Brain Aneurysm

Overview

A brain aneurysm, also known as a cerebral aneurysm or intracranial aneurysm, is a bulge or ballooning in a blood vessel in the brain. It often looks like a berry hanging on a stem. Blood flow pressure on a weak area of the vessel wall can cause aneurysms to form and grow. If the aneurysm leaks or ruptures, it can lead to a subarachnoid hemorrhage, causing bleeding in the brain and potentially causing severe health issues or even death.

Understanding the disease

Symptoms

The symptoms of a brain aneurysm can vary depending on whether it is ruptured or unruptured. For a ruptured aneurysm, the key symptom is a sudden, severe headache, which is often described as the worst headache ever experienced. Other symptoms may include nausea and vomiting, stiff neck, blurred or double vision, sensitivity to light, seizure, drooping eyelid, confusion, and loss of consciousness. For a leaking aneurysm, symptoms may include a sudden, extremely severe headache that may last several days to two weeks. For an unruptured aneurysm, symptoms may include pain above and behind one eye, dilated pupil, change in vision or double vision, and numbness on one side of the face. If you experience a sudden, severe headache or any other symptoms mentioned, seek immediate medical attention.

Risk Factors

Risk factors for developing a brain aneurysm include:

1. Older age: Brain aneurysms can occur at any age, but they are more common in adults between ages 30 and 60.
2. Being female: Brain aneurysms are more common in women than in men.
3. Cigarette smoking: Smoking is a risk factor for brain aneurysms to form and for brain aneurysms to rupture.
4. High blood pressure: This condition can weaken arteries, making aneurysms more likely to form and rupture.
5. Drug use, particularly using cocaine: Drug use raises blood pressure and can lead to an infection, which can cause a mycotic aneurysm.
6. Heavy alcohol use: This also can increase blood pressure.
7. Inherited connective tissue disorders, such as Ehlers-Danlos syndrome: These disorders weaken blood vessels.
8. Family history: Having a parent, brother, sister, or child with an aortic aneurysm increases the risk of an aortic aneurysm and rupture. for genetic conditions and being exposed to radiation as risk factors for developing brain aneurysms.

Development

Brain aneurysms develop when there is a weak area in the wall of an artery in the brain. The aneurysm forms and grows as blood flow puts pressure on the weak area, causing it to balloon out. There are different types of brain aneurysms, such as saccular aneurysms (berry aneurysms) and fusiform aneurysms. Saccular aneurysms are the most common type and look like a round, blood-filled sac protruding from the main artery or one of its branches. Fusiform aneurysms cause bulging on all sides of the artery, while mycotic aneurysms are caused by an infection that weakens the artery wall.

Assessment and Diagnosis

Triage

If you suspect a brain aneurysm, it's important to see a doctor immediately. In the case of an unruptured brain aneurysm, you should make an appointment with your doctor. If you experience any symptoms associated with a ruptured aneurysm or a "leaking" aneurysm, seek emergency care right away. These symptoms include a sudden, severe headache, nausea and vomiting, stiff neck, blurred or double vision, sensitivity to light, seizure, drooping eyelid, loss of consciousness, and confusion. Remember that sudden, severe headaches can indicate a serious medical condition, so it's crucial to consult a doctor for proper evaluation and treatment.

Diagnosis

To diagnose a brain aneurysm, a series of tests and procedures are used, including:

1. CT scan: A specialized X-ray that produces 2D slices of the brain to detect bleeding in the brain or another type of stroke.
2. MRI scan: Uses magnetic fields and radio waves to create computerized images of the brain.
3. Angiogram: X-rays and a special dye are used to produce pictures of blood flow in the brain's blood vessels, providing more information if there is concern about a possible aneurysm or other blood vessel problem.
4. CT angiogram: Creates detailed images of the arteries providing blood flow in the brain by injecting dye to observe blood flow, and can detect the presence of an aneurysm.
5. Lumbar puncture (spinal tap): A procedure to draw cerebrospinal fluid from your back with a needle to detect the presence of red blood cells if you have symptoms of a ruptured aneurysm but a CT scan doesn't show evidence of bleeding. In general, screening for unruptured brain aneurysms using imaging tests is not recommended unless you are at high risk, such as having a family history of brain aneurysms or specific disorders that increase the risk of developing an aneurysm. Consult your healthcare provider to discuss the potential benefits of a screening test in your individual case.

Management and Treatment

Complications

Complications of a brain aneurysm can include re-bleeding, vasospasm, hydrocephalus, and brain damage due to reduced blood flow and oxygenation. Re-bleeding is a risk for aneurysms that have already ruptured or leaked, and it can cause further damage to brain cells. Vasospasm occurs when blood vessels in the brain narrow after a rupture, leading to reduced blood flow and potentially causing an ischemic stroke. Hydrocephalus is the buildup of fluid within the brain due to the blockage of cerebrospinal fluid flow caused by the blood from the ruptured aneurysm.

Home Remedies

It is important to note that brain aneurysms are serious medical conditions that require prompt medical attention. Home remedies are not a substitute for professional medical care, and self-diagnosis or self-treatment can be dangerous. If you suspect that you or someone you know may have a brain aneurysm, seek immediate medical attention.

Treatment

There are different treatments for brain aneurysms, depending on whether the aneurysm has ruptured or not. For a ruptured brain aneurysm, immediate medical treatment is necessary to prevent further bleeding and brain damage. Treatment options may include:

1. Surgical clipping: A neurosurgeon will place a metal clip on the aneurysm to stop blood flow into it. This is done by making an opening in the skull and locating the aneurysm.
2. Endovascular coiling: A less invasive procedure where a tiny coil is inserted through an artery in the groin and guided to the aneurysm. The coil is placed inside the aneurysm, which helps to seal it off and prevent further bleeding. For an unruptured brain aneurysm, treatment may be recommended to prevent it from rupturing in the future. Options may include:
3. Observation: If the aneurysm is small and stable, your healthcare provider may recommend periodic check-ups and monitoring without any immediate treatment.
4. Medications: Certain medications may be prescribed to control risk factors like high blood pressure, high cholesterol, or sleep apnea, which can contribute to aneurysm growth.
5. Surgical clipping or endovascular coiling: Depending on the size and location of the aneurysm, your healthcare provider may recommend surgical clipping or endovascular coiling to prevent rupture. It's essential to consult with your healthcare provider to determine the best treatment plan based on your specific situation and individual needs.

Preparing for medical consultation

To prepare for an appointment for a brain aneurysm, you should be aware of any pre-appointment restrictions and ask if there's anything you need to do in advance. Write down any symptoms you're experiencing, including those that may seem unrelated to a brain aneurysm. Also, prepare a list of key personal information, including any family history of heart disease, aneurysms, or connective tissue disease. Prepare a list of questions to ask your healthcare provider, such as the size, location, and overall appearance of the aneurysm, the likelihood of rupture, recommended treatment, and steps to lower the risk of rupture.