Brain Aneurysm - Symptoms, Causes, and Treatment

A Guide to Recognizing Brain Aneurysm Symptoms

A brain aneurysm may attack unexpectedly, often hiding in plain sight until it becomes a life-threatening crisis. While some aneurysms are silent, others give subtle hints that should not be overlooked. Being aware of brain aneurysm symptoms early on may be the difference between rapid recovery and severe complications, or worse.

From headaches to changes in vision, these warning signs warrant your undivided attention. Therefore, continue reading to know more about this disease.

What is a Brain Aneurysm?

A brain aneurysm is a bulge of a blood vessel within the brain, sometimes developing when high blood pressure erodes a part of the vessel wall. Also referred to as a cerebral or intracranial aneurysm, it may be silent or deadly if it leaks or ruptures and causes a hemorrhagic stroke, most frequently a subarachnoid haemorrhage.

Although most brain aneurysm symptoms are not prominent and do not lead to a medical emergency, a ruptured aneurysm is a medical emergency. Therefore, your doctors may suggest preventive treatment if the risks outweigh the benefits.

Here are the different types of brain aneurysms:

1. Saccular (Berry) Aneurysm

The saccular or berry aneurysm is the most frequent type of brain aneurysm. It derives its name from its shape, a berry attached to a stem.

2. Fusiform Aneurysm

A fusiform aneurysm consists of a symmetrical bulge around the entire circumference of a part of the artery. It is not stem-like in appearance, like the berry-shaped saccular aneurysm.

3. Mycotic Aneurysm

Mycotic aneurysms are infections, usually bacterial or fungal, of the arteries in the brain. The infections cause weakening of the walls of the arteries, resulting in the development of an aneurysm.

Symptoms of Brain Aneurysm

Brain aneurysm symptoms depend on whether the aneurysm is unruptured, leaking or ruptured. Here are the different symptoms for different types of brain aneurysms:

Signs of an Unruptured Aneurysm

Most unruptured aneurysms do not have symptoms. However, if they become larger or put pressure on the tissues around them, they may cause:

1. Pain Above or Around the Eye: Due to pressure on nerves behind the eye.
2. Dilated Pupil in a Single Eye: Reflects compression of nerves used to control the pupil.
3. Numbness of an Entire Side of the Face: Results from excessive pressure on facial nerves.
4. Double or Blurred Vision: Result of an interruption in the optic nerve function.
5. Headaches and Concentration Difficulty: Non-local brain pressure manifestations.
6. Loss of Balance or Coordination: An indicator that the aneurysm could impact motor pathways.

Signs of a Leaking Aneurysm

Rupturing brain aneurysm symptoms include a sudden, severe headache (sentinel headache), usually days before the rupture occurs. You should seek immediate medical assistance because this is an important warning sign.

Symptoms of a Ruptured Aneurysm

A ruptured aneurysm has a 40% mortality rate within 24 hours. Immediate ER care is vital. A ruptured aneurysm produces a severe and unbearable headache. Other symptoms that can lead to an emergency include:

1. Nausea and vomiting
2. Stiff neck or pain in the neck
3. Seizures or loss of consciousness
4. Sensitivity to light (photophobia)
5. Weakness of limbs or the body on one side
6. Sudden confusion or blurred vision
7. Cardiac arrest in advanced cases

Causes of Brain Aneurysm

Brain aneurysm symptoms include developing a bulge at points where arteries branch off, where the walls of the vessels are inherently weaker. Here are some factors that are the causes of this disease:

• Smoking: It is a high-risk factor. Toxic chemicals from tobacco may harm the walls of blood vessels, particularly in those with a genetic history of aneurysms.
• Hypertension: If you have hypertension, there can be extra strain on blood vessels, causing them to bulge. Moreover, there is a higher risk of this disease with improper diet, physical inactivity, heavy salt and alcohol intake and age.
• Family History: With a history of brain aneurysms, you are more likely to have this disease. However, this cause is not common.
• Age and Sex: These two are the most common contributing factors causing this disease. Aneurysms are more prevalent after the age of 40 and in females because of lower levels of estrogen after menopause.

Diagnosis and Screening of Brain Aneurysms

Brain aneurysm symptoms may be hard to diagnose unless they rupture. However, early diagnosis is vital to stop life-threatening consequences. Various sophisticated imaging methods and procedures are discussed below:

• Computerised Tomography (CT) Scan: It is usually the initial test when this disease is suspected. It generates cross-sectional images that may detect bleeding within the brain due to a ruptured aneurysm.
• CT Angiogram (CTA): The test is carried out by injecting a contrast dye through a vein to outline blood flow in brain arteries, identifying unruptured aneurysms or the extent of bleeding.
• Magnetic Resonance Imaging (MRI): An MRI uses magnetic fields and radio waves to create detailed pictures of the brain. A specialised MRI called an MR Angiogram (MRA) gives pictures of blood vessels and can identify aneurysms before they burst.
• Lumbar Puncture: If bleeding is suspected but does not appear on a CT scan, a lumbar puncture is done to test the cerebrospinal fluid for blood, suggesting a suspected rupture.
• Cerebral Angiogram: This is the most conclusive test. A doctor places a catheter in an artery and directs it to the brain, where dye is injected to create detailed pictures of the blood vessels and verify the location and size of the aneurysm.

Treatment of Brain Aneurysm

Treatment of a brain aneurysm varies based on its size, location, and whether it has ruptured. Here are the different treatment methods for brain aneurysms:

• Surgical Clipping: One of the most widely used treatments is surgical clipping, in which a neurosurgeon clips a small metal clip at the aneurysm base to prevent blood flow and rupture.
• Endovascular Coiling: This method is a less invasive alternative, in which a thin catheter is passed through the groin and advanced into the brain. Doctors place small platinum coils into aneurysms, promoting clotting and obstructing blood flow.
• Flow Diverters: Doctors insert flow diverters and stent-like devices into arteries to deflect blood away from aneurysms, facilitating the healing of the blood vessels.  
• Lifestyle Changes: One of the most important treatments is altering your lifestyle to a healthier one. With regular exercise, avoiding smoking and healthy eating, you can minimise the chances of a rupture.
• Non-operative Measures: If an aneurysm is small and unruptured, physicians can suggest careful monitoring with periodic imaging and risk management measures. However, intervention is typically required immediately for ruptured or larger aneurysms.
• Making Informed Decisions: Early symptoms of brain aneurysms can help patients avoid any medical emergencies. Doctors give nimodipine to prevent vasospasm after rupture.

Final Thoughts

Overall, brain aneurysms may attack silently, but awareness and watchfulness can be the difference between life and death. Awareness of the brain aneurysm symptoms and familiarity with the diagnostic and treatment facilities enable individuals to take early and effective action. Proactive action can make a big difference through lifestyle modification or medical intervention. Hence, awareness, early action, and assistance can save not just your life but the lives of the people you hold dear.