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Brain Aneurysm Causes, Symptoms and Treatment

25 October 2011 29,487 views One Comment

What is a brain aneurysm?

A brain (cerebral) aneurysm is a bulging, weak   area in the wall of an artery that supplies blood to the brain. In most cases,   a brain aneurysm causes no symptoms and goes unnoticed. In rare cases, the   brain aneurysm ruptures, releasing blood into the skull and causing a   stroke. When a brain aneurysm ruptures,   the result is called a   subarachnoid hemorrhage. Depending on the severity of   the hemorrhage, brain damage or death may result. The most common   location for brain aneurysms is in the network of blood vessels at the base of   the brain called the circle of Willis. What causes a brain aneurysm? A person may inherit the tendency   to form aneurysms, or aneurysms may develop because of hardening of the   arteries (atherosclerosis) and aging. Some risk factors that can   lead to brain aneurysms can be controlled, and others can't. The following risk   factors may increase your risk of developing an aneurysm or, if you already   have an aneurysm, may increase your risk of it rupturing:
  • Family history. People who have a family history of brain aneurysms are more likely to have an aneurysm than those who don't.
  • Previous aneurysm. People who have had a brain aneurysm are more likely to have another.
  • Gender. Women are more likely to develop a brain aneurysm or to suffer a subarachnoid hemorrhage.
  • Race. African Americans are more likely than whites to have a subarachnoid hemorrhage.
  • Hypertension. The risk of subarachnoid hemorrhage is greater in people with a history of high blood pressure (hypertension).
  • Smoking. In addition to being a cause of hypertension, the use of cigarettes may greatly increase the chances of a brain aneurysm rupturing.
What are the symptoms? Most brain aneurysms cause no symptoms and may only be discovered during   tests for another, usually unrelated, condition. In other cases, an unruptured   aneurysm will cause problems by pressing on areas in the brain. When this   happens, the person may suffer from severe headaches, blurred vision, changes   in speech, and neck pain, depending on what areas of the brain are affected   and how bad the aneurysm is. Symptoms of a ruptured brain aneurysm often   come on suddenly. If you have any of the following symptoms or   notice them in someone you know, call 911 or other emergency services right away:
  • A sudden, severe headache that is different from past headaches.
  • Neck pain.
  • Nausea and vomiting.
  • Sensitivity to light.
  • Fainting or loss of consciousness.
  • Seizures.
How is a brain aneurysm diagnosed? 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. Sometimes a   lumbar puncture may be used if your doctor suspects that you have a ruptured cerebral aneurysm with a   subarachnoid hemorrhage.
  • 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 a 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 the best way to locate small (less than 5 mm) brain aneurysms.
How is it treated? Your doctor will consider several factors before   deciding the best treatment for you. Things that will determine the type of   treatment you receive include your age, size of the aneurysm, any additional   risk factors, and your overall health. Because the risk of a   small (less than 10 mm) aneurysm rupturing is low and surgery for a brain   aneurysm is often risky, your doctor may want to continue to   observe your condition rather than perform surgery. If your aneurysm   is large or causing pain or other symptoms, though, or if you have had a previous   ruptured aneurysm, your doctor may recommend surgery. The following surgeries are used to treat both ruptured and unruptured   brain aneurysms:
  • Coil embolization. During this procedure, a small tube is inserted into the affected artery and positioned near the aneurysm. Tiny metal coils are then moved through the tube into the aneurysm, relieving pressure on the aneurysm and making it less likely to rupture. This procedure is less invasive and is believed to be safer than surgical clipping, although it may not be as effective at reducing the risk of a later rupture. It should be done in a large hospital where many such procedures are done.
  • 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.
Some aneurysms bulge in such a way that the aneurysm has to   be cut out and the ends of the blood vessel stitched together, but this is very   rare. Sometimes the artery is not long enough to stitch together, and a   piece of another artery has to be used. Aneurysms that have bled   are very serious and in many cases lead to death or disability. Management   includes hospitalization, intensive care to relieve pressure in the brain   and maintain breathing and vital functions (such as blood pressure), and   treatment to prevent rebleeding. Copyright © 2011 Everyday Health, Inc.
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One Comment »

  • Denis Dama said:

    How can one tell if a particular headache is caused by a bleeding aneurysm? It can be a tough call, but certain features make a ruptured aneurysm more likely. First, a headache due to a ruptured aneurysm is typically of very abrupt onset (often described as a “thunderclap”) and is classically the worst headache of one’s life. In people who already have recurrent severe headaches from other causes, the headache due to a ruptured aneurysm might feel different from the more usual attacks…

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