# Brain Aneurysm Treatment in Barcelona · Coiling, Flow Diverter and Clipping > Brain aneurysm treatment in Barcelona: diagnosis with CT angiography and digital subtraction angiography, endovascular treatment (coiling, flow diverter) and microsurgery (clipping). Vascular neurosurgery team led by Dr. Abel Ferrés. Care for national and international patients with remote second opinion. URL: https://brainandspine-bcn.com/en/brain-aneurysm-treatment-barcelona/ Fuente: Brain & Spine Barcelona — https://brainandspine-bcn.com --- # Brain aneurysm treatment in Barcelona Precise diagnosis and treatment of brain aneurysm using endovascular techniques (**coiling**, **flow diverter**) and microsurgery (**clipping**), with a vascular neurosurgery team in Barcelona. We assess each case individually to choose the safest option. Cerebrovascular surgery Updated 22/06/2026 Reviewed by Dr. Abel Ferrés A brain aneurysm is a bulge in the wall of a brain artery. Most produce no symptoms, but rupture causes a subarachnoid haemorrhage, a serious neurological emergency. In Barcelona we have all the diagnostic and therapeutic tools (endovascular and microsurgical) to treat them with maximum safety. ## What is a brain aneurysm? A brain aneurysm is an **abnormal enlargement or bulging of a brain artery**, caused by weakening of the vessel wall. This weakened area balloons outward, forming a sac that, subjected to continuous blood flow pressure, can grow over time and, in some cases, rupture. Most unruptured aneurysms **produce no symptoms and are not dangerous**: many people live with them their entire lives without knowing it. However, an aneurysm can rupture and bleed. Rupture of a brain aneurysm is a critical situation that, without urgent treatment, can be fatal within the first 24 hours and leave neurological deficits in survivors. ## Types of brain aneurysm Not all aneurysms are alike. Their shape, size and location determine both the risk of rupture and the treatment strategy: - **Saccular (berry) aneurysm:** the most common. It has a sac shape with a neck connecting it to the artery. It typically occurs at bifurcations of arteries at the base of the brain. - **Fusiform aneurysm:** dilation affecting the entire circumference of an arterial segment, without a defined neck. More complex to treat. - **Mycotic aneurysm:** uncommon, associated with infections that weaken the arterial wall. - **By size:** small (<7 mm), medium, large (>10 mm) and giant (>25 mm). Size directly influences rupture risk. ## Causes and risk factors Aneurysms develop through a combination of arterial wall predisposition and factors that weaken it or increase pressure on it. The main risk factors are: - **Poorly controlled arterial hypertension.** - **Smoking**, the most important modifiable factor. - Alcohol and stimulant drug use (cocaine, amphetamines). - **Family history** of aneurysm or subarachnoid haemorrhage. - Age (more frequent from age 40) and female sex. - Hereditary conditions such as polycystic kidney disease or certain connective tissue disorders. ## Symptoms and ruptured aneurysm (subarachnoid haemorrhage) The vast majority of **unruptured aneurysms are asymptomatic** and discovered incidentally on imaging performed for another reason. Large aneurysms may occasionally compress adjacent structures and cause pain behind the eye, double vision or drooping eyelid. When an aneurysm ruptures, **subarachnoid haemorrhage** occurs, a life-threatening emergency. The most characteristic symptom is a **sudden, extremely severe headache**, described as "the worst of my life" (thunderclap headache), which may be accompanied by: - Neck stiffness and cervical pain. - Nausea and vomiting. - Sensitivity to light. - Loss of consciousness or convulsive seizures. - Neurological deficit (weakness, speech or vision disturbance). Faced with these symptoms, immediate A&E attendance is essential: prognosis depends directly on the speed of diagnosis and treatment. ## Diagnosis of brain aneurysm Diagnosis relies on vascular imaging that locates the aneurysm, measures its size and analyses its morphology: - **CT angiography:** fast and widely available in A&E, ideal for detecting haemorrhage and the responsible aneurysm. - **MR angiography:** uses no radiation or iodinated contrast; useful for screening and follow-up of unruptured aneurysms. - **Cerebral angiography (digital subtraction angiography):** the **reference test**. Provides maximum anatomical detail of the aneurysm and arteries, essential for treatment planning and often allows treatment during the same procedure. ## Endovascular treatment: coiling and flow diverter **Endovascular treatment** is performed from inside the artery, without opening the skull. Access is through an artery (usually femoral or radial) and microcatheters are navigated to the aneurysm under fluoroscopic guidance. ### Coil embolisation (coiling) This involves filling the aneurysm sac with **fine platinum coils** that cause thrombosis of the aneurysm and exclude it from circulation. It is a minimally invasive technique with rapid recovery, especially indicated for many ruptured and unruptured aneurysms. ### Flow diverter A **densely woven stent** placed in the artery at the level of the aneurysm. Rather than filling the sac, it redirects blood flow through the artery and promotes progressive thrombosis of the aneurysm. Particularly useful for large, fusiform or wide-necked aneurysms that are difficult to treat with coils. ## Microsurgical treatment: clipping **Surgical clipping** is an open microsurgery technique with a long track record and excellent long-term results. Through a craniotomy, the neurosurgeon exposes the aneurysm using an operating microscope and places a **titanium clip at the neck of the aneurysm**, permanently excluding it from circulation whilst preserving flow in the healthy artery. It is a reference option for certain aneurysms depending on their location and morphology, and in patients whose anatomy does not favour an endovascular approach. It is part of our team's [cerebrovascular surgery](https://brainandspine-bcn.com/en/brain-surgery/vascular-neurosurgery/) repertoire. ## How is treatment decided? There is no single technique that is best for all cases. The decision is **individualised and multidisciplinary**, jointly assessed by vascular neurosurgery, interventional neuroradiology and neurology. Factors considered include: - Whether the aneurysm is ruptured or unruptured. - Size, shape, neck and location of the aneurysm. - The patient's age, general condition and preferences. - The estimated risk of rupture versus the risk of treatment. For many small unruptured aneurysms, **active surveillance** with periodic imaging checks may be chosen, reserving intervention for when it is justified. You can meet the team that carries out this assessment on our [medical team](https://brainandspine-bcn.com/en/team/) page and review the full range of procedures at [brain surgery](https://brainandspine-bcn.com/en/brain-surgery/). ## Recovery and prognosis Recovery depends greatly on whether the aneurysm was ruptured. For **unruptured aneurysm treatment**, especially via the endovascular route, admission is usually brief (1-2 days) and return to normal life is rapid. After a **subarachnoid haemorrhage**, recovery is longer: it requires intensive care admission, management of complications such as vasospasm and hydrocephalus, and neurological follow-up for weeks or months. Prognosis improves very significantly when diagnosis and treatment are prompt. In all cases, **imaging follow-up checks** are performed to confirm long-term aneurysm occlusion. Medical review: Dr. Abel Ferrés · Vascular Neurosurgery · Brain & Spine Barcelona ## Frequently asked questions about brain aneurysm Is an unruptured brain aneurysm dangerous? Most unruptured brain aneurysms produce no symptoms and many never rupture. The risk of rupture depends on size, location, morphology and factors such as smoking or hypertension. This is why individualised assessment by a vascular neurosurgery team is essential. What are the symptoms of a ruptured brain aneurysm? The most characteristic symptom is a sudden, extremely severe headache described as the worst of one's life ("thunderclap headache"), which may be accompanied by neck stiffness, nausea, vomiting, loss of consciousness or neurological deficit. It is a medical emergency requiring immediate attention. What is the difference between coiling and clipping? Coiling is an endovascular treatment: the aneurysm is accessed from inside the artery via a catheter and filled with platinum coils. Clipping is open microsurgery: the neurosurgeon places a clip at the neck of the aneurysm to exclude it from circulation. The choice depends on each case. How is a brain aneurysm diagnosed? Vascular imaging tests are used, including CT angiography, MR angiography and cerebral angiography (digital subtraction angiography), which is the reference test and provides the anatomical detail needed to plan treatment. What is a flow diverter? A flow diverter is a densely woven stent placed in the artery at the level of the aneurysm. It redirects blood flow and promotes progressive thrombosis of the aneurysm. It is especially useful for large, fusiform or wide-necked aneurysms. How long is recovery after treatment? For endovascular treatment of unruptured aneurysms, discharge usually occurs in 1-2 days and return to normal activity is rapid. After a subarachnoid haemorrhage, recovery is longer, with intensive care admission and neurological follow-up for weeks or months. Can brain aneurysms be prevented? They cannot be fully prevented, but controlling blood pressure, stopping smoking, moderating alcohol consumption and avoiding stimulant drugs reduces the risk of formation and rupture. In people with a family history, screening with imaging tests may be recommended. Where is brain aneurysm treated in Barcelona? At Brain & Spine Barcelona, based at Hospital El Pilar (Balmes 271), our cerebrovascular neurosurgery team assesses each case and offers both endovascular and microsurgical treatment, coordinated with interventional neuroradiology and intensive care.