monitored with periodic imaging. I carefully evaluate each patient's individual situation to recommend the most appropriate management strategy.
Schedule a Consultation
If you've been diagnosed with a brain aneurysm or have concerns about your risk, I'm here to help. Together, we'll develop a personalized treatment plan based on your specific situation.
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