Brain Aneurysm

(Cerebral Aneurysm; Intracranial Aneurysm; Intracerebral Aneurysm; Aneurysm, Brain; Aneurysm, Cerebral; Aneurysm, Intracranial; Aneurysm, Intracerebral)

Definition

An aneurysm is an outpouching of a blood vessel wall. This can occur anywhere there are blood vessels, including in the brain. The bulging, blood-filled pocket can put pressure on parts of the brain. In addition, the blood vessel can rupture (hemorrhage). Early detection and diagnosis may help prevent severe or fatal complications in some patients. Many aneurysms go unnoticed for a lifetime and cause no symptoms.
Brain Aneurysm
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Causes

Aneurysms form in areas where the artery wall becomes thin or weak. Thinning artery walls and resulting aneurysms can be caused by a number of factors. Common causes include:
  • Congenital (present at birth) weakness in artery wall
  • High blood pressure
  • Infection
  • Trauma or injury to the brain
  • Tumor
  • Plaque build-up on artery walls

Risk Factors

These factors increase your chance of developing a brain aneurysm. These risk factors also increase your chance of a rupture. Older adults are more likely to develop an aneurysm than children. Females are at slightly higher risk. Tell your doctor if you have any of these risk factors:

Symptoms

Symptoms may include:
  • Pain behind the eye
  • Numbness, sometimes on one side of the face or body
  • Weakness on one side of the body or face
  • Vision changes
  • Drooping eyelid
  • Differences between the size of the pupils
  • Speech impairment
Most aneurysms do not cause symptoms until they leak or rupture. A leaking or ruptured aneurysm may cause:
  • Headache
  • Nausea
  • Vomiting
  • Stiff neck
  • Confusion or sleepiness
  • Loss of consciousness
  • Seizures

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Tests may include the following:

Treatment

Talk with your doctor about the best treatment plan for you. Other medical conditions; lifestyle factors; as well as the type, size, and location of the aneurysm will direct treatment. For a known aneurysm that is not leaking or ruptured, treatment options include the following:

Monitoring

Your doctor may need to monitor you to see if the aneurysm gets larger or begins to leak.

Medicines

Medications are not used to fix an aneurysm. Medications may be used to help lower blood pressure, treat pain, or stop side effects of the aneurysm, such as seizures.

Endovascular Embolization

During this procedure, a catheter is thread up to the aneurysm. Coils, a special liquid, or balloons are used to fill the aneurysm and stop circulation, causing it to clot. This may need to be done more than once.

Surgery

Surgical options include:
  • Microvascular clipping—A neurosurgeon cuts off blood flow to the aneurysm.
  • Microvascular occlusion—A neurosurgeon clamps off the entire artery leading to the aneurysm. Sometimes a bypass procedure (rerouting a new blood vessel) is done too.

Prevention

In many cases, there is no known way to prevent an aneurysm from forming. To help reduce your chances of getting a brain aneurysm or having it burst, take the following steps:
  • Control high blood pressure.
  • If you smoke, talk to your doctor about ways to quit.
  • Do not use illegal drugs.
  • Discuss with your doctor:
    • Benefits and risks of oral contraceptives
    • Whether it is safe to use daily aspirin or other pain medications that may thin the blood

RESOURCES

The Brain Aneurysm Foundation
http://www.bafound.org

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES

Brain Injury Association of Alberta
http://www.biaa.ca

Heart and Stroke Foundation Canada
http://www.heartandstroke.ca

References

NINDS cerebral aneurysms information page.National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/cerebral%5Faneurysm/cerebral%5Faneurysms.htm. Updated February 23, 2015. Accessed March 11, 2015.

Vlak M, Rinkel, Gabriel J, et al. Trigger factors and their attributable risk for rupture of intracranial aneurysms: a case-crossover study. Stroke. 2011 May 5.

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