What You Should Know About Brain Aneurysms

A brain aneurysm (also known as a cerebral aneurysm) is a weak, bulging spot on the wall of an artery in the brain, and can be detected through non-invasive medical imaging tests, such as MRI or CT scans. According to the Brain Aneurysm Foundation, approximately 1 in 50 Canadians have unruptured brain aneurysms, while an estimated 2,800 to 3,500 Canadians will suffer from a burst (ruptured) aneurysm each year. There are as many as 500,000 deaths related to brain aneurysms on a global scale.

There are a number of reasons why brain aneurysms occur, which can include things like high blood pressure, atherosclerosis (a condition that causes plaque to build up and harden in the arteries), as well as trauma. The risk of developing a brain aneurysm also increases if you are a smoker, overweight or obese, over the age of 40, female, engage in illicit drug use, have an infection, have a brain tumour, are African American or Hispanic, or if you have other pre-existing health conditions such as Polycystic Kidney Disease, Ehlers-Danlos Syndrome, Marfan Syndrome, as well as Fibromuscular Dysplasia.

There are two types of brain aneurysms that can occur: Saccular or fusiform. A saccular aneurysm is the most common type, accounting for as many as 90% of subarachnoid hemorrhages. While the fusiform aneurysm is less common, and seldom ruptures. They also differ in shape. A saccular aneurysm often has a berry-like shape, with a neck and a stem, while a fusiform aneurysm looks like an expanded blood vessel. The other differences between unruptured and ruptured brain aneurysms is that one type may not cause symptoms, while the other will. The treatment options also vary when it comes to unruptured aneurysms. Things that are taken into consideration include whether or not there is a high risk of hemorrhage (i.e. if it’s likely to rupture), the size and location of the aneurysm, the current health status of the patient, their age, if there is a family history of brain aneurysms, and other factors.

While unruptured brain aneurysms are typically asymptomatic, there are some warning signs that you need to pay close attention to. For example, if you have a localized headache, if your pupils appear dilated, if your vision is blurred or double, if you have pain above or behind your eye, have trouble speaking, or experience weakness or numbness. In many cases, people who have a ruptured aneurysm will experience more sudden symptoms. For example, they may have a headache that is described as being the worst headache of their life, may have nausea of vomiting, stiff neck, sudden vision problems, sudden changes in mental status, sudden trouble walking, sudden dizziness, seizures, sensitivity to light, and loss of consciousness. If you experience any of these symptoms, you should seek immediate medical attention. Whether the brain aneurysm is ruptured or unruptured, it’s critical that you get an early diagnosis to prevent the hemorrhage from resulting in devastating and irreversible neurological outcomes — or worse — being fatal.

Once a brain aneurysm has been diagnosed, doctors will determine the best course of action for treatment. In some cases, doctors will choose to observe brain aneurysms that haven’t ruptured, while other treatment options can include open surgery, as well as endovascular coiling, which is a minimally invasive procedure in which a catheter is passed through the groin and up into the aneurysm in the brain. Platinum coils are then released. These coils embolize the aneurysm and prevent blood from getting to into it. This procedure can take anywhere from 1 and a half to 2 hours. Following the procedure, you can expect to stay in hospital for at least 24 hours, but may be able to return to normal activity as soon as 2 days later depending on your circumstances. It is important that you follow all post-operative instructions given to you by your doctors to ensure that you have a speedy and full recovery.

Originally published at alighahary.ca on December 3, 2018.



Dr. Ali Ghahary is a Family Physician in Vancouver, British Columbia, Canada. http://www.alighahary.ca

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