A small, balloon-shaped bulge on the wall of the blood vessels that supply blood to the brain is referred to as a brain aneurysm. These are weak spots in the walls of the blood vessels that get filled with blood. In most cases, aneurysms appear in the blood vessels at the base of the brain. These small sacs may remain without any symptoms for a long period and may not even be noticeable. In rare cases, aneurysms may leak or rupture. When rupture or leaking occurs, blood releases into the space between the brain and its covering. This condition is referred to as subarachnoid hemorrhage. This is a life-threatening situation that requires immediate medical attention. The major causes of this condition are heredity, thickening of artery walls, and aging.
The network of the blood vessels which is located at the base of the brain is the most common location where brain aneurysms occur. This network of blood vessels is known as the circle of willis.
Factors that Increase the Risk of Aneurysm
There are several other factors that are found to increase the risk of developing aneurysms. These factors include:
- History of aneurysms – Those who have previously experienced an aneurysm are at greater risk of developing others in the future.
- Family history – Those with a family history of aneurysms have an increased risk of developing this condition.
- Gender – Women are more likely to develop aneurysms as compared to men.
- High blood pressure – Hypertension increases the risk of rupture in aneurysms.
- Smoking – Smoking cigarettes is one of the common risk factors for developing aneurysms.
- Race – It has been observed that individuals of African American decent are at a higher risk of developing aneurysms.
In most cases, aneurysms are discovered during tests conducted for other medical conditions. Aneurysms may apply pressure on the surrounding areas causing headaches, slurred speech, neck pain, and blurred vision depending on the area of the brain affected.
When to Seek Medical Attention
If an individual is experiencing the symptoms listed below, it could indicate that they have a ruptured aneurysm. It is of extreme importance that this individual seeks medical assistance right away if the following symptoms are displayed:
- Sudden severe headache
- Pain in the neck
- Sensitivity to light
- Loss of consciousness
- Feelings of confusion
- Eyelid drooping
As previously mentioned, an individual suffering from a brain aneurysm will not show any symptoms of the condition or the symptoms will go unnoticed. Aneurysms are usually discovered when tests are performed for other conditions. If a ruptured aneurysm is present, it can be identified by pressing on areas in the brain. In such cases, people will complain of severe headaches, sudden changes in speech, vision issues, and pain in the neck. The symptoms that occur are usually based on which part of the brain that is affected and how severe the condition is. When an individual is suffering from a brain aneurysm, it will come on suddenly.
Diagnosis of Brain Aneurysm
If a doctor believes that a brain aneurysm is present, they may suggest that the following tests be conducted:
- Computed tomography scan (CT scan): Using a CT scan, the doctor can detect bleeding in the brain. If the doctor suspects a ruptured aneurysm, they can use a lumbar puncture.
- Computed tomography angiogram scan (CTA scan): The CTA scan is one of the most precise methods of evaluating the blood vessels. In a CTA scan, the combination of special computing techniques, CT scanning, and contrast material (Dye) is used to produce images of the blood vessels.
- Magnetic resonance angiography (MRA): This test uses a magnetic field and radio wave energy pulses to provide images of blood vessels within the body. A dye is often used while carrying out an MRA. This dye helps make the blood vessels more visible; thus, helping to better diagnose the presence of a brain aneurysm.
- Cerebral angiogram: To carry out a cerebral angiogram, the doctor will insert a catheter through the blood vessel located in the groin or arm. This catheter is then eased upwards through the vessel in the brain. Prior to inserting the catheter, a dye is injected into the cerebral artery. If there are any problems in the artery, including aneurysm, the dye will help this issue be clearly displayed on the X-ray. Though this test is considered riskier than others, it is far better in locating even the smallest aneurysm in the brain.
Treatment of Brain Aneurysm
The treatment for a brain aneurysm is based on the health condition of the patient, age, and size of aneurysm. If the bulging is large and applies pressure in the surrounding areas, causing other symptoms, surgery may be suggested. In one of the surgical procedures, a small metal clip is placed at the base of the aneurysm to isolate it and to prevent it from rupturing. In a less invasive procedure, small metal coils are placed in the aneurysm to relieve the pressure and stop it from breaking. However, if there are no symptoms and your doctor believes that your aneurysm is not at risk of rupture, they may simply monitor the condition rather than recommend a specific treatment.
In some instances, the aneurysm may bulge in such a way that it would need to be cut off. Once this extraction is complete, those ends of the blood vessels would be stitched together. However, this is a rare occurrence. Sometimes, the artery is not long enough for both end to be stitched together. In such cases, a piece of the other artery is taken for stitching the ends.
If the aneurysm were to begin bleeding, it is a serious matter and often leads to a lifetime disability or death. In such instances, the main aim of the healthcare provider and staff would be to relieve pressure off the brain, maintain regular breathing, stabilize other vital functions, and avoid bleeding instances.
Risk Factors of Brain Aneurysm
There are several risk factors which are known to contribute to the weakening of the artery wall; thus, leading to an increased risk of developing a brain aneurysm. This condition is more often found in adults than children. It is also more commonly found in women than in men. Below are some of the factors that increase the risk of brain aneurysm development:
- Head injury
- Certain types of blood infections
- Hypertension or high blood pressure
- Alcohol consumption
- Use of cocaine or other drug abuse
- Arteriosclerosis or hardening of the arteries
- Dip in estrogen levels due to menopause or any other hormonal changes.
Below are the risk factors which can develop at birth:
- Abnormally narrow aorta – This means that there is a coarctation of the aorta. This is the large blood vessel which delivers blood, rich in oxygen, from the heart to the body.
- Inherited connective tissue disorders – One such syndrome of inherited connective tissue disorder is called Ehlers-Danlos syndrome, which often tends to weaken the blood vessels.
- Family history of brain aneurysm – This is a common concern when someone is affected with this medical condition. It is often related to either the parents or siblings.
- Polycystic kidney disease – This is an inherited disorder in which clusters of cysts form in the kidneys.
- Cerebral arteriovenous malformation (AVM) – This refers to a tangle of abnormal blood vessels connecting veins and arteries in the brain. These arteries are responsible for transporting oxygen-rich blood from the heart to the brain.
Complications of Brain Aneurysm
A brain aneurysm can create severe complications if it is not detected in time. When there is a rupture in the aneurysm, the bleeding caused due to this rupture would only last for few seconds; however, it would cause direct damage to the surrounding cells and would potentially even destroy those cells. Apart from this damage, the blood enters the skull and can put pressure inside the cranium. If the pressure becomes too elevated, it can lead to disruption in the supply of blood and oxygen to the brain. This can result in loss of consciousness or, in severe cases, lead to the affected individual dying instantly.
Complications of Ruptured Aneurysm
Below are a few complications which could develop due to a ruptured aneurysm:
- Hydrocephalus – When there is a rupture in the brain that results in bleeding in the space between the brain and its surrounding tissues, which is the case most often, this blood can cause a blockage of the circulation of fluid which surrounds the spinal cord and brain. This condition can lead to further damage in the tissues since the excess of cerebrospinal fluid can increase pressure on the brain.
- Re-bleeding – If there is an aneurysm which has leaked or ruptured, it can also cause re-bleeding again. This can further lead to damage of brain cells.
- Vasospasm – The blood vessels which are present in the brain can tend to narrow erratically after the rupture. This medical condition can limit the flow of blood to the brain cells, leading to additional cell loss and damage.