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How do doctors keep an eye on aneurysms?

Dr. Geoffrey P. Colby, MD
Neurosurgery
Non-invasive imaging techniques can be used, usually a computed tomography (CT) angiogram or a magnetic resonance (MR) angiogram with intravenous contrast injection. A three-dimensional image of the aneurysm can be generated. The size can be measured carefully to see if it develops any irregularities in shape. These features will help determine whether an aneurysm is enlarging, weakening, and headed towards a rupture. This method of monitoring is called conservative therapy, non-operative treatment, or watchful waiting. A certain percentage of aneurysms will gradually grow bigger over time. However, an aneurysm does not have to grow bigger before it ruptures. Inflammation is thought to play a role in the thinning/weakening of the aneurysm wall. It is possible that the aneurysm wall can thin out to the point of breaking before the aneurysm grows to a particular size. For this reason, careful evaluation of an aneurysm by a specialist is recommended to determine the risks and rewards of monitoring versus treatment.

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