Disease: Aneurysm, brain

Appointments & care

At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.

Mayo Clinic in Minnesota has been recognized as the best Neurology & Neurosurgery hospital in the nation for 2014-2015 by U.S. News & World Report.

A brain aneurysm (AN-yoo-riz-um) is a bulge or ballooning in a blood vessel in the brain. It often looks like a berry hanging on a stem.

A brain aneurysm can leak or rupture, causing bleeding into the brain (hemorrhagic stroke). Most often a ruptured brain aneurysm occurs in the space between the brain and the thin tissues covering the brain. This type of hemorrhagic stroke is called a subarachnoid hemorrhage.

A ruptured aneurysm quickly becomes life-threatening and requires prompt medical treatment.

Most brain aneurysms, however, don't rupture, create health problems or cause symptoms. Such aneurysms are often detected during tests for other conditions.

Treatment for an unruptured brain aneurysm may be appropriate in some cases and may prevent a rupture in the future.

Source: http://www.mayoclinic.com

Ruptured aneurysm

Ruptured aneurysm

A sudden, severe headache is the key symptom of a ruptured aneurysm. This headache is often described as the "worst headache" ever experienced.

Common signs and symptoms of a ruptured aneurysm include:

  • Sudden, extremely severe headache
  • Nausea and vomiting
  • Stiff neck
  • Blurred or double vision
  • Sensitivity to light
  • Seizure
  • A drooping eyelid
  • Loss of consciousness
  • Confusion

'Leaking' aneurysm

In some cases, an aneurysm may leak a slight amount of blood. This leaking (sentinel bleed) may cause only a:

  • Sudden, extremely severe headache

A more severe rupture almost always follows leaking.

Unruptured aneurysm

An unruptured brain aneurysm may produce no symptoms, particularly if it's small. However, a large unruptured aneurysm may press on brain tissues and nerves, possibly causing:

  • Pain above and behind an eye
  • A dilated pupil
  • Change in vision or double vision
  • Numbness, weakness or paralysis of one side of the face
  • A drooping eyelid

Seek immediate medical attention if you develop a:

  • Sudden, extremely severe headache

If you're with someone who complains of a sudden, severe headache or who loses consciousness or has a seizure, call 911 or your local emergency number.

Source: http://www.mayoclinic.com

Brain aneurysms develop as a result of thinning artery walls. Aneurysms often form at forks or branches in arteries because those sections of the vessel are weaker.

Although aneurysms can appear anywhere in the brain, they are most common in arteries at the base of the brain.

Source: http://www.mayoclinic.com

Appointments & care

At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.

If you have a sudden, severe headache or other symptoms possibly related to a ruptured aneurysm, you will have a test or series of tests to determine if you have had bleeding into the space between your brain and surrounding tissues (subarachnoid hemorrhage) or another type of stroke.

If bleeding has occurred, then your emergency care team will determine if a ruptured aneurysm is the cause.

If you have symptoms of an unruptured brain aneurysm — such as pain behind the eye, changes in vision and paralysis on one side of the face — you will likely have the same tests.

Diagnostic tests include:

  • Computerized tomography (CT). A CT scan, a specialized X-ray exam, is usually the first test used to determine if you have bleeding in the brain. The test produces images that are 2-D "slices" of the brain.

    With this test, you may also receive an injection of a dye that makes it easier to observe blood flow in the brain and may indicate the site of a ruptured aneurysm. This variation of the test is called CT angiography.

  • Cerebrospinal fluid test. If you've had a subarachnoid hemorrhage, there will most likely be red blood cells in the fluid surrounding your brain and spine (cerebrospinal fluid). Your doctor will order a test of the cerebrospinal fluid if you have symptoms of a ruptured aneurysm but a CT scan hasn't shown evidence of bleeding.

    The procedure to draw cerebrospinal fluid from your back with a needle is called a lumbar puncture, or spinal tap.

  • Magnetic resonance imaging (MRI). An MRI uses a magnetic field and radio waves to create detailed images of the brain, either 2-D slices or 3-D images.

    A type of MRI that assesses the arteries in detail (MRI angiography) may detect the site of a ruptured aneurysm.

  • Cerebral angiogram. During this procedure, also called a cerebral arteriogram, your doctor inserts a thin, flexible tube (catheter) into a large artery — usually in your groin — and threads it past your heart to the arteries in your brain. A special dye injected into the catheter travels to arteries throughout your brain.

    A series of X-ray images can then reveal details about the conditions of your arteries and the site of a ruptured aneurysm. This test is more invasive than others and is usually used when other diagnostic tests don't provide enough information.

Computerized tomography (CT). A CT scan, a specialized X-ray exam, is usually the first test used to determine if you have bleeding in the brain. The test produces images that are 2-D "slices" of the brain.

With this test, you may also receive an injection of a dye that makes it easier to observe blood flow in the brain and may indicate the site of a ruptured aneurysm. This variation of the test is called CT angiography.

Cerebrospinal fluid test. If you've had a subarachnoid hemorrhage, there will most likely be red blood cells in the fluid surrounding your brain and spine (cerebrospinal fluid). Your doctor will order a test of the cerebrospinal fluid if you have symptoms of a ruptured aneurysm but a CT scan hasn't shown evidence of bleeding.

The procedure to draw cerebrospinal fluid from your back with a needle is called a lumbar puncture, or spinal tap.

Magnetic resonance imaging (MRI). An MRI uses a magnetic field and radio waves to create detailed images of the brain, either 2-D slices or 3-D images.

A type of MRI that assesses the arteries in detail (MRI angiography) may detect the site of a ruptured aneurysm.

Cerebral angiogram. During this procedure, also called a cerebral arteriogram, your doctor inserts a thin, flexible tube (catheter) into a large artery — usually in your groin — and threads it past your heart to the arteries in your brain. A special dye injected into the catheter travels to arteries throughout your brain.

A series of X-ray images can then reveal details about the conditions of your arteries and the site of a ruptured aneurysm. This test is more invasive than others and is usually used when other diagnostic tests don't provide enough information.

Screening for brain aneurysms

The use of imaging tests to screen for unruptured brain aneurysms is generally not recommended. However, you may want to discuss with your doctor the potential benefit of a screening test if you have:

  • A parent or sibling who has had a ruptured brain aneurysm, particularly if you have two such first-degree family members with brain aneurysms
  • A congenital disorder that increases your risk of a brain aneurysm

Source: http://www.mayoclinic.com

When a brain aneurysm ruptures, the bleeding usually lasts only a few seconds. The blood can cause direct damage to surrounding cells, and the bleeding can damage or kill other cells. It also increases pressure inside the skull.

If the pressure becomes too elevated, the blood and oxygen supply to the brain may be disrupted to the point that loss of consciousness or even death may occur.

Complications that can develop after the rupture of an aneurysm include:

  • Re-bleeding. An aneurysm that has ruptured or leaked is at risk of bleeding again. Re-bleeding can cause further damage to brain cells.
  • Vasospasm. After a brain aneurysm ruptures, blood vessels in your brain may narrow erratically (vasospasm). This condition can limit blood flow to brain cells (ischemic stroke) and cause additional cell damage and loss.
  • Hydrocephalus. When an aneurysm rupture results in bleeding in the space between the brain and surrounding tissue (subarachnoid hemorrhage) — most often the case — the blood can block circulation of the fluid surrounding the brain and spinal cord (cerebrospinal fluid).

    This condition can result in an excess of cerebrospinal fluid that increases pressure on the brain and can damage tissues (hydrocephalus).

  • Hyponatremia. Subarachnoid hemorrhage from a ruptured brain aneurysm can disrupt the balance of sodium in the blood supply. This may occur from damage to the hypothalamus, an area near the base of the brain.

    A drop in blood sodium levels (hyponatremia) can lead to swelling of brain cells and permanent damage.

Hydrocephalus. When an aneurysm rupture results in bleeding in the space between the brain and surrounding tissue (subarachnoid hemorrhage) — most often the case — the blood can block circulation of the fluid surrounding the brain and spinal cord (cerebrospinal fluid).

This condition can result in an excess of cerebrospinal fluid that increases pressure on the brain and can damage tissues (hydrocephalus).

Hyponatremia. Subarachnoid hemorrhage from a ruptured brain aneurysm can disrupt the balance of sodium in the blood supply. This may occur from damage to the hypothalamus, an area near the base of the brain.

A drop in blood sodium levels (hyponatremia) can lead to swelling of brain cells and permanent damage.

Source: http://www.mayoclinic.com

If you have an unruptured brain aneurysm, you may lower the risk of its rupture by making these lifestyle changes:

  • Don't smoke or use recreational drugs. If you smoke or use recreational drugs, talk to your doctor about strategies or an appropriate treatment program to help you quit.
  • Eat a healthy diet and exercise. Changes in diet and exercise can help lower blood pressure. Talk to your doctor about changes appropriate for you.
  • Limit caffeine. Caffeine is a stimulant that can cause a sudden increase in blood pressure.
  • Avoid straining. Sudden, forceful and sustained exertion of the type you expend when you lift heavy weights can cause a sudden increase in blood pressure.

Source: http://www.mayoclinic.com

A number of factors can contribute to weakness in an artery wall and increase the risk of a brain aneurysm. Brain aneurysms are more common in adults than in children and more common in women than in men.

Some of these risk factors develop over time; others are present at birth.

Risk factors that develop over time

These include:

  • Older age
  • Smoking
  • High blood pressure (hypertension)
  • Hardening of the arteries (arteriosclerosis)
  • Drug abuse, particularly the use of cocaine
  • Head injury
  • Heavy alcohol consumption
  • Certain blood infections
  • Lower estrogen levels after menopause

Risk factors present at birth

These include:

  • Inherited connective tissue disorders, such as Ehlers-Danlos syndrome, that weaken blood vessels
  • Polycystic kidney disease, an inherited disorder that results in fluid-filled sacs in the kidneys and usually increases blood pressure
  • Abnormally narrow aorta (coarctation of the aorta), the large blood vessel that delivers oxygen-rich blood from the heart to the body
  • Cerebral arteriovenous malformation (brain AVM), an abnormal connection between arteries and veins in the brain that interrupts the normal flow of blood between them
  • Family history of brain aneurysm, particularly a first-degree relative, such as a parent, brother or sister

Source: http://www.mayoclinic.com

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