Brain Aneurysm: Symptoms, Causes, Diagnosis, and Treatment

A bulging or ballooning in a blood vessel in the brain is known as an aneurysm. An aneurysm frequently resembles a berry hanging on a stem.

A brain aneurysm may rupture or leak, resulting in brain haemorrhage (hemorrhagic stroke) (hemorrhagic stroke). Typically, a ruptured brain aneurysm occurs in the space between the brain and the delicate tissues that cover it. A subarachnoid haemorrhage is a medical term for this type of hemorrhagic stroke.

The aneurysm widens even further as blood pours into the bulge, like a balloon that gets thinner and more liable to pop as it fills with air. Your brain bleeds if the aneurysm ruptures or leaks (bursts open). Sometimes it results in a hemorrhagic stroke, which is bleeding in or around the brain that can cause deadly brain damage. They are also known as cerebral aneurysms. “Cerebral” refers to the brain.

Symptoms

Despite their frightening appearance, most brain aneurysms don’t cause symptoms or other health problems. It’s possible to live a long life without ever recognising it. Aneurysms can, however, occasionally enlarge, leak, or rupture. You require medical assistance straight away if you experience a hemorrhagic stroke, which is significant brain bleeding.

• Burst aneurysm
• A ruptured aneurysm’s primary symptom is an abrupt, intense headache. This headache is sometimes referred to as the “worst headache” ever.

Common indications of a ruptured aneurysm, in addition to a severe headache, include:

• Nausea and vomiting
• Stiff neck
• Double or blurry vision
• Sensitivity to light
• Seizure
• A drooping eyelid
• Consciousness loss
• Confusion

Leaking Aneurysm

Aneurysms sometimes leak blood. This leak will only lead to sudden and excruciating headaches.The leak is often followed by a more serious fracture.

Unruptured Aneurysm

Particularly if it’s small, a brain aneurysm that hasn’t ruptured may not show any symptoms. A larger unruptured aneurysm, however, may put pressure on the brain’s structures and neurons, potentially leading to:

• Discomfort behind and above one eye
• a dilated pupil
• Eyesight changes or double vision
• One half of the face is numb.

Causes

A weakening in the brain’s blood vessel walls is what leads to brain aneurysms. Though the precise cause isn’t often obvious, there are several potential explanations for why this might occur.

The primary blood veins that travel up the neck and into the brain must carry a lot of blood to the brain.

Similar to how a tree’s trunk develops into branches and twigs, these blood arteries branch out into progressively smaller vessels.

Because these regions are frequently weaker, the spots where the blood arteries divide and branch off are where the majority of aneurysms form.

Increased Risk

A variety of factors can impact your chance of getting a brain aneurysmchance of getting a brain aneurysm can be affected by a variety of factors. These are covered in this.

Smoking

Your risk of getting a brain aneurysm might be considerably increased by smoking cigarettes.

According to studies, the majority of those who have been diagnosed with a brain aneurysm currently smoke or have in the past. People with a family history of brain aneurysm are particularly at risk. It is unclear why smoking raises the risk of brain aneurysms. It’s possible that the toxic components in cigarette smoke affect the blood vessel walls.

High Blood Pressure

Your risk of developing an aneurysm may increase if you have high blood pressure because it can put more pressure on the walls of the blood vessels inside your brain.

High blood pressure is more likely to occur in you if you:

• Obese and/or have blood pressure
• Consume a lot of salt, little fruits and vegetables, little physical activity, and lots of Coffee or other caffeinated beverages.
• Consumption of alcohol
• Older than 65

Prevention

Once your doctor finds an aneurysm, it’s very unlikely that it’ll heal on its own. The good news is you can take efforts to stop it from developing or leaking. You can also take the following actions to lessen your risk of developing a new aneurysm:

• Stop smoking.
• Eat a balanced diet.
• Regular exercise and avoiding heavy lifting all the time (stick with moderate exercise).
• Maintain control of your high blood pressure with medication and lifestyle adjustments.

Diagnosis

Angiography is the most common method used to diagnose a brain aneurysm.. An X-ray technique called angiography is used to examine blood vessels.

This includes inserting a needle, generally in the groin, through which a small tube called a catheter can be directed into one of your blood veins.

• Local anaesthetic is used where the needle is inserted so that you won’t feel any pain.
• Guided by a series of X-rays displayed on a monitor, the catheter is carefully advanced into the neck’s blood vessels that deliver blood to the brain.
• Once the catheter is in position, a special dye is injected through it into the arteries of the brain.
• Magnetic resonance angiography (MRI scans) is usually used to look for brain aneurysms that have not ruptured. This imaging technique uses magnetic energy and radio signals to capture clear, detailed pictures of the brain’s structure.
• CT angiography is generally recommended when a ruptured aneurysm is suspected and bleeding in the brain, known as a subarachnoid haemorrhage, is present.
• During this scan, multiple X-ray images are captured and then combined by a computer to form a detailed three-dimensional image.
• In some cases, a ruptured aneurysm may not be detected on a CT scan. If the CT scan shows no signs of bleeding but your symptoms indicate a possible ruptured aneurysm, doctors may perform a lumbar puncture to confirm the diagnosis.

Treatment

Treatment for a brain aneurysm depends on whether it has ruptured or not. If the CT scan shows no abnormalities but your symptoms strongly indicate a ruptured aneurysm, a lumbar puncture is typically performed for confirmation.

1. Treatment for a Ruptured Aneurysm

A ruptured aneurysm is a medical emergency. It needs immediate treatment to stop bleeding and reduce the risk of another rupture. There are two main surgical methods used:

Surgical Clipping

In this procedure, a surgeon removes a small part of the skull to reach the aneurysm. A tiny metal device is secured at the bottom of the aneurysm to prevent blood from entering it. This prevents further bleeding and reduces the chance of another rupture. Most people recover within several weeks, but recovery time can vary based on the condition.

Endovascular Coiling

This is a less invasive option. The doctor introduces a narrow catheter into an artery in the wrist or groin and skillfully steers it toward the location of the aneurysm. Small soft coils are placed inside the aneurysm. These coils block blood flow and help form a clot that seals the aneurysm. Although safer for some people, there’s a small chance the aneurysm might reappear and need another treatment.

Flow Diversion

This treatment is often used for large or hard-to-reach aneurysms. A small mesh tube called a stent is positioned within the blood vessel next to the aneurysm. The stent helps divert blood flow away from the aneurysm, enabling it to heal on its own over time.

In some cases, additional procedures like angioplasty (to widen narrowed vessels) or shunt surgery (to drain extra fluid and relieve pressure in the brain) may be required.

Medicines can also help manage symptoms after a rupture.

• Pain relievers for headaches.
• Calcium channel blockers to prevent narrowing of blood vessels.
• Anti-seizure drugs if seizures occur.
• Vasodilator medicines to improve blood flow and reduce the risk of stroke. After recovery, some people may need rehabilitation therapy to regain physical, speech, or thinking skills.

2. Treatment for an Unruptured Aneurysm

If an aneurysm hasn’t ruptured, your doctor will decide whether treatment is needed. Some small aneurysms that don’t cause symptoms may only need regular check-ups and imaging tests.

Treatment may be recommended if:

• The aneurysm is large or growing.
• It causes symptoms.
• You have a family history of aneurysm rupture.

Options for treatment include surgical clipping, endovascular coiling, or flow diversion, depending on the aneurysm’s size, shape, and location.

Your healthcare team will also consider your age, overall health, and risk factors before recommending a procedure.

In certain situations, making lifestyle adjustments can lower the chances of an aneurysm rupturing. These include:

• Quitting smoking.
• Managing high blood pressure.
• Eating a balanced diet and exercising regularly.

Frequently Asked Questions