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When an aneurysm bleeds, most often the bleeding stops quickly. But if the blood touches brain cells, the cells may be damaged. Blood in the cerebrospinal fluid (CSF) increases pressure on the brain. Leaked blood may also touch nearby arteries. This may cause these arteries to narrow.
Blood from an aneurysm can leak into the CSF in the space around the brain (the subarachnoid space). The pool of blood forms a clot, called a hematoma. Blood can irritate, damage, or destroy nearby brain cells. This may cause problems with body functions or mental skills. Leaked blood may be removed during surgery.
Blood from a torn aneurysm can block CSF circulation. This can lead to fluid buildup and increased pressure on the brain. The open spaces in the brain (ventricles) then enlarge. This problem is called hydrocephalus. It can make a patient lethargic, confused, or incontinent. To remove leaked blood and trapped CSF, a drain may be placed in the ventricles.
An artery may narrow if leaked blood touches it. This response, called vasospasm, may happen up to 14 days after an aneurysm bleeds. Vasospasm can decrease blood needed in other parts of the brain. It can be fatal. To treat vasospasm, the patient’s blood pressure and fluid intake are increased. This increases the force of the blood and widens the artery.
The health care team will want to prevent further bleeding and control complications. The timing of surgery may depend on your loved one’s condition. After treatment, your loved one will be closely observed to see how well the surgery worked. While waiting for answers, you may choose to let some people go home to rest. Then other family members can wait for news.