Brain Aneurysm

What is a brain aneurysm?

 

A brain aneurysm is a bulge or ballooning in a blood vessel in the brain. Most common in people between the ages of 35 and 65 years of age, aneurysms occur at the base of the brain and are usually caused by a defect in an artery that was present at birth.


A hemorrhage can occur when an aneurysm ruptures, leading to bleeding on the brain’s surface and into the space around the brain. This often happens without warning and can be life threatening. Before rupturing, aneurysms usually produce no symptoms or warning signs. Once an aneurysm ruptures you can experience “the worst headache ever.”


Once an aneurysm has ruptured, the goal is to prevent further bleeding and prevent brain damage.


Diagnosis of Brain Aneurysm


Because unruptured brain aneurysms often do not cause any symptoms, many are discovered in people who are being treated for a different condition.


If your doctor believes that you have a brain aneurysm, you may have the following tests:

  • Computed tomography (CT) scan. A CT scan can help identify bleeding in the brain.
  • Computed tomography angiogram (CTA) scan. CTA is a more precise method of evaluating blood vessels than a standard CT scan. CTA uses a combination of CT scanning, special computer techniques, and contrast material (dye) injected into the blood to produce images of blood vessels.
  • Magnetic resonance angiography (MRA). Similar to CTA, MRA uses a magnetic field and pulses of radio wave energy to provide pictures of blood vessels inside the body. As with CTA and cerebral angiography, a dye is often used during MRA to make blood vessels show up more clearly.
  • Cerebral angiogram. During this X-ray test, a catheter is inserted through a blood vessel in the groin or arm and moved up through the vessel into the brain. A dye is then injected into the cerebral artery. As with the above tests, the dye allows any problems in the artery, including aneurysms, to be seen on the X-ray. Although this test is more invasive and carries more risk than the above tests, it is a good way to locate small brain aneurysms (such as aneurysms that are less than 5 mm).

Treatment of Brain Aneurysm


Your doctor will determine the type of treatment you receive based on your age, size and location of the aneurysm, your overall health and any additional health concerns.


If you have an aneurysm with a low risk of rupture, you and your doctor may want to continue to observe your condition rather than do surgery. If your aneurysm is large or causing pain or other symptoms or if you have had a previous ruptured aneurysm, your doctor may recommend surgery.


The following procedures are used to treat both ruptured and unruptured brain aneurysms:

  • Endovascular embolization: During this procedure, a small tube is inserted into the affected artery and positioned near the aneurysm. For coil embolization, soft metal coils are then moved through the tube into the aneurysm, filling the aneurysm and making it less likely to rupture. In mesh embolization, mesh is placed in the aneurysm, reducing blood flow to the aneurysm and making it less likely to rupture. These procedures are less invasive than surgery. But they involve risks, including rupture of the aneurysm.
  • Surgical clipping: This surgery involves placing a small metal clip around the base of the aneurysm to isolate it from normal blood circulation. This decreases the pressure on the aneurysm and prevents it from rupturing. Whether this surgery can be done depends on the location of the aneurysm, its size, and your general health.

Aneurysms that have bled are very serious. Emergency treatment will include hospitalization, intensive care to relieve pressure in the brain and to maintain breathing and vital functions (such as blood pressure) and treatment to prevent rebleeding.

 

Warning Signs/ Symptoms of Brain Aneurysm

 

Unruptured brain aneurysms typically do not cause symptoms and are small. Large unruptured aneurysms can occasionally press on the brain or the nerves and may result in various symptoms. If you are experiencing any of the following symptoms, please contact your physician

  • Localized headache
  • Dilated pupils
  • Blurred or double vision
  • Pain above and behind eye
  • Weakness and numbness
  • Difficulty speaking

Aneurysms that have ruptured usually cause immediate symptoms. Seek medical attention immediately if you are experiencing any of the following symptoms:

  • Sudden severe headache, the worst headache of your life
  • Loss of consciousness
  • Nausea/vomiting
  • Stiff neck
  • Sudden blurred or double vision
  • Sudden pain above/behind the eye or difficulty seeing
  • Sudden change in mental status/awareness
  • Sudden trouble walking or dizziness
  • Sudden weakness and numbness
  • Sensitivity to light (photophobia)
  • Seizure
  • Drooping eyelid

Frequently asked Questions About Brain Aneurysms

 

What causes a brain aneurysm?


Many aneurysms are genetic. Other causes include trauma or injury to the head, high blood pressure, infection, tumors, diseases of the vascular system, cigarette smoking and drug abuse. They can also be more common in people with other medical issues such as connective tissue disorders, polycystic kidney disease, and certain circulatory disorders.


Do all aneurysms need treatment?


No. Treatment depends on the location and size of the aneurysm but always check with your physician if you have any symptoms or suspect an aneurysm.


What are the symptoms of an aneurysm?


Aneurysms typically cause headaches or vision that is blurred but most remain silent until they are discovered accidently through brain imaging.

 

Does a ruptured aneurysm need treatment?

 

Yes, always.

 

Can a ruptured aneurysm cause death?

 

Yes. When an aneurysms ruptures, blood leaks into the brain and causes pressure on brain tissue and cause permanent damage leading to death.

 

Is a brain aneurysm the same as a stroke?


A brain aneurysm is a ballooning or bulging of a blood vessel in the head. If this ruptures and bleeds, it is known as a hemorrhagic stroke.