Brain aneurysm 101: All you need to know about this life-threatening condition

Women suffer from brain aneurysms much more than men; the ratio stands at three women to every two men. If you have been experiencing a number of health issues, including eye problems, severe headache, nausea, or neck pain, you could be suffering from a brain aneurysm, a condition when a bulge forms in the blood vessels in the brain, and fills it with blood. 

Many patients who suffer from brain aneurysms often produce no symptoms, unless the aneurysm leaks or ruptures, causing bleeding in your brain. This is known as hemorrhagic stroke, which is characterised by bleeding in or around the brain that can lead to brain damage, and be fatal. These aneurysms are also called cerebral aneurysms. Fortunately, most brain aneurysms don’t rupture or create health problems. 

To understand more about this condition, we got in touch with Dr Anurag Saxena, HOD and consultant, department of neurosurgery, HCMCT Manipal Hospitals, Dwarka, New Delhi. 

Brain aneurysms are a life-threatening condition

According to Dr Saxena, aneurysms mean ballooning or outpouching from the weakened blood vessel walls of the brain. Because blood vessels in and around the brain are not supported by surrounding structures like muscles, these aneurysms have a tendency to rupture and cause serious haemorrhage.

Watch out for these signs and symptoms of a brain aneurysm

The type of signs and symptoms depend on whether it ruptures or not. 

“Majority of unruptured aneurysms produce no symptoms. The most devastating situation occurs, when they rupture causing a bleed known as subarachnoid haemorrhage,” says Dr Saxena. 

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Unruptured aneurysms can cause the following symptoms, if they keep on growing and causing pressure over brain structures. 

• Mild-to-moderate headaches
• Eye pain and double vision
• Dizziness 
• Small bleeds from unruptured aneurysms can cause episodes of sudden headaches, which become better with time. These are called sentinel headaches, and indicate impending ruptures.

A ruptured aneurysm is an emergency

An unruptured aneurysm might not initially have any symptoms, but that usually changes as it grows in size. Therefore, symptoms of unruptured brain aneurysms are warning signs for a ruptured brain aneurysm. With a ruptured brain aneurysm, you need emergency care. Its symptoms are:

• Sudden, severe headache (often described as the worst headache one has ever felt)
• Loss of consciousness
• Vomiting or nausea
• Stiff neck
• Double or blurred vision
• Seizure
• Drowsiness

Remember, the sudden, severe headache is a key symptom of a ruptured aneurysm. 

Plus, there are some brain aneurysm triggers

Dr Saxena also points out certain reasons or causes of developing brain aneurysms. Dr Saxena says aneurysms develop mainly due to the weakening of the blood vessel wall, leading to its ballooning. The main associative factors are:

• Atherosclerosis 
• Prolonged and untreated hypertension 
• Smoking
• Family history of aneurysms 
• Certain diseases associated with brain aneurysms are Marfan’s syndrome, polycystic kidney disease, ehler danlos disease, etc.

Apart from this, the American Heart Association, in an article, published in their journal Stroke, stated that there are certain factors that can trigger the rupture of an existing aneurysm. These factors include excessive exercise, coffee or soda consumption, straining during bowel movements, intense anger, startling, and sexual intercourse. In some cases, aneurysms can also form or rupture from head trauma, brain tumors, and infections, however, this is not as common. 

Also, read: This is what happens to your brain when you exercise regularly

Should the unruptured aneurysm be treated? 

Dr Saxena explains that the treatment largely depends on size, location, and type of aneurysm. Most of the time, unruptured aneurysms are found incidentally, during brain imaging (CT or MRI) done for other problems. Once the diagnosis is made, further investigations including CT angiogram or digital subtraction angiography are needed to delineate it further and plan treatment. 

Various treatment options include:

If the size of the aneurysm is small and the risk of rupture is very low, then patients are kept in close observation with serial imaging at regular intervals. 

• Surgical clipping involves microscopic surgery and putting a clip at the base of the aneurysm to cut it off, in order to avoid the future risk of bleeding. 
• Endovascular treatment includes coiling or stenting the aneurysm or the parent artery to block the aneurysm from inside.

If you’re experiencing any symptoms or your primary care doctor suspects an aneurysm, you should visit a neurosurgeon for better treatment.