Medical Author: Charles Patrick Davis, MD, PhD
Medically Reviewed on 7/8/2022
Doctor's Notes on Brain Aneurysm
A brain aneurysm is an abnormal bulge or ballooning of a blood vessel in the brain. The walls of an aneurysm are not as stable as normal blood vessel walls. Usually, there is no sign or symptom of their presence. Aneurysms often are found incidentally. When they either leak blood or burst (rupture), then signs and symptoms develop. Signs and symptoms are variable and are related to the area where the aneurysm is located. However, a common sign of most aneurysms is a headache described as "the worst headache of my life." Other signs and symptoms possibly encountered are
- visual defects,
- photophobia,
- face pain,
- nosebleeds,
- dilated pupils,
- focal neurological problems,
- confusion,
- nausea and vomiting,
- cardiac dysrhythmias,
- seizures,
- stroke symptoms,
- neck pain or stiffness,
- difficulty breathing and,
- in some patients, death.
The signs and symptoms are mainly caused by the blood that leaks or pours into the brain tissue, compromising brain cells and other brain components with inflammatory reactions and/or by putting pressure on them (for example, an expanding hematoma). The cause of brain aneurysms is controversial; currently, genetic and environmental factors together is a favored theory, but it may change. Medical conditions that increase risk for them include polycystic kidney disease, lupus, sickle cell anemia, endocarditis, fungal infections, hypertension, cancers, smoking, alcohol use, connective tissue disorders, head trauma, and others.
What Are the Treatments for a Brain Aneurysm (Unruptured)?
There are two common surgical treatment options for brain aneurysms:
- Surgical clipping is where a neurosurgeon removes a section of skull and places a small metal clip as the neck or base of the aneurysm to stop blood flow into it.
- Endovascular coiling is where a hollow plastic tube is put into an artery and is threaded into the neck or base of the aneurysm and then a soft wire inside the tube is coiled up inside the aneurysm. This seals the aneurysm off from blood flow.
- Other treatments
- Stop smoking
- No recreational drug use
- Treat hypertension
- Healthy diet and exercise
Your doctors can decide what options are best for your condition. Note that the two surgical options listed above are used in some patients with leaky or ruptured aneurysms.
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Worst Headache of Your Life
The worst headache of your life may be a life-threatening emergency. Symptoms such as a headache with fever and a stiff neck, a headache that starts with a thunderclap, a headache following a head injury, a headache with loss of vision or numbness of the arms or legs, or a headache with a fever (not caused by the flu) are emergent medical conditions. Treatment of the worst headache of your life depends on the cause of the headache.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.