What is a Brain Aneurysm?

The blood vessels in our body are a complex maze of channels susceptible to a number of complications. Just like any other part of the body, the brain needs blood to function. Because many of our most vital neurological processes take place in the brain, blood complications in or near the area can be a major cause for concern.

One concern is a brain aneurysm, a swollen or bulging blood vessel in the brain.  Roughly 6 million Americans, one in 50, sustain an unruptured brain aneurysm every year. Nearly 30,000 Americans sustain a more serious ruptured brain aneurysm.

Here are some warning signs, symptoms and possible treatments for brain aneurysms:

Causes and Risk Factors

Weakening of the walls in a brain artery is the primary cause of brain aneurysms. As the walls weaken and thin out, they’re more susceptible to stretching or bulging.

Arteries have to twist and turn to change direction, and these locations are where brain aneurysms often form. The blood vessels can be even weaker at these branch points, allowing for easier stretching of the artery walls. Aneurysms are most frequently found near the base of the brain, but it’s possible for them to be present anywhere in the brain.

Like all heart- and blood-related complications, many long term risk factors for brain aneurysms are hereditary. Other factors, though, can be preventable. Age, gender (women are more susceptible than men) and genetics can affect risk, including a few specific factors inherited at birth. Choices such as diet, smoking, alcohol or drugs, and levels of exercise and activity also affect your risk. Heart and blood health are about limiting risk in whatever areas are possible.

Types and Symptoms

There are two primary types of brain aneurysm:

1. Unruptured: Far more common, almost always without symptoms
2. Ruptured: Less common, much more serious. Involves blood leaking into the brain

There are certain occasions where unruptured brain aneurysms can show symptoms and require treatment. This usually occurs if the aneurysm grows large enough to press up against the brain or nerves of the brain and cause neurological issues. Potential symptoms of an unruptured brain aneurysm include:

• Headaches
• Blurred vision
• Pain or weakness
• Difficulty speaking.

Aneurysms may occasionally “leak” rather than rupture, causing just a small amount of blood to pool into the brain. An extreme headache is usually the only major symptom here, but it can indicate a major rupture.

Ruptured brain aneurysms often cause major bleeding into the brain, known as a hemorrhagic stroke. Symptoms of ruptured aneurysms are typically immediate and obvious, beginning with an extreme and often unbearable headache. Others symptoms include:

• Problems with vision
• Nausea or vomiting
• Pain or stiffness in the neck
• Drooping eyelids
• Seizure or loss of consciousness, in some cases

Fatality rates on ruptured brain aneurysms are at roughly 40 percent, and they require immediate and speedy medical attention. In cases where patients survive a ruptured brain aneurysm, the speed with which they were rushed to treatment after experiencing initial symptoms can often play a huge role in in which neurological functions are affected in the aftermath.

Treatment

In most cases where an unruptured brain aneurysm is discovered, the only major treatments are reduction of pain and necessary follow-ups to confirm the issue hasn’t become more severe. In some rare cases, a procedure similar to those for ruptured aneurysms could be required.

These surgical procedures are by far the most common approach for survivors of ruptured brain aneurysms:

Surgical clipping: In this procedure, a surgeon enters the brain by removing a portion of the skull temporarily. The surgeon then clips the neck of the aneurysm with a small metal clip, blocking the flow of blood to the aneurysm and closing it off. This procedure is invasive and has a moderate to high risk level in many cases, but is also generally the more effective and permanent treatment of the two when successful.

Endovascular coiling: Using a catheter to enter the brain (typically through the groin or another area of the body) rather than removing a portion of the skull, endovascular coiling is a less invasive process. When the catheter has reached the affected area in the brain, a soft wire is fed through it. The wire coils up once it reaches the inside of the aneurysm, blocking blood flow and activating the body’s natural blood clotting mechanisms. As the aneurysm clots, it becomes sealed. Endovascular coiling is less invasive, but also poses a larger risk for recurrence in the future.

Additionally, medications and procedures are put in place to supplement one of these larger surgeries. These can include pain relievers and anti-seizure medications, as well as frequent checkups and potential injections. In some cases, patients undergo speech or occupational therapy. And of course, any person can actively take preventative measures against these and other forms of serious heart and blood disease by practicing healthy habits during daily life.

Revere Health Neurology specialists treat patients with a variety of neurological disorders.

 

Sources:

• “Brain aneurysm.” The Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/brain-aneurysm/basics/definition/con-20028457
• “About Brain Aneurysms.” Brain Aneurysm Foundation. http://www.bafound.org/about-brain-aneurysms/brain-aneurysm-basics/