Brain Aneurysms: What You Need to Know

Sometimes called a “ticking time bomb,” an aneurysm is a very rare vascular event in which an artery wall weakens and balloons or widens abnormally as it fills with blood. Typically, aneurysms develop over several years silently without symptoms. 

When they remain small, aneurysms do not bleed or cause problems. However, all aneurysms have the potential to rupture and cause bleeding into the surrounding area, called hemorrhaging. When an aneurysm ruptures suddenly, the bleeding can result in hemorrhagic stroke, brain damage, coma or death. 

It’s essential to seek immediate medical attention if you experience aneurysm symptoms, especially a sudden, severe headache accompanied by other symptoms. About 10 to 20 percent of people with cerebral aneurysms die before they get to the hospital.

Symptoms of Large Growing Aneurysms May Be:

• Pain above/behind eye
• Numbness and/or weakness
• Paralysis on one side of face
• Dilated pupil
• Vision changes/double vision
• Headaches 

Ruptured Aneurysms May Cause:

• Sudden/extremely severe headache
• Double vision
• Nausea and/or vomiting
• Stiff neck
• Light sensitivity
• Loss of consciousness (brief or prolonged)
• Cardiac arrest 

In relatively rare cases, someone with an aneurysm which is leaking a small amount of blood will have what’s called a sentinel or warning headache days or weeks prior to a major rupture. 

Treatment

Over the last 10 to 15 years there’s been dramatic advances in treatment options for aneurysms. About 90 to 95% of the cerebral aneurysms we see can be treated without major surgery. Instead, we can treat aneurysms endovascularly, meaning going inside an arm or leg artery using a catheter to check the aneurysm, size it and determine what kind of treatment it requires. 

One treatment option is platinum coil embolization, which involves placing a tiny metal coil inside the aneurysm sac, where it forms a clot that acts like a plug. Another option is flow diversion, in which a flexible mesh tube is placed to direct the blood flow away from the aneurysm. There are also other web and sac devices we can deploy. Sometimes, surgery is required in which we open the brain from the outside to repair the aneurysm. 

Prevention

Early detection and treatment of the aneurysm is the best way to prevent the bleeding in the brain. 

While aneurysms are usually “silent” or without warning signs, there are things you can do to protect yourself. Talk to your doctor about undergoing screening for aneurysms, which can include CT angiograms or MR angiogram or brain cath if you: 

• Had a brain aneurysm in the past
• Had stroke called a subarachnoid hemorrhage in the past
• Have two or more close relatives who have had aneurysm or bleeding kind of stroke 
• Have a genetic condition which may increase risk, including polycystic kidney disease, Marfan Syndrome or Ehlers-Danlos syndrome IV

Lifestyle factors can also play a role in aneurysms. High blood pressure can increase the size of aneurysm, and if it ruptures, more blood comes out. Smoking also increases the size of the aneurysm and lengthens the amount of time needed to recover from stroke. Drinking alcohol is toxic to our arteries and vessels, causing them to constrict and leading to high blood pressure. 

Improving your general health can help decrease the chance of rupture and increase your chances of recovering. Things you can do include eating a heart-healthy diet, getting regular exercise and quitting smoking.  

The good news is we are better at diagnosing and treating these aneurysms than ever before, and it’s not a death sentence it used to be. If you have questions or would like to schedule an appointment, our experts are a phone call away. Reach out to the CHI Health Neurological Institute for more info.