Some persons may be at risk of brain aneurysm if they have family members who has experienced one.

In addition, genetic and lifestyle factors that weaken the walls of blood vessels greatly increase the risk of aneurysm. Below are the general list of common risk factors for aneurysm:

• genetic conditions that weaken blood vessels, including polycystic kidney disease, some connective tissue disorders, and arteriovenous malformations (AVM)
• a close family member, such as a parent, child, or sibling, having an aneurysm
• brain aneurysms are more common in females than in males and more likely to affect adults between 30 and 60 years old.
• uncontrolled high blood pressure
• drug use disorder, particularly that involving drugs that raise blood pressure, such as amphetamines and cocaine
• using illicit drugs intravenously
• smoking
• a brain tumor
• head injuries
• infections in the arteries

The Diagnosis

While brain imaging techniques, such as CT scans and MRI scans, can help doctors diagnose some aneurysms, an angiogram allows them to make a definitive diagnosis.

To perform a cerebral angiogram, a doctor will insert a small, thin tube called a catheter into a blood vessel in the groin and direct it into the blood vessels of the brain under X-ray guidance. There, they will inject a dye that makes it easier to see the blood vessels and any unusual structures.

An angiogram can help the doctor assess the size and severity of the aneurysm, as well as it’s type. This information helps them make appropriate treatment recommendations. Let’s now consider some treatment options available for aneurysm.

The treatment procedures

Not all brain aneurysms require immediate treatment. If the aneurysm is small, a doctor may recommend monitoring it over time.

The best treatment option will depend on the following factors:

• the person’s age
• any neurological or medical conditions
• whether the aneurysm has ruptured
• the risk of the aneurysm rupturing
• any family history of subarachnoid hemorrhage

A person with a family or personal history of aneurysm rupture may need treatment even if the aneurysm is small.

A doctor may recommend an endovascular procedure or surgery to treat the aneurysm.

Endovascular procedure

During an endovascular procedure, a surgeon inserts a catheter through the groin, then navigates to the aneurysm. After that, they will pack the aneurysm with metal coils or a stent to redirect the blood flow. Doing this stops blood from flowing into the aneurysm, which prevents rupture.

Surgery

Surgery for an aneurysm requires an operation on the brain, which will take place under general anesthesia. This procedure usually requires a person to spend several days in the hospital, and it may be necessary to shave the person’s head. During the operation, a surgeon clips the aneurysm to prevent blood from flowing into it.

After above treatment options, most aneurysms do not reoccur.

Additional options

• Platinum coil embolization:

This procedure is a less invasive procedure than microvascular surgical clipping.  A doctor will insert a hollow plastic tube (a catheter) into an artery, usually in the groin, and thread it through the body to the brain aneurysm.

Using a wire, the doctor will pass detachable coils (tiny spirals of platinum wire) through the catheter and release them into the aneurysm.  The coils block the aneurysm and reduce the flow of blood into the aneurysm. The procedure may need to be performed more than once during the person’s lifetime because aneurysms treated with coiling can sometimes recur.

• Flow diversion devices:

Other endovascular treatment options include placing a small stent (flexible mesh tube) similar to those placed for heart blockages, in the artery to reduce blood flow into the aneurysm.  A doctor will insert a hollow plastic tube (a catheter) into an artery, usually in the groin, and thread it through the body to the artery on which the aneurysm is located.

This procedure is used to treat very large aneurysms and those that cannot be treated with surgery or platinum coil embolization.

Other treatments

Other treatments for a ruptured cerebral aneurysm aim to control symptoms and reduce complications.  These treatments include:

• Antiseizure drugs (anticonvulsants). These drugs may be used to prevent seizures related to a ruptured aneurysm.

• Calcium channel-blocking drugs.  Risk of stroke by vasospasm can be reduced with calcium channel-blocking drugs.
• A shunt, which funnels cerebrospinal fluid from the brain to elsewhere in the body, may be surgically inserted into the brain following rupture if the buildup of cerebrospinal fluid (hydrocephalus) is causing harmful pressure on surrounding brain tissue.

Rehabilitative therapy.   Individuals who have suffered a subarachnoid hemorrhage often need physical, speech, and occupational therapy to regain lost function and learn to cope with any permanent disability.

However, some treatment options for complex medical conditions such as aneurysm come with some risks too. The next section considers the risk and possible complications that may occur.

The risks an complications  commonly associated with treatment

Both endovascular treatment and brain surgery come with risks, including:

• heart or lung damage
• stroke
• surgical complications, such as infection
• death
• surgery failure that makes further treatment necessary

Complications

An unruptured aneurysm typically does not cause  any complications. However, a ruptured aneurysm can cause serious, lasting health conditions, and it can be fatal.

Possible complications of a ruptured brain aneurysm include:

• hemorrhagic stroke, a type of stroke that occurs as a result of bleeding in the brain
• rebleeding, which happens when an aneurysm ruptures again
• changes in the sodium level in the brain, which may cause permanent brain damage
• vasospasm, a spasm that causes arteries to narrow, limiting blood flow to the brain and potentially causing serious brain damage or a stroke
• seizures
• hydrocephalus, which happens when cerebrospinal fluid accumulates in the brain, causing dangerous pressure that may damage this organ

In the next section, we will learn about some strategies that can help you reduce and prevent risk of having aneurysm.

Prevention strategies

A healthful lifestyle may help reduce the risk of a brain aneurysm.

Some aneurysms are not preventable. However, a healthful lifestyle can promote blood vessel health and reduce the risk of an aneurysm.

You can reduce your risk by using the following strategies:

• quitting smoking, if applicable
• abstaining from using drugs that elevate blood pressure
• avoiding or limiting medications that increase blood pressure, under the guidance of a doctor
• adopting a healthful lifestyle that includes a balanced diet and regular exercise
• talking to a healthcare professional about strategies to control blood pressure
• seeking advice on further strategies to reduce aneurysm risk if a first degree relative (a parent, child, or sibling) has had an aneurysm

Individuals who have unruptured aneurysms should talk to a doctor about how to minimize the risk of rupture. Ongoing monitoring can reduce this risk and guide a doctor’s treatment decisions. Is an aneurysm the same as stroke? Find the answer in the next section.

Differences between an aneurysm and stroke

An aneurysm is not a stroke, but it can cause one. When an aneurysm bursts, this deprives the brain of blood, potentially leading to a stroke.

The symptoms of a ruptured aneurysm and stroke are similar but not identical. While both cause neurological symptoms, such as dizziness or blurred vision, aneurysms also typically cause headaches.

Both conditions are serious medical emergencies that demand immediate treatment. Therefore, a person should see a doctor whether they have symptoms of an aneurysm, stroke, or both.

Summary

Family history, genetic and lifestyle factors that weaken the walls of blood vessels are common causes and risk factors of aneurysm.

People who experience subarachnoid hemorrhage may have permanent neurological damage.  Other individuals recover with little or no disability.

An angiogram can help the doctor assess the size and severity of the aneurysm, as well as it’s type. This information helps them make appropriate treatment recommendations.

Diagnosing and treating a cerebral aneurysm as soon as possible will help increase the chances of making a full recovery. Recovery from treatment or rupture may take weeks to months.

Book to link: The understanding of brain hemorrhage and aneurysm made simple.