To operate or not? When it comes to brain aneurysms, the answer isn’t always clear.

Brain aneurysms are enlarged areas of the arteries that can rupture and cause bleeding in and around the brain, a stroke, and even death.

Surgery is an option to treat some unruptured aneurysms—though the procedure has its risks—while many small aneurysms can be safely left untreated, if they don’t grow.

But determining which route is best is no easy task, says Bharathi Jagadeesan, M.D., an associate professor in the Medical School’s departments of Radiology, Neurology, and Neurosurgery, and a University of Minnesota Health interventional neuroradiologist.

“At best, we’re providing an educated guess,” he says. “We need to come up with reliable biomarkers that can tell us which aneurysms need surgery and which can be left alone.”

With support from the Wallin Neuroscience Discovery Fund, Jagadeesan has teamed up with U colleagues in neurosurgery, aerospace engineering, and the Center for Magnetic Resonance Research (CMRR) to better understand how aneurysms work—and why and when they rupture.

The group’s ongoing research involves scanning patients’ aneurysms using a high-powered 7 Tesla MRI machine at the CMRR. The scanner produces a high-resolution image of the aneurysm and the blood flowing through it, which is then 3D-printed and tested using engineering instruments.

Jagadeesan says the goal is to identify blood flow patterns linked to higher-risk aneurysms, helping doctors make more accurate treatment recommendations and giving patients greater peace of mind.

“We want to be able to say to a patient, ‘Your aneurysm looks similar to those that have remained stable for years, so let’s stay put for now,’” he says. “Or we’ll have the evidence to say, ‘The pattern of blood flow in your aneurysm is a bit concerning; perhaps we should treat it.’”