16800 Brain Aneurysm

Overview

A brain aneurysm is a weak, bulging spot on the wall of an artery in the brain. Think of it like a tiny balloon on a blood vessel. Most brain aneurysms do not cause problems, but if one grows weak and bursts, it can cause bleeding in the brain, which is a medical emergency.

Brain aneurysms are not very common, but they are not rare either. Studies suggest that about 1 to 5 in 100 people may have a brain aneurysm, but most never know it because they never rupture.

A brain aneurysm can happen at any age, but it is more common in adults over 40. Women are slightly more likely than men to have a brain aneurysm. Certain inherited conditions, high blood pressure, and smoking can increase the risk.

Symptoms

Common symptoms

• Most unruptured aneurysms cause no symptoms at all.
• If an aneurysm presses on nearby nerves or brain tissue, you might have pain above or behind the eye, a droopy eyelid, double vision, or a change in your vision.
• You may notice a dilated pupil or numbness on one side of the face.
• Some people experience headaches, dizziness, or trouble concentrating, but these symptoms are often caused by other conditions.

Symptoms in children

• Brain aneurysms in children are very rare.
• If they occur, symptoms may include a sudden severe headache, vomiting, neck stiffness, or sensitivity to light — which could indicate bleeding.
• A child with an unruptured aneurysm may have no symptoms, but could develop vision problems or headaches as the aneurysm grows.

Symptoms in older adults

• Older adults may have slightly different signs, such as confusion, memory problems, or general weakness, which can be mistaken for aging or other conditions.
• A sudden severe headache is still the most important warning sign of a rupture at any age.
• If an unruptured aneurysm is present, symptoms from pressure on the brain tissue may be less obvious and could include balance problems or personality changes.

Causes

Main causes

• The exact cause of most brain aneurysms is unknown.
• A brain aneurysm develops when a section of the artery wall becomes thin and weak, often at a spot where the artery branches off.
• Over time, the pressure of blood flow pushes the weak area outward, creating a bulge.
• In rare cases, an injury, infection, or a genetic condition can damage the artery wall and lead to an aneurysm.

Risk factors

• High blood pressure (hypertension)
• Smoking or tobacco use
• Drinking large amounts of alcohol
• Being over 40 years old
• Being female
• Having a family history of brain aneurysms
• Certain inherited disorders, such as polycystic kidney disease or connective tissue disorders
• A history of a head injury

When to see a doctor

See a doctor urgently if:

• If you have a sudden, very severe headache that came on quickly, call your local emergency number right away.
• If you have any weakness, numbness, trouble speaking, or vision changes that come on suddenly, get emergency help immediately.
• If you are with someone who collapses, has a seizure, or becomes unconscious, call emergency services immediately.

Book a routine appointment if:

• If you have a persistent headache that is new or different from your usual headaches, see a doctor.
• If you have eye pain, double vision, or a droopy eyelid, make an appointment with a healthcare provider.
• If you have a family history of brain aneurysms and are worried about your risk, talk to your doctor about whether screening is right for you.

Diagnosis

A brain aneurysm is usually diagnosed with imaging tests that take detailed pictures of the blood vessels in the brain. If you have symptoms of a ruptured aneurysm, a doctor will order emergency tests right away. If an unruptured aneurysm is suspected, your doctor may recommend one or more imaging scans.

Tests that may be done

• CT (computed tomography) scan — a quick X-ray scan that can show bleeding in the brain.
• CTA (CT angiography) — a CT scan with dye to highlight the blood vessels and show the aneurysm.
• MRI (magnetic resonance imaging) — a scan that uses magnets and radio waves to create images of the brain.
• MRA (magnetic resonance angiography) — an MRI that focuses on the blood vessels.
• Cerebral angiogram — a more detailed test where a thin tube is inserted into a blood vessel and dye is injected into the brain's arteries.

What to expect at your appointment

If you are having tests for a brain aneurysm, you may be given a hospital appointment for a scan. Some tests, like a CT scan, are quick and painless. For an angiogram, you may be given a sedative to help you relax. The doctor will go through the results with you and explain what they mean and what next steps are needed.

Treatment

Treatment for a brain aneurysm depends on its size, location, whether it has ruptured, and your overall health. If an aneurysm is small and not causing symptoms, your doctor may recommend 'watchful waiting' — that means regular checkups and imaging scans to see if it changes. If the aneurysm is large or ruptured, treatment may involve a procedure to prevent bleeding.

Self-care at home

• If you are being monitored for an unruptured aneurysm, attend all follow-up appointments and scans as recommended.
• Control high blood pressure through lifestyle changes and any medicines your doctor prescribes.
• Quit smoking and avoid secondhand smoke.
• Limit alcohol intake.
• Avoid straining activities that could raise pressure in the brain (like heavy lifting) — but always ask your doctor for specific advice.

Medical treatments

There are no medicines that can cure or shrink an aneurysm. However, your doctor may give you medications to lower blood pressure, manage pain, or prevent seizures. If the aneurysm is at risk of bleeding, a specialist may recommend a procedure such as 'coiling' (filling the aneurysm with tiny coils to block blood flow) or 'clipping' (placing a small metal clip on the base of the aneurysm to seal it off). The choice of procedure depends on your individual situation, and the doctor will explain the risks and benefits.

When is surgery considered?

Surgery (such as clipping) is generally considered for aneurysms that have ruptured, are causing symptoms, or are at high risk of rupturing. Sometimes a less invasive procedure called endovascular coiling is preferred. Your healthcare team will discuss the best option for you.

Living with this condition

Living with a brain aneurysm — whether it has been treated or is simply being watched — can bring worry and uncertainty. It is important to follow your doctor's advice, keep all medical appointments, and learn the warning signs of a rupture. Many people live full, active lives with an unruptured aneurysm that never causes problems.

Lifestyle tips

• Do not smoke or use tobacco in any form.
• Keep your blood pressure healthy — monitor it regularly if you have high blood pressure.
• Stay physically active, but ask your doctor which activities are safe for you.
• Get enough sleep and manage stress with relaxation techniques like deep breathing or gentle exercise.
• Avoid using recreational drugs, including cocaine or stimulants, which can dangerously spike blood pressure.

Diet and exercise

A heart-healthy diet and regular, moderate exercise can help keep your blood pressure in a good range. Eat plenty of fruits, vegetables, whole grains, and lean proteins. Try to limit salty foods, saturated fats, and sugary drinks. Aim for at least 30 minutes of gentle activity, like brisk walking, on most days — but check with your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Learning you have a brain aneurysm can understandably cause anxiety, fear, or depression. It is normal to worry about the future. Talk to your doctor about how you are feeling — they can suggest counselling, support groups, or other resources. Remember that most aneurysms do not rupture, and many are treatable.

Prevention

You cannot always prevent a brain aneurysm, but you can reduce your risk of having one and lower the chance of it rupturing. Controlling blood pressure, not smoking, eating well, and avoiding heavy alcohol use are the most important steps. If you already have an aneurysm, these measures can help keep it stable.

Screening programmes

Screening for brain aneurysms is not usually recommended for everyone. You may be offered screening if you have a strong family history (two or more close relatives with brain aneurysms) or certain inherited conditions. Talk to your doctor about your personal risk factors.

Complications

If left untreated

• If a brain aneurysm is left untreated and it ruptures, it can cause serious bleeding in the brain (subarachnoid hemorrhage).
• Bleeding in the brain can lead to stroke, permanent brain damage, or disability.
• A ruptured aneurysm can cause dangerous swelling in the brain or a buildup of fluid (hydrocephalus).
• Rupture can lead to vasospasm — a narrowing of blood vessels that can deprive the brain of oxygen.
• Without prompt emergency treatment, a ruptured aneurysm can be fatal.

Long-term outlook

It can be frightening to hear that you have a brain aneurysm, but there is genuine reason for hope. Many aneurysms are small, stable, and never rupture. With modern treatments and careful monitoring, the outlook for unruptured aneurysms is very good. If an aneurysm does rupture, getting to an emergency department quickly greatly improves your chances of recovery. Many people go on to live full and active lives after treatment.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.