Each time a public figure unexpectedly dies from a brain aneurysm, the news is jarring and upsetting, and it is almost impossible not to feel somewhat paranoid. After all, aneurysms seem often to occur out of nowhere.
According to the National Institute of Neurological Disorders and Stroke, a brain aneurysm (frequently referred to as a cerebral aneurysm) is a weak spot on a brain artery that balloons out and then fills with blood. If the bulging aneurysm puts pressure on the brain tissue or nerves, it could rupture and spill blood into surrounding tissue, a phenomenon known as hemorrhage. A ruptured aneurysm can cause critical health problems, including brain damage, hemorrhagic stroke, coma, or even death.
Two doctors explain the likelihood of a frightening health issue like this happening, the risk factors, and any possible warning signs.
How common are brain aneurysms?
“It’s difficult to know how common cerebral aneurysms are, as most are found postmortem, but studies estimate between 0.2% and 8%,” said cardiologist with Manhattan Cardiology and contributor to Lab Finder, Dr. Karishma Patwa.
The Brain Aneurysm Foundation reports that 1 in 50 people in the United States has an intact or unruptured aneurysm (an aneurysm in the brain that has not stopped bleeding). However, the annual rate of an aneurysm rupturing is not as common — occurring in approximately every 8 to 10 per 100,000 people — responsible for 3% to 5% of all new strokes. Aneurysms in the brain are most common in adults ages 30 to 60 and are more likely to affect women instead of men, according to the National Institute.
“Overall, the vast majority of brain aneurysms have no symptoms and do not rupture,” said the director of the Cedars-Sinai Neurovascular Center, Dr. Michael Alexander. According to the Brain Aneurysm Foundation, the majority of aneurysms are small, about one-eighth inch to almost 1 inch, and an estimated 50% to 80% of all aneurysms don’t ever rupture.
What causes a brain aneurysm?
According to Dr. Patwa, the cause of aneurysm is multifactional. “There seems to be an interaction between hypertension, coronary artery disease, and a genetic predisposition to congenital diseases that are associated with vascular abnormalities,” the doctor explained.
Alexander adds that since most ruptures of brain aneurysms are spontaneous and there is no actual cause, “Although there can be a hereditary risk, most [ruptured] aneurysms occur with no apparent genetic component.”
Patwa notes that adults with specific genetic conditions, including Marfan syndrome, polycystic kidney disease, lupus, or Ehlers-Danlos, can have a higher risk of developing a brain aneurysm.
“Smoking and uncontrolled high blood pressure are suspected to increase the risk for aneurysm growth and rupture but do not cause the aneurysm,” Alexander explains. Hypertension makes blood push harder against the walls of blood vessels, and specific circumstances — a sudden burst of anger, ongoing stress, struggling to carry, lift, or move heavy objects — can raise blood pressure that is unmanaged even more as well as possibly result in a ruptured aneurysm, says the Cleveland Clinic.
Additional risk factors that can weaken the walls of arteries and may contribute to the development of a brain aneurysm include illegal substance abuse (usually cocaine), obesity, and excessive alcohol consumption, says Patwa.
Are there warning signs?
Small aneurysms that are a stable size usually don’t produce any symptoms. “However, if aneurysms are growing, patients may experience sudden headaches, nausea, vomiting, and loss of consciousness,” Patwa says. “Unfortunately, some large aneurysms produce no symptoms at all.”
Additional possible signs of a non-ruptured brain aneurysm include a gradual loss of vision, a droopy eyelid on one side, problems with walking or balance, or enlarged pupils, said Alexander. “However, if any aneurysm bleeds or ruptures, the symptoms are not subtle,” he said. “A ruptured aneurysm may cause the worst headache of a person’s life — and it may last a few weeks.” It can also cause “sensitivity of the eyes to light, neck stiffness — like with meningitis — and sometimes nausea and vomiting,” said Alexander.
Can a brain aneurysm be treated?
If a brain aneurysm is suspected, it can be diagnosed with imaging exams, including CT scans (x-rays that can show brain bleeding), an MRS (magnetic resonance angiography, a type of MRI that examines blood vessels), and an MRI (magnetic resonance imaging, creating a detailed image of the brain), according to Brigham and Women’s Hospital. “If an aneurysm that has ruptured is detected, treatment will focus on reducing the risk of rupture and possibly surgery to prevent rupture,” said Patwa.
Patwa notes that whether or not an aneurysm ruptures depends on its location and size, along with the general health of a patient. Unfortunately, both Alexander and Patwa say the prognosis for a brain aneurysm that has ruptured is bleak. When it ruptures, there is a 50% to 60% chance of death, with almost 25% occurring within the first 24 hours.
Suppose there is a possibility that you or a loved one is experiencing a cerebral aneurysm that has ruptured. In that case, Patwa stresses the importance of calling 911 immediately and getting to the emergency room to undergo early and rapid imaging.
According to Patwa, “Once diagnosed, patients will be immediately stabilized and sent for emergency surgery with either surgical clipping,” — where a neurosurgeon places a metal clip to stop blood flow — “or endovascular coiling” — where a catheter is threaded through blood vessels to act as a stent to the aneurysm.
