A brain (cerebral) aneurysm is a bulging, weak area in the wall of an artery that supplies blood to the brain. In most cases, a brain aneurysm causes no symptoms and goes unnoticed. In rare cases, the brain aneurysm ruptures, releasing blood into the skull and causing a stroke.
When a brain aneurysm ruptures, the result is called a subarachnoid hemorrhage. Depending on the severity of the hemorrhage, brain damage or death may result.
The most common location for brain aneurysms is in the network of blood vessels at the base of the brain called the circle of Willis.
A person may inherit the tendency to form aneurysms, or aneurysms may develop because of hardening of the arteries (atherosclerosis) and aging. Some risk factors that can lead to brain aneurysms can be controlled, and others can't. The following risk factors may increase your risk for an aneurysm or, if you already have an aneurysm, may increase your risk of it rupturing:
Most brain aneurysms cause no symptoms and may only be discovered during tests for another, usually unrelated, condition. In other cases, an unruptured aneurysm will cause problems by pressing on areas in the brain. When this happens, the person may suffer from severe headaches, blurred vision, changes in speech, and neck pain, depending on what areas of the brain are affected and how bad the aneurysm is.
Symptoms of a ruptured brain aneurysm often come on suddenly. If you have any of the following symptoms or notice them in someone you know, call 911 or other emergency services right away:
Because unruptured brain aneurysms often do not cause any symptoms, many are discovered in people who are being treated for a different condition.
If your doctor believes that you have a brain aneurysm, you may have the following tests:
The treatment options for a brain aneurysm depend on a few things. These things include your age, size and location of the aneurysm, any additional risk factors, and your overall health.
If you have an aneurysm with a low risk of rupture, you and your doctor may want to continue to observe your condition rather than do surgery. You might make this choice because surgery also has risks. Your doctor may suggest ways to keep your blood vessels as healthy as possible, such as managing high blood pressure and not smoking. If your aneurysm is large or causing pain or other symptoms, though, or if you have had a previous ruptured aneurysm, your doctor may recommend surgery.
The following procedures are used to treat both ruptured and unruptured brain aneurysms:
Both of these procedures should be done in a hospital where many procedures like these are done.
Some aneurysms bulge in such a way that the aneurysm has to be cut out and the ends of the blood vessel stitched together, but this is very rare. Sometimes the artery is not long enough to stitch together, and a piece of another artery has to be used.
Aneurysms that have bled are very serious. In many cases, they lead to death or disability. Management includes hospitalization, intensive care to relieve pressure in the brain and maintain breathing and vital functions (such as blood pressure), and treatment to prevent rebleeding.
Other Works Consulted
- Connolly ES Jr, et al. (2012). Guidelines for the management of aneurysmal subarachnoid hemorrhage: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. Published online May 3, 2012 (doi: 10.1161/STR.0b013e3182587839). Also available online: http://stroke.ahajournals.org/content/early/2012/05/03/STR.0b013e3182587839.full.pdf+html.
- Ropper AH, et al. (2014). Cerebrovascular diseases. In Adams and Victor's Principles of Neurology, 10th ed., pp. 778–884. York: McGraw-Hill Education.
- Thompson BG, et al. (2015). Guidelines for the management of patients with unruptured intracranial aneurysms: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 46(8): 2368–2400. DOI: 10.1161/STR.0000000000000070. Accessed August 22, 2015.
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