Aneurysm in the brain
Aneurysm - cerebral; Cerebral aneurysm; Aneurysm - intracranialAn aneurysm is a weak area in the wall of a blood vessel that causes the blood vessel to bulge or balloon out. When an aneurysm occurs in a blood vessel of the brain, it is called an intracranial aneurysm. These usually occur around or under the part of the brain called the cerebrum and, when this is true, are called a cerebral aneurysm.
Causes
Aneurysms around the brain occur when there is a weakened area in the wall of a blood vessel. An aneurysm may be present from birth (congenital). Or, it may develop later in life.
Aneurysms
An aneurysm is an abnormal widening or ballooning of a part of an artery due to weakness in the wall of the blood vessel.
Read Article Now Book Mark ArticleThere are many types of brain aneurysms. The most common type is called a berry aneurysm. This type can vary in size from a few millimeters (mm) to over a centimeter (cm). Giant berry aneurysms can be bigger than 2.5 cm or 1 inch (in). These are more common in adults. Berry aneurysms, especially when there is more than one, are sometimes passed down through families.
Other types of cerebral aneurysms involve widening of an entire blood vessel (fusiform aneurysms). Aneurysms can occur in any blood vessel that supplies the brain. Hardening of arteries (atherosclerosis), trauma, and infection can all injure the blood vessel wall and cause cerebral aneurysms.
Atherosclerosis
Atherosclerosis, sometimes called "hardening of the arteries," occurs when fat, cholesterol, and other substances build up in the walls of arteries. ...
Read Article Now Book Mark ArticleBrain aneurysms are relatively common. One in 50 people has a brain aneurysm, but only a small number of these aneurysms cause symptoms or rupture.
Risk factors include:
- Family history of cerebral aneurysms
- Medical problems such as polycystic kidney disease, coarctation of the aorta, and endocarditis
Polycystic kidney disease
Polycystic kidney disease (PKD) is a kidney disorder passed down through families. In this disease, many cysts form in the kidneys, causing them to ...
Read Article Now Book Mark ArticleCoarctation of the aorta
The aorta is a larger artery that carries blood from the heart to the vessels that supply the rest of the body with blood. If part of the aorta is n...
Read Article Now Book Mark ArticleEndocarditis
Endocarditis is inflammation of the inside lining of the heart chambers and heart valves (endocardium). It is caused by a bacterial or, rarely, a fu...
Read Article Now Book Mark Article - High blood pressure, smoking, alcohol, and cocaine, methamphetamine, or amphetamine drug use
Symptoms
A person may have an aneurysm without having any symptoms. This kind of aneurysm may be found when an MRI or CT scan of the brain is done for another reason.
A brain aneurysm may begin to leak a small amount of blood. This may cause a severe headache that a person may describe as "the worst headache of my life." It may be called a thunderclap or sentinel headache. This means the headache could be a warning sign of a future rupture that may occur days to weeks after the headache first started.
Headache
A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are rare. Most people with headaches can feel much better...
Read Article Now Book Mark ArticleSymptoms may also occur if the aneurysm pushes on nearby structures in the brain or breaks open (ruptures) and causes bleeding into the brain.
Symptoms depend on the location of the aneurysm, whether it breaks open, and what part of the brain it is pushing on. Symptoms may include:
- Double vision
- Loss of vision
- Headaches
- Eye pain
- Neck pain
- Stiff neck
- Ringing in the ears
Ringing in the ears
Tinnitus is the medical term for "hearing" noises in your ears. It occurs when there is no outside source of the sounds. Tinnitus is often called "r...
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A sudden, severe headache is one symptom of an aneurysm that has ruptured. Other symptoms of an aneurysm rupture may include:
- Confusion, no energy, sleepiness, or stupor
No energy
Fatigue is a feeling of weariness, tiredness, or lack of energy.
Read Article Now Book Mark ArticleSleepiness
Drowsiness refers to feeling more sleepy than normal during the day. People who are drowsy may fall asleep when they do not want to or at times whic...
Read Article Now Book Mark ArticleStupor
Decreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...
Read Article Now Book Mark Article - Eyelid drooping
Eyelid drooping
Ptosis (eyelid drooping) in infants and children is when the upper eyelid is lower than it should be. This may occur in one or both eyes. Eyelid dr...
Read Article Now Book Mark Article - Headaches with nausea or vomiting
- Muscle weakness or difficulty moving any part of the body
Muscle weakness
Weakness is reduced strength in one or more muscles.
Read Article Now Book Mark Article - Numbness or decreased sensation in any part of the body
Numbness
Numbness and tingling are abnormal sensations that can occur anywhere in your body, but they are often felt in your fingers, hands, feet, arms, or le...
Read Article Now Book Mark Article - Problems speaking
- Seizures
Seizures
A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...
Read Article Now Book Mark Article - Stiff neck (occasionally)
- Vision changes (double vision, loss of vision)
- Loss of consciousness (coma)
Coma
Decreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...
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NOTE: A ruptured aneurysm is a medical emergency. Call 911 or the local emergency number.
Exams and Tests
An eye exam may show signs of increased pressure in the brain, including swelling of the optic nerve or bleeding into the retina of the eye. A clinical exam may show abnormal eye movement, speech, strength, or sensation.
The following tests may be used to diagnose an intracranial or cerebral aneurysm and determine the cause of bleeding in the brain:
- Cerebral angiography or spiral CT angiogram (CTA) of the head to show the location and size of the aneurysm
Cerebral angiography
Cerebral angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the brain.
Read Article Now Book Mark ArticleCT angiogram
CT angiography (CTA) combines a CT scan with the injection of dye. CT stands for computed tomography. This technique is able to create pictures of ...
Read Article Now Book Mark Article - Spinal tap
Spinal tap
Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...
Read Article Now Book Mark Article - CT scan of the head
CT scan of the head
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
Read Article Now Book Mark Article - Electrocardiogram (ECG)
Electrocardiogram
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
Read Article Now Book Mark Article - MRI of the head or MRI angiogram (MRA)
MRI of the head
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
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Treatment
Two common methods are used to repair a brain aneurysm.
Repair a brain aneurysm
Brain aneurysm repair is surgery to correct an aneurysm in or near the brain. This is a weak area in a blood vessel wall that causes the vessel to b...
Read Article Now Book Mark Article- Clipping is done during open brain surgery (craniotomy).
Brain surgery (craniotomy)
Brain surgery is an operation to treat problems in the brain and surrounding structures.
Read Article Now Book Mark Article - Endovascular repair is most often done. It usually involves placing a very small coil and possibly a stent (called coiling and stenting) into or around the aneurysm. This is a less invasive and most common way to treat aneurysms.
Not all aneurysms need to be treated right away. Those that are very small (less than 3 mm or 0.12 in) are less likely to break open.
Your health care provider will help you decide whether or not it is safer to have surgery to block off the aneurysm before it can break open. Sometimes people are too ill to have surgery, or it may be too dangerous to treat the aneurysm because of its location.
A ruptured aneurysm is an emergency that needs to be treated right away. Treatment may involve:
- Being admitted to a hospital's intensive care unit (ICU)
- Complete bed rest and activity restrictions
- Drainage of blood from the brain area (cerebral ventricular drainage)
- Medicines to prevent seizures
- Medicines to control headaches and blood pressure
- Medicines to prevent vasospasm, which is a constriction of the arteries of your brain, leading to decreased blood flow
Once the aneurysm is repaired, treatment may be needed to prevent a stroke from a blood vessel spasm.
Outlook (Prognosis)
How well you do depends on many things. People who are in a deep coma after an aneurysm rupture do not do as well as those with less severe symptoms.
Ruptured cerebral aneurysms are often deadly. Of those who survive, some have no permanent disability. Others have moderate to severe disability.
Possible Complications
Complications of aneurysm in the brain may include:
- Increased pressure inside the skull
- Hydrocephalus, which is caused by an accumulation of cerebrospinal fluid in the ventricles of the brain
Hydrocephalus
Hydrocephalus is a buildup of fluid inside the skull that leads to the brain pushing against the skull. Hydrocephalus means "water on the brain. "...
Read Article Now Book Mark Article - Loss of movement in one or more parts of the body
- Loss of sensation of any part of the face or body
- Seizures
- Stroke
Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
Read Article Now Book Mark Article - Subarachnoid hemorrhage (bleeding around the brain)
Subarachnoid hemorrhage
Subarachnoid hemorrhage is bleeding in the area between the brain and the thin tissues that cover the brain. This area is called the subarachnoid sp...
Read Article Now Book Mark Article - Intracerebral hemorrhage (bleeding in the brain)
When to Contact a Medical Professional
Go to the emergency room or call 911 or the local emergency number if you have a sudden or severe headache, especially if you also have nausea, vomiting, seizures, or any other nervous system symptom.
Also call if you have a headache that is unusual for you, especially if it is severe or your worst headache ever.
Prevention
There is no known way to prevent a berry aneurysm from forming. Treating high blood pressure may reduce the chance that an existing aneurysm will rupture. Controlling risk factors for atherosclerosis may reduce the likelihood of some types of aneurysms.
High blood pressure
Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...
Read Article Now Book Mark ArticlePeople who are known to have an aneurysm may need regular visits with their provider to make sure the aneurysm is not changing size or shape.
If unruptured aneurysms are discovered in time, they can be treated before causing problems or monitored with regular imaging (usually yearly).
The decision to repair an unruptured cerebral aneurysm is based on the size and location of the aneurysm, and the person's age and general health.
References
American Stroke Association website. What you should know about cerebral aneurysms. www.stroke.org/en/about-stroke/types-of-stroke/hemorrhagic-strokes-bleeds/what-you-should-know-about-cerebral-aneurysms. Updated December 5, 2018. Accessed June 6, 2024.
National Institute of Neurological Disorders and Stroke website. Cerebral aneurysms. www.ninds.nih.gov/health-information/disorders/cerebral-aneurysms. Updated July 19, 2024. Accessed September 6, 2024.
Szeder V, Tateshima S, Jahan R, Saver JL, Duckwiler GR. Intracranial aneurysms and subarachnoid hemorrhage. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 67.
Thompson BG, Brown RD Jr, Amin-Hanjani S, et al. Guidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2015:46(8):2368-2400. PMID: 26089327 pubmed.ncbi.nlm.nih.gov/26089327/.
Cerebral aneurysm - illustration
An aneurysm is a sac-like protrusion of an artery caused by a weakened area within the vessel wall. If a cerebral (brain) aneurysm ruptures, the escaping blood within the brain may cause severe neurologic complications or death. A person who has a ruptured cerebral aneurysm may complain of the sudden onset of the worst headache of my life.
Cerebral aneurysm
illustration
Cerebral aneurysm - illustration
Weakness, numbness, or other loss of nerve function may indicate that an aneurysm may be causing pressure on adjacent brain tissue. Symptoms such as a severe headache, nausea, vomiting, vision changes or other neurological changes can indicate the aneurysm has ruptured and is bleeding into the brain. A ruptured intracranial aneurysm causes intracranial bleeding and is considered very dangerous.
Cerebral aneurysm
illustration
Cerebral aneurysm - illustration
An aneurysm is a sac-like protrusion of an artery caused by a weakened area within the vessel wall. If a cerebral (brain) aneurysm ruptures, the escaping blood within the brain may cause severe neurologic complications or death. A person who has a ruptured cerebral aneurysm may complain of the sudden onset of the worst headache of my life.
Cerebral aneurysm
illustration
Cerebral aneurysm - illustration
Weakness, numbness, or other loss of nerve function may indicate that an aneurysm may be causing pressure on adjacent brain tissue. Symptoms such as a severe headache, nausea, vomiting, vision changes or other neurological changes can indicate the aneurysm has ruptured and is bleeding into the brain. A ruptured intracranial aneurysm causes intracranial bleeding and is considered very dangerous.
Cerebral aneurysm
illustration
Review Date: 5/10/2024
Reviewed By: Luc Jasmin, MD, Ph.D., FRCS (C), FACS, Department of Neuroscience, Guam Regional Medical City, Guam; Department of Surgery, Johnson City Medical Center, TN; Department of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.