Two weeks ago, a doctor I know from my hometown hospital called me, saying that there was a female patient in her 40s who was being considered for “subarachnoid hemorrhage”. When I heard about it, I asked the patient to come to the hospital as soon as possible. However, the patient did not come to Wuhan for consultation until last Monday. At that time, the beds in the department were tight, so I suggested that the patient be hospitalized as an emergency. But the patient and his family didn’t listen and went home again in the afternoon. On Thursday, a CT angiogram was done, and it was confirmed to be a “cerebral aneurysm”. I told him to come to the hospital early. The patient had a sudden onset of symptoms about a month ago, and was not in a coma at the time, but had a severe headache. After a few days of treatment at the local hospital, the headache gradually improved and she had no other discomfort, so she took my suggestion of early hospitalization lightly. Unbeknownst to me, the patient had taken a considerable risk over the past month. Once the brain aneurysm ruptures again, the patient’s life will be in great danger. So, for “brain aneurysm”, patients and families are prone to what kind of misunderstanding? Misconception 1: Thinking cerebral aneurysm is a “tumor”. Cerebral aneurysm is not a “tumor”, but a cerebrovascular disease. Cerebral aneurysm occurs due to some reasons, resulting in the weak wall of cerebral arteries, the arterial wall like “blowing up a balloon” like a bulge. The walls of the aneurysms are very thin, sometimes as thin as a layer of paper, and it is conceivable that under the impact of highly pressurized arterial blood, such a weak part of the artery can rupture very easily. The bulging aneurysm part of the brain artery is shaped like a “tumor”, but it is not a tumor and is very different from a tumor. Therefore, although brain aneurysms are dangerous, after treatment, they do not require radiotherapy or chemotherapy like tumors. Myth 2: After “subarachnoid hemorrhage”, the symptom disappears, so it is fine. The discovery of a brain aneurysm is usually sudden, and most patients are found because of a hemorrhage. This type of hemorrhage is unique in that it is mainly located in the interstices of the brain tissue and is called a “subarachnoid hemorrhage”. This type of subarachnoid hemorrhage is not caused by trauma, and 70-80% are caused by cerebral aneurysms. If a CT scan reveals more bleeding in the “saddle region” of the brain, almost 90% of the cases are caused by cerebral aneurysms. Therefore, for patients with subarachnoid hemorrhage, cerebral angiography should be done to rule out the possibility of cerebral aneurysm, and should be done as early as possible. Why do doctors pay so much attention to patients with subarachnoid hemorrhage? Because after domestic and international research, if it is a cerebral aneurysm, the first hemorrhage may cause one-third of the patients to die at that time, and if the remaining patients do not undergo surgery or interventional therapy, half of the patients will have re-bleeding within six months; and once re-bleeding, the mortality rate can be as high as 70-80%. Moreover, many of these rebleeds occur early after the first bleed. Therefore, once the “subarachnoid hemorrhage” is considered, it is necessary to check for cerebral aneurysms as soon as possible. The symptoms of the hemorrhage should not be ignored just because they have disappeared. The most critical treatment for cerebral aneurysms is not to treat the bleeding that has already occurred, but to treat the aneurysm itself as soon as possible to detect this “time bomb”. Myth 3: Interventional treatment must be safer than craniotomy. Cerebral aneurysm treatment mainly includes interventional embolization and craniotomy. Some patients are suitable for interventional treatment, some are suitable for surgical treatment, and in most cases, both are suitable. Due to the fear of craniotomy, some family members wishfully think that interventional therapy is so expensive and “minimally invasive” that it must be safer than surgical treatment. In fact, with the advancement of medical technology, in many cases, craniotomy can also achieve a better result, and in some cases, it is safer than interventional therapy. For example, if an aneurysm rupture occurs during interventional embolization therapy, it is quite dangerous, and most of the final results are unsatisfactory; however, if an intraoperative aneurysm rupture occurs during surgery, the vast majority of them still have a chance to be remedied. Of course, with the improvement of people’s living standards, more and more patients are not willing to “open the brain”, and choose not to open the skull of the interventional therapy. Therefore, patients and their families with subarachnoid hemorrhage should avoid the above misconceptions and seek treatment at neurosurgical centers with more experience in dealing with such cases. It is also important not to worry too much about the disease. Although aneurysms are dangerous, with the continuous improvement of medical technology and the updating of medical equipment, the vast majority of patients with cerebral aneurysms can achieve better results.