A brain aneurysm, also known as a cerebral aneurysm or intracranial aneurysm (IA), is an abnormal bulge on the wall of an artery in the brain. Brain aneurysms are often revealed when they rupture. Although women are more likely than men to experience aneurysms, they can occur for anyone at any age.
Definition & Facts
An estimated 6 million people in the United States have an unruptured aneurysm. A ruptured aneurysm will cause bleeding into the brain or the space closely surrounding the brain. A ruptured brain aneurysm can result in a subarachnoid hemorrhage (SAH), which can lead to a hemorrhagic stroke, brain damage and death.
The most common type of aneurysm that accounts for about 90% of all IA is called a saccular cerebral aneurysm. It is also the most common cause of non-traumatic subarachnoid hemorrhage. This type of aneurysm is often known as a “berry” aneurysm due to its shape forming at the “Y” segment of arteries known as the arterial bifurcation. Another type of aneurysm is the fusiform aneurysm which rarely ruptures and appears inflamed on all sides of the blood vessel.
Symptoms & Complaints
A physician should evaluate any individual experiencing some or all of the following symptoms, regardless of age, immediately:
- Dilated pupils
- Blurred vision or double vision
- Pain above and behind the eye
- Loss of balance and coordination
- Short-term memory loss
- Difficulty speaking
- Weakness and numbness
Typical symptoms of a ruptured aneurysm often begin with an individual experiencing severe headaches. Ruptured brain aneurysms that result in SAH will cause the following symptoms suddenly due to the blood that escaped into the space around the brain:
- A substantially painful sudden and immediate headache
- Loss of consciousness
- Nausea and vomiting
- Stiff neck and/or neck pain
- Sensitivity to light
- Eyelid drooping
The thinning of the arterial walls can be caused by a variety of conditions including high blood pressure and atherosclerosis which is the hardening of the arteries. As blood flows against the thinned portion of the arterial wall, aneurysms can form without notice due to the wear and tear of the artery. The arterial wall gradually becomes thinner from the dilation, causing the weakened wall to swell outward. This type of pressure may cause the aneurysm to rupture and allow blood to escape into the space around the brain.
Certain risk factors for cerebral aneurysms include:
- Strong family history of aneurysms
- High blood pressure or chronic hypertension
- Drug use (particularly cocaine, crack or amphetamines)
- Smoking cigarettes
- Traumatic brain injury
- Other disorders: Fibromuscular dysplasia, Ehlers-Danlos syndrome, Polycystic kidney disease, Marfan syndrome, collagen vascular disease
Diagnosis & Tests
Patients that display symptoms of an aneurysm are referred to a neurologist. Fortunately, through evaluation and image screening technology, individuals at high risk of developing a brain aneurysm can be identified easily. Individuals undergo testing utilizing:
- Angiogram (arteriogram)
- Magnetic resonance angiography (MRA)
- Computed tomography angiography
- Intra-arterial digital subtraction angiography (IADSA)
Treatment & Therapy
The prognosis for a patient with a ruptured cerebral aneurysm largely depends on the extent and location of the aneurysm, the person’s age, overall health and neurological condition of the patient. Unruptured aneurysms may require no treatment with constant monitoring or consistent follow-up and observation. If the unruptured aneurysm is treated successfully, the recovery period is generally shorter than that following the treatment of a ruptured aneurysm. Ruptured aneurysms may be treated with either endovascular coiling or open surgical aneurysm clipping in order to prevent re-bleeding by sealing off the aneurysm.
Prevention & Prophylaxis