The University Hospital Mannheim is to establish a national center for brain aneurysms, aiming to improve diagnosis and coordinate highly specialized treatment in Germany. The Hector Foundation will provide €3.5 million for the center’s first three years of development.
Around 5.5 million people in Germany have a brain aneurysm, a bulge in a blood vessel that can cause a severe stroke if it ruptures. The frequency of aneurysms has risen over the past two decades, from 2.9% to 6.6%. Researchers say the increase cannot be explained solely by an ageing population or changes in lifestyle.
Nima Etminan, head of neurosurgery in Mannheim and the center’s incoming director, said the team treats complex aneurysms and assesses bleeding risk using specially developed scores and blood markers. The researchers also plan to use clinical data and artificial intelligence models to improve estimates of whether an aneurysm may rupture or grow. A blood biomarker intended to indicate an aneurysm’s stability is in development.
Improving risk assessments could help avoid unnecessary procedures. The wider use of imaging has led to more aneurysms being discovered, and Etminan argues that some are operated on too often. Preventive procedures should be reserved for cases where the risk of rupture is high, since an intervention itself carries risks of stroke and death. For aneurysms discovered by chance, the rupture risk is below 1%, while patients with polycystic kidney disease or a family and genetic history of aneurysms face higher risks.
The center will also investigate why aneurysms have become more common, particularly among people in middle age, and what environmental factors may contribute. Known risk factors for developing an aneurysm include high blood pressure, smoking and stimulants such as amphetamines or cocaine.
Mannheim’s specialist service for cerebrovascular conditions has operated since 2021 and performs about 120 procedures a year. The hospital also has a dedicated intensive care unit for these patients. If an aneurysm ruptures, rapid specialist treatment is needed to prevent a severe stroke. The new center aims to strengthen care and improve treatment standards nationally, including through telemedicine.
Sources: FAZ.