What happens when someone goes to the emergency room with an aneurysm?


When someone is hospitalized for a ruptured brain aneurysm, a computed tomography (CT) brain angiogram is done to give doctors a clear picture of the blood vessels involved, pinpointing the bleeding aneurysm. The angiogram can also spot unruptured aneurysms in the brain.

Doctors may be able to reach a ruptured aneurysm by snaking a catheter from a blood vessel in the person's groin to the brain. Then they plug the bleeding bulge with tiny platinum coils, creating a dam in the wall of the blood vessel. If the person also has an unruptured aneurysm, after a few days doctors may do a second procedure, using a stent-like device, known as a flow diverter, to bypass the unruptured aneurysm.

Dr. Geoffrey P. Colby, MD

When someone goes to the emergency room with an aneurysm and symptoms of a possible aneurysm rupture, a computed tomography (CT) scan is typically done. A CT is an excellent means for detecting blood that might have leaked out from an aneurysm. If leakage is evident, further testing is done to identify the location of the aneurysm, and treatment begins so that the aneurysm doesn't bleed again.

When a patient has had what appears to be the rupture of an aneurysm, is it bleeding at that moment in time? No, it's not. The aneurysm bleeds for a few seconds, then seals itself off. A clot forms at the top, closing the hole. In this case treatment is necessary to seal the aneurysm so that a second hemorrhage, which is almost invariably fatal, doesn't occur.

If the aneurysm did not seal itself off and the bleeding is ongoing and continuous, the patient is dead on arrival. That is universally a fatal event.

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