Brain aneurysms often come without warning, preceded by few or no symptoms. Yet in just a split second, an aneurysm can change your life. When most people think of a brain aneurysm, they're actually thinking of the sudden effects of a ruptured brain aneurysm. What you might not realize is that many people live with a brain aneurysm without ever knowing it, and without experiencing a single symptom. Here's what you need to know about this potentially life threatening brain issue.
What is a Brain Aneurysm?
A brain aneurysm is a bulging malformation in one of the brain's blood vessels. It can look a lot like a balloon or a berry. Most brain aneurysms produce no symptoms, and a brain aneurysm does not necessarily indicate an underlying health problem. Some of the most common causes of brain aneurysms include:
- Congenital abnormalities that make aneurysm formation more likely; if you have a family history of aneurysms, you may be more vulnerable to aneurysms yourself.
- Injury to the brain's blood vessels, including due to traumatic brain injuries.
- High blood pressure.
- Smoking.
- Sex and race. Though no one knows why, women and African-Americans are more vulnerable to brain aneurysms.
- A previous history of aneurysms.
- Age-related weakening of the walls of the brain's blood vessels. As the vessels weaken, they can develop aneurysms and other malformations.
Why Are Brain Aneurysms Dangerous?
Simply having a brain aneurysm does not necessarily mean your brain will be harmed. The problem with brain aneurysms is that they can leak or rupture. A bleeding brain aneurysm can cause extensive brain damage, pressure in the skull, and other brain injuries. The symptoms of a ruptured brain aneurysm vary greatly depending upon the location of the aneurysm and the severity of the bleed, but ruptured brain aneurysms can be fatal.
Symptoms of a Brain Aneurysm
Many brain aneurysms are completely asymptomatic. Most people with a brain aneurysm only learn about the aneurysm when it ruptures, or incidental to a brain scan for another condition. However, some people with aneurysms experience a handful of warning signs. The extent and severity of symptoms depends on a number of idiosyncratic factors, including aneurysm location and size.
Some symptoms to discuss with your doctor include:
- Changes in consciousness or personality.
- Visual changes, especially blurred or double vision.
- Numbness, paralysis, or weakness in the face, especially if only concentrated on one side.
- A drooping eyelid.
- A pupil that remains dilated regardless of light.
- Pain behind or above one eye.
- Unexplained changes in speech patterns.
- Unexplained exhaustion or fatigue.
- Changes in mental health.
These symptoms can also indicate a wide variety of other issues, so it's important to talk to your doctor rather than self-diagnosing with an aneurysm. The only conclusive way to determine whether or not an aneurysm is present is with brain imaging scans. Your doctor will determine the most appropriate scan for your symptoms.
Symptoms of a Ruptured Brain Aneurysm
A ruptured or leaking brain aneurysm is a medical emergency that demands immediate treatment in an emergency room. If you experience a sudden, intense headache—particularly if you have no previous history of headaches, or the headache differs markedly from your usual headache pattern—call your doctor immediately. Some common symptoms associated with a ruptured aneurysm include:
- Stiff neck or neck pain
- Unexplained nausea or vomiting
- Changes in consciousness, mood or personality
- Dizziness or confusion
- Light sensitivity
- Numbness in part of the body
- Asymmetrical symptoms, such as the ability to raise only one arm or close only one eye
- Seizures
- Confusion
Brain Aneurysm Treatment
Treatment for brain aneurysms depends on whether the aneurysm is ruptured or unruptured.
Treatment for Ruptured or Leaking Brain Aneurysms
Treatment may vary depending upon the specifics of your case, but the most common surgical treatments for ruptured and leaking brain aneurysms are:
- Embolization: This procedure involves the insertion of a tube into the affected blood vessel. A doctor then inserts coils into the aneurysm, filling it and reducing the risk of further bleeding. Mesh embolization involves a similar process, but instead relies on mesh to fill the aneurysm. Embolization is less invasive than some other brain surgeries, so doctors often choose it as a more conservative option when the risks of surgery is great.
- Aneurysm clipping: This surgical procedure clips a metal clip around the aneurysm's base to isolate it from the blood vessel. This reduces pressure on the aneurysm, preventing further bleeding and rupture.
Treatment for Unruptured Brain Aneurysms
Surgery for unruptured brain aneurysms is risky, and only 1-2% of brain aneurysms rupture each year. If your aneurysm is small—less than 10mm—your doctor might advise watchful waiting rather than aggressive treatment. If your doctor does opt to perform surgery, surgeries for unruptured brain aneurysms are the same as those for ruptured brain aneurysms.
Brain Aneurysm Prognosis and Long-Term Care
An unruptured brain aneurysm does not typically require any specialized medical care, though your doctor might recommend lifestyle remedies, such as quitting smoking and eating a balanced diet, to improve your overall health and reduce your risk of experiencing future aneurysms.
If an aneurysm has ruptured, you may require long-term care, particularly if the ruptured aneurysm has damaged surrounding brain tissue. After stabilizing you, your doctor may recommend a number of treatment options, including:
- Lifestyle remedies to reduce the risk of future aneurysms.
- Physical, speech, and occupational therapy to improve brain function and teach your brain to work around your injury. Therapy may even improve functioning over time, and promote the development of new neural circuits.
- Ongoing brain scans to check for more aneurysms.
- Psychotherapy to help you learn to cope with your injuries.
- Support groups to help you see how others have coped with the aftermath of brain aneurysms.
- Education about brain health and brain aneurysms.
- Medication to reduce the risk of a future aneurysm. This may include blood thinners, blood pressure medication, and a host of other treatments.
