Neurological Surgery

Neurological Surgery

111 Colchester Avenue
Main Campus, East Pavilion, Level 5
Burlington,  Vermont  05401

 802-847-0654

Monday 8:00 AM - 5:00 PM

Tuesday 8:00 AM - 5:00 PM

Wednesday 8:00 AM - 5:00 PM

Thursday 8:00 AM - 5:00 PM

Friday 8:00 AM - 5:00 PM

A brain (or cerebral or intracranial) aneurysm is a bulging or stretched area of a blood vessel in the brain.

Brain aneurysms pose a serious health risk. If they burst or rupture, they can cause life-threatening complications, including stroke, permanent nerve damage, or death.

Most patients with a ruptured or leaking brain aneurysm complain of a sudden, extremely severe headache. Some even describe their headache as the worst headache of their life. Other ruptured or leaking brain aneurysm symptoms include:

  • Sudden, extremely severe headache
  • Passing out (also called loss of consciousness)
  • Seizure
  • Nausea and vomiting
  • Stiff neck
  • Blurred or double vision
  • Sensitivity to light
  • A drooping eyelid
  • Confusion

Call 911 immediately if you or someone you are with has a sudden, severe headache, passes out, or has a seizure.

If the brain aneurysm has not ruptured there may or may not be symptoms depending on where it is in the brain and its size. Unruptured brain aneurysm symptoms can include:

  • Pain above and behind an eye
  • A dilated pupil
  • Change in vision or double vision
  • Numbness, weakness or paralysis of one side of the face
  • A drooping eyelid

Brain Aneurysm Care at UVM Medical Center

Whether you need emergency care for a ruptured brain aneurysm, or diagnosis, evaluation and treatment of an ongoing problem, we provide a caring, personalized approach that puts patients at the center of everything we do:

  • Our neurosurgeons are committed to a personal approach and work closely with you and your family through all aspects of your care.
  • Treatment plans are individualized to meet your needs.
  • We offer comprehensive treatment for patients with cerebral aneurysms - from observation and monitoring of unruptured brain aneurysms to expert emergency care and treatment for life-threatening situations.
  • We collaborate with other clinicians involved in your care, including neurologists, neuroradiologists and others. We're committed to making sure you have all the information necessary to make the best decisions about your treatment.
  • Our team uses the latest technology and minimally invasive procedures to treat brain aneurysms. We offer Endovascular Surgery and Coiling, a less invasive procedure than traditional, open surgery that reduces your recovery time and risk of complications.
  • The UVM Medical Center has been recognized nationally by the American Stroke Association for the quality of our stroke care. In addition, our Multidisciplinary Stroke Center is nationally certified as a Primary Stroke Center, recognizing our commitment to improving long-term success for patients.

Brain Aneurysm Diagnosis

At The UVM Medical Center, our neuroradiologists (or brain imaging specialists) work closely with your care team during diagnosis. These professionals are specially trained in conducting brain imaging studies to detect a brain aneurysm and use a wide range of imaging technologies including diagnostic X-ray, CT or CAT scans, MRI, nuclear medicine and ultrasound. The process of diagnosis may involve the following:

  • Computed Tomography (CT) scan - This test provides comprehensive images of the brain with a high degree of accuracy. CT scans produce detailed, two-dimensional images of the brain. We offer the most advanced CT technology available today, providing comprehensive images of organs within seconds with a high degree of accuracy.
  • Magnetic Resonance Imaging (MRI) - An MRI uses magnetic fields and radio waves to produce cross-sectional images of your body. The UVM Medical Center offers the latest technology in Open MRI, offering a comfortable option for patients who prefer an open setting. In imaging cerebral aneurysms, a dye may be used to improve images of the blood vessels or the site of a ruptured aneurysm. This procedure is known as MRI angiography.
  • Cerebral Angiogram - A test that involves inserting a catheter into an artery in your groin and guiding it to the brain. A dye injected into the catheter travels to the blood vessels of the brain. X-ray images then can reveal the condition of your arteries. This can help detect the location and size of brain aneurysms.
  • Computed Tomography Angiography (CT Angiography) - This test uses the technology of a CT scan combined with angiography to create detailed images of the blood vessels in the brain.

Treatments for Brain Aneurysm

We offer comprehensive treatment for patients with brain aneurysms, from observation and monitoring of unruptured brain aneurysms to expert emergency care and treatment for life-threatening situations.

Patients experiencing a ruptured aneurysm - often characterized by sudden, severe headaches, loss of consciousness, or seizures - require immediate, emergency care.

If you have an existing cerebral aneurysm that hasn't ruptured, or need diagnosis and evaluation of a suspected problem, you will be referred by your primary care physician to a neurologist or neurosurgeon.

Brain aneurysm treatment options at The UVM Medical Center include:

Non-Surgical Treatments

  • Lifestyle Changes: It is important that you are an equal partner in your care. There are some changes you can make to help reduce the risk that your aneurysm will rupture and the need to have brain surgery, including:
    • Quit smoking and recreational drug use
    • Follow a healthy diet of fruits, vegetables, and lean meats and proteins

    • Get 30 minutes of physical activity that gets your heart pumping most days of the week

    • Limit caffeine

  • Observation: If you have an intact cerebral aneurysm that is very small or in a low-risk area, observation and periodic testing may be recommended. We will work closely with you to determine the best method of treating your aneurysm, taking into account factors such as your age, overall health, and family history.
  • Medications: Medications may be used to treat brain aneurysms - either to help prevent a rupture, or to relieve symptoms or complications following a burst aneurysm. At The UVM Medical Center, we offer the full range of medical therapies and the latest medicines available. We work closely with you to develop an individual treatment plan that meets your needs.
    • Pain relievers - A pain reliever such as acetaminophen may be used to treat symptoms such as headache pain.

    • High blood pressure medication - These medicines may be prescribed for patients with unruptured aneurysms who have high blood pressure, to relieve pressure in the blood vessels.

    • Calcium channel blockers - These drugs work by preventing calcium from entering cells of the blood vessel walls. They can help lessen vasospasm - when blood vessels widen and narrow erratically following a ruptured aneurysm.

    • Vasopressors - A drug given intravenously that is used to prevent stroke due to insufficient blood flow. It works by raising the blood pressure to enable the blood to flow through narrowed vessels.

    • Vasodilators - A drug that causes blood vessels to expand.

    • Anti-seizure drugs - Medications used to treat seizures associated with a ruptured aneurysm.

Brain Aneurysm Surgery

  • Endovascular Surgery and Coiling: A less invasive procedure than traditional, open surgery, this method involves inserting a catheter into an artery in your groin and guiding it to the site of the aneurysm, using x-ray imaging. A thin wire is advanced into the aneurysm and forms a coil, disrupting blood flow and causing a clot.
  • Surgical Clipping: This open surgical procedure involves placing a metal clip at the base of the aneurysm, which cuts off its blood flow, causing it to deflate. Imaging experts identify the exact site of the aneurysm with cerebral angiography. The procedure involves opening the skull, locating the blood vessel that feeds the aneurysm, and inserting the clip or clips.

Brain Aneurysms at UVM Medical Center: How We Compare

The UVM Medical Center's medical experts offer comprehensive, experienced diagnosis and treatment for brain aneurysms. Should your cerebral aneurysm need surgery, our neurosurgeons are highly trained in performing surgical procedures. We treat x patients a year, and our neurosurgeons are specially trained in the most recent techniques, including minimally invasive surgery and microsurgical techniques. Patients benefit from advanced facilities and equipment, along with access to the latest technology.