Once an aneurysm has bled, there is a high risk that it will bleed again, especially within 48 to 72 hours after the first bleed. With each bleed, the chances for recovery lessen. For this reason, ruptured aneurysms are ideally treated as soon as possible.
However, for patients who are in a coma, have major medical problems, or are quite elderly, treatment may worsen their condition. In these situations, treatment is often withheld until the patient becomes more stable.
Sometimes, if also present, unruptured aneurysms are treated at the same time as the ruptured aneurysm. However, unruptured aneurysms are not at a high risk of bleeding right away. They may be treated at another time, following recovery from the subarachnoid hemorrhage, or may be followed. Separating treatments can minimize risks and complications for the patient.
For all brain aneurysm patients — whether or not their aneurysm has ruptured — risk factors should be controlled. First-degree relatives of patients with familial aneurysms should also control their risk factors.
- Cigarette smoking: you should not smoke, and you should be provided with assistance in smoking cessation if you are a current cigarette smoker.
- High blood pressure: you should know your blood pressure, and if it is elevated, be treated with medications (anti-hypertensive medications) to reduce it.