A brain aneurysm, also known as a cerebral or intracranial aneurysm, is a weakened area in the wall of a blood vessel in the brain that becomes abnormally enlarged or balloon-like.
Many brain aneurysms remain small and may never cause symptoms. However, an aneurysm can sometimes grow, leak, or rupture. A ruptured brain aneurysm can cause bleeding around the brain, known as subarachnoid hemorrhage (SAH), which is a life-threatening medical emergency requiring immediate treatment.
Early diagnosis and appropriate management are important, particularly when an aneurysm has characteristics that increase the risk of rupture.
What Causes a Brain Aneurysm?
A brain aneurysm develops when a weakened portion of a blood vessel wall becomes enlarged. The exact cause is not always known.
Several factors may increase the risk of developing a brain aneurysm, including:
- High blood pressure
- Smoking
- Family history of brain aneurysm
- Certain inherited conditions affecting blood vessels
- Atherosclerosis and other vascular conditions
- Previous significant head injury in some cases
- Certain infections or inflammatory conditions affecting blood vessels
Having one or more risk factors does not necessarily mean that a person will develop an aneurysm.
Symptoms of an Unruptured Brain Aneurysm
Many unruptured brain aneurysms do not produce any symptoms and may be discovered incidentally during brain imaging performed for another reason.
However, a larger aneurysm may sometimes press against nearby nerves or brain structures and cause:
- Pain around or behind the eye
- Visual disturbances
- Double vision
- Drooping of an eyelid
- Numbness or weakness affecting part of the face
- Difficulty moving an eye
- Headache or other neurological symptoms
The symptoms depend largely on the aneurysm’s size and location.
Symptoms of a Ruptured Brain Aneurysm
A ruptured brain aneurysm can cause sudden bleeding around the brain.
The most characteristic symptom is a sudden, extremely severe headache, often described as the worst headache a person has ever experienced. This type of headache is sometimes called a thunderclap headache.
Other symptoms may include:
- Nausea and vomiting
- Neck stiffness
- Sensitivity to light
- Loss of consciousness
- Seizures
- Confusion
- Severe weakness or neurological deficits
- Difficulty speaking
- Vision problems
A sudden severe headache accompanied by neurological symptoms or loss of consciousness requires immediate emergency medical attention.
Why Is a Ruptured Brain Aneurysm Dangerous?
When an aneurysm ruptures, blood can enter the space surrounding the brain, causing a subarachnoid hemorrhage.
The bleeding can increase pressure inside the skull and may lead to serious complications, including:
- Brain injury
- Reduced consciousness
- Seizures
- Stroke-like neurological deficits
- Vasospasm and reduced blood flow to the brain
- Hydrocephalus
- Rebleeding
Because the risk of complications can be significant, a ruptured brain aneurysm requires urgent assessment and treatment.
How Is a Brain Aneurysm Diagnosed?
When a brain aneurysm is suspected, doctors may recommend several imaging tests depending on the clinical situation.
CT Scan of the Brain
A CT scan can quickly identify bleeding in the brain and is commonly used when a patient presents with sudden severe headache or suspected subarachnoid hemorrhage.
CT Angiography
CT angiography (CTA) uses contrast imaging to visualize the blood vessels of the brain and can help identify an aneurysm.
MR Angiography
MR angiography (MRA) can also be used to evaluate cerebral blood vessels and detect certain aneurysms.
Cerebral Angiography
In selected cases, digital subtraction angiography (DSA) may be performed. It provides highly detailed images of the cerebral blood vessels and can be particularly useful for treatment planning.
Brain Aneurysm Treatment
Not every brain aneurysm requires immediate treatment. Management depends on several factors, including:
- Size of the aneurysm
- Location
- Shape and characteristics
- Whether the aneurysm has ruptured
- Patient’s age and overall health
- Family history
- Previous history of subarachnoid hemorrhage
- Other risk factors
Treatment options may include careful observation and regular imaging for selected low-risk aneurysms, or active treatment when the risk of rupture or other complications is considered significant.
For aneurysms requiring intervention, two major treatment approaches are microsurgical clipping and endovascular treatment.
Microsurgical Clipping
Microsurgical clipping is a neurosurgical procedure in which the surgeon places a small clip at the base or neck of the aneurysm to prevent blood from entering it.
The procedure is performed using microsurgical techniques and is designed to permanently exclude the aneurysm from normal blood circulation while preserving the surrounding cerebral blood vessels.
The suitability of clipping depends on the aneurysm’s location, size, shape, patient’s condition, and other factors.
Endovascular Treatment
Endovascular treatment is performed from inside the blood vessels rather than through an open surgical approach.
Depending on the aneurysm’s characteristics, techniques may include:
- Coiling
- Stent-assisted coiling
- Flow-diverter treatment
- Other advanced endovascular techniques
The appropriate method is selected according to the individual characteristics of the aneurysm and the patient’s clinical condition.
Can a Brain Aneurysm Be Prevented?
Not all brain aneurysms can be prevented. However, reducing modifiable risk factors may help protect overall blood vessel health.
Important measures include:
- Controlling high blood pressure
- Avoiding smoking
- Maintaining a healthy body weight
- Exercising regularly
- Following a balanced diet
- Managing diabetes and cholesterol when applicable
- Following medical advice if there is a family history or previously identified aneurysm
People with a known brain aneurysm should follow the recommended monitoring and treatment plan provided by their specialist.
When Should You Seek Emergency Medical Attention?
A sudden, severe headache that reaches maximum intensity within seconds or minutes can be a warning sign of a ruptured brain aneurysm.
Emergency medical attention is particularly important when severe headache is accompanied by:
- Loss of consciousness
- Vomiting
- Neck stiffness
- Seizure
- Confusion
- Weakness or numbness
- Speech difficulty
- Vision problems
A suspected ruptured brain aneurysm is a medical emergency and should be evaluated immediately.
Brain Aneurysm Treatment by Prof. Dr. Haradhan Deb Nath
Prof. Dr. Haradhan Deb Nath, Professor of Neurosurgery, has extensive experience in the diagnosis and surgical management of complex neurological conditions, including brain aneurysms and other cerebrovascular disorders.
He evaluates patients with suspected or diagnosed brain aneurysms using detailed neurological assessment and appropriate vascular imaging. Treatment is planned according to the aneurysm’s size, location, morphology, rupture status, and the patient’s overall clinical condition.
For patients who require surgical management, appropriate neurosurgical techniques may be considered based on the individual case. His expertise includes microsurgical procedures and the management of complex brain and vascular neurosurgical conditions.
The goal of treatment is to prevent aneurysm rupture or rebleeding while protecting normal brain function and preserving the surrounding blood vessels.
If you or a family member has been diagnosed with a brain aneurysm, or is experiencing symptoms suggestive of aneurysm rupture, timely consultation with an experienced neurosurgeon is essential for appropriate evaluation and treatment planning.