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Understanding Brain Aneurysms: Symptoms, Causes, and Treatments

Alan Lucks | MD

Medically reviewed by Alan Lucks | MD, Alan Lucks MDPC Private Practice - New York on September 20th, 2023.

Key Takeaways

  • These balloon-like bulges form when arterial walls weaken, affecting 3-5% of the population, with 85% located in the circle of Willis at the brain's base.
  • Rupture creates a "thunderclap headache"—the worst headache of your life that peaks within seconds—along with neck stiffness, vomiting, and potential loss of consciousness.
  • Women over 40 face higher risk, especially those who smoke (3x increased risk), have hypertension, or carry genetic mutations like those causing polycystic kidney disease.
  • Surgical clipping involves placing a metal clip at the aneurysm neck, while endovascular coiling fills the bulge with platinum coils—both prevent rupture in 90-95% of cases.
  • Unruptured aneurysms smaller than 7mm are often monitored with MRI every 1-2 years, as annual rupture risk is typically less than 1%.

A brain aneurysm is a weak spot in the wall of a blood vessel inside the brain that can sometimes bulge out and potentially burst, causing a serious condition called a subarachnoid hemorrhage. While most brain aneurysms don't cause symptoms or health problems, it's essential to understand the risks, symptoms, and treatment options.

Types of Brain Aneurysms

There are three main types of brain aneurysms:

Saccular aneurysms: The most common type, these aneurysms bulge out in a dome shape and are connected to the artery by a narrow neck.

Fusiform aneurysms: Less common, these aneurysms cause the entire artery wall to bulge out, creating a widened spot in the blood vessel.

Mycotic aneurysms: Rare aneurysms caused by bacterial, fungal, or viral infections that weaken the artery wall.

Symptoms of Brain Aneurysms

Symptoms of a brain aneurysm depend on whether it has ruptured or not. Unruptured aneurysms may not cause any symptoms, but as they grow larger, they can press on the brain and nerves, causing:

  • Dilated pupils

  • Blurred or double vision

  • Drooping eyelid

  • Difficulty speaking

  • Weakness and numbness on one or both sides of the face

A ruptured brain aneurysm is a medical emergency and requires immediate attention. Symptoms include:

  • Sudden, intense headache

  • Loss of consciousness

  • Nausea and vomiting

  • Stiff neck

  • Sensitivity to light

  • Confusion or trouble with mental awareness

  • Seizures

Understanding Brain Aneurysms: Symptoms, Causes, and Treatments

Causes and Risk Factors

Brain aneurysms can develop due to inherited conditions or risk factors such as:

  • Age (being over 40)

  • Gender (women are more likely to develop aneurysms)

  • Smoking

  • High blood pressure

  • Family history of brain aneurysms

  • Alcohol and drug abuse

  • Traumatic head injury

  • Certain medical conditions (e.g., Ehlers-Danlos syndrome, polycystic kidney disease)

Diagnosing Brain Aneurysms

Doctors use various scans and tests to diagnose brain aneurysms, including:

Treatment Options for Brain Aneurysms

Treatment for brain aneurysms depends on factors such as the size, location, and whether the aneurysm has ruptured. Options include:

  • Surgical clipping

  • Endovascular coiling

  • Flow diverter surgery

  • Microvascular clipping

  • Medications to manage symptoms and prevent complications

For ruptured aneurysms, prompt treatment is crucial to prevent further bleeding and potentially life-threatening complications.

Preventing Brain Aneurysms and Monitoring

While there are no guaranteed ways to prevent brain aneurysms, you can reduce your risk by:

  • Quitting smoking

  • Managing high blood pressure

  • Avoiding drug use

  • Limiting alcohol consumption

  • Maintaining a healthy diet and exercise routine

  • Regular follow-ups with intermittent imaging to monitor the size of known unruptured aneurysms

If you experience symptoms of a brain aneurysm, especially a sudden, severe headache, seek medical attention immediately. Early detection and treatment can significantly improve outcomes and prevent life-threatening complications. By understanding the risks, symptoms, and treatment options for brain aneurysms, you can take steps to protect your health and well-being.

The Bottom Line

Most brain aneurysms never rupture, but when they do, immediate emergency treatment within the first 24 hours is critical for survival and preventing permanent brain damage. Regular screening may be recommended if you have multiple risk factors or family history. If you're experiencing sudden severe headache or concerning neurological symptoms, Doctronic can help you quickly assess whether emergency care is needed.

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