What are the other Names for this Condition? (Also known as/Synonyms)

• Cerebral Aneurysm
• Intracerebral Aneurysm
• Intracranial Aneurysm

What is Brain Aneurysm? (Definition/Background Information)

• A Brain Aneurysm is a bulging, weakened area in the wall of a blood vessel in the brain, often compared to a balloon filled with blood. This can occur due to a combination of genetic and environmental factors. It is a serious medical condition
• The factors influencing Brain Aneurysms include older age, tobacco use, alcohol consumption, and a host of other contributory factors. Generally, older women are more prone to developing this condition
• If an aneurysm ruptures, it can lead to a potentially life-threatening condition known as a subarachnoid hemorrhage, causing bleeding into the space around the brain. Aneurysms may not cause symptoms until they rupture, making early detection challenging
• A Brain Aneurysm can be diagnosed through various brain imaging techniques, such as a CT scan or cerebral angiogram. Management may involve monitoring, lifestyle modifications, or, in some cases, surgical or endovascular intervention.
• Brain Aneurysms may be prevented in some cases by managing high blood pressure and reducing alcohol consumption and tobacco use. The prognosis is influenced by various factors, with a primary emphasis on whether the aneurysm undergoes rupture or remains intact.

Who gets Brain Aneurysm? (Age and Sex Distribution)

• Brain Aneurysms are more likely to occur in adults between the ages of 35 and 60 than in individuals of any other age group, including children
• Women are more likely to be affected than men
• Generally, individuals from all races and ethnicities are at risk for the condition

What are the Risk Factors for Brain Aneurysm? (Predisposing Factors)

The risk factors for developing a Brain Aneurysm may include:

• Advanced age
• Smoking: A higher use of tobacco products can increase the risk of developing a Brain Aneurysm, as well as portray an increased risk for a rupture.
• High blood pressure or hypertension: It can increase the pressure on the arteries, thereby increasing the risk. High BP also increases the chance of bleeding into the subarachnoid space (the space between the brain and the thin tissues that cover the brain) in case of aneurysmal rupture
• Arteriosclerosis (hardening of the arterial walls): Increased levels of arteriosclerosis can weaken the artery wall, which increases the risk
• Alcohol consumption: High levels of regular alcohol consumption correspondingly increase the risk of developing a Brain Aneurysm
• A positive family history of the condition
• Medical conditions, such as Ehlers-Danlos syndrome, polycystic kidney disease, Marfan syndrome, and fibromuscular dysplasia

It is important to note that having a risk factor does not mean one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Brain Aneurysm? (Etiology)

The exact cause of a Brain Aneurysm is often unclear, but several factors may contribute to their formation. Some common factors associated with the development of Brain Aneurysms include:

• Weakness in the arterial wall: Aneurysms can occur when there is a weakened area in the wall of a blood vessel in the brain, often due to a combination of genetic and environmental factors
• Genetic factors: A family history of Brain Aneurysms may increase the risk, suggesting a genetic predisposition to the condition
• Age and gender: The risk of developing an aneurysm increases with age, and women are more likely than men to develop them
• High blood pressure (hypertension): Chronic high blood pressure can contribute to the weakening of blood vessel walls over time
• Smoking: Tobacco use is a significant risk factor for the development and rupture of Brain Aneurysms
• Drug abuse: Certain substances, particularly cocaine, can contribute to the development of aneurysms
• Atherosclerosis: The buildup of fatty deposits (plaque) on the artery walls can weaken blood vessels
• Trauma or Injury: Head injuries or trauma to the blood vessels in the brain can lead to the formation of aneurysms.

Not everyone with risk factors will develop a Brain Aneurysm, and aneurysms can also occur in individuals without any apparent risk factors.

What are the Signs and Symptoms of Brain Aneurysm?

Usually, unruptured Brain Aneurysms cause no symptoms, but large-sized ones can potentially press against the brain. An unruptured Brain Aneurysm that is pressing against the brain can cause:

• Headache
• Blurred vision
• Changes in speech
• Neck pain

A ruptured Brain Aneurysm constitutes a medical emergency, and emergency services should be informed immediately, particularly if the following symptoms are noted:

• Sudden and severe headache
• Neck pain
• Nausea 
• Light sensitivity
• Fainting
• Seizures

Additionally, most Brain Aneurysms do not cause symptoms unless they rupture, making them challenging to detect and manage before an event occurs.

How is Brain Aneurysm Diagnosed?

Most Brain Aneurysms go unnoticed because no signs and symptoms are observed until the aneurysm ruptures. The following tests and procedures may be used in the diagnosis of a Brain Aneurysm:

• A thorough physical examination and evaluation of one’s medical history
• Cerebral angiography: A dye is injected into the blood vessels to allow visualization of the insides of the blood vessel
• Computed tomography (CT) of the brain: It is a non-invasive diagnostic tool to detect Brain Aneurysms and if they have ruptured
• Magnetic resonance imaging (MRI) of the head for capturing detailed images of the brain
• Cerebrospinal fluid analysis is used to detect any blood in the spinal fluid (it can help indicate a hemorrhage)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Brain Aneurysm?

The possible complications of Brain Aneurysms include:

• Re-bleeding: An aneurysm that was bleeding before could reopen and lead to further brain damage
• Vasospasm: After an aneurysm ruptures, the blood vessels in the brain may narrow and constrict to limit the amount of blood lost. This can lead to a lack of blood reaching the brain cells, resulting in further brain injury
• Hydrocephalus: Blood in the surrounding tissue of the brain can inhibit the circulation of the brain and spinal cord fluid
• Hyponatremia: A ruptured aneurysm can disrupt the sodium balance, which can lead to brain swelling and damage
• Severe seizures

How is Brain Aneurysm Treated?

Generally, the choice of treatment for aneurysms depends on several factors including:

• Size of the aneurysm
• Age of the patient
• The state and location in the brain of the aneurysm
• Kidney function
• Other health condition(s) that may adversely affect surgery or repair of the aneurysm

Ruptured Brain Aneurysms pose a severe threat due to bleeding into the surrounding tissues. The treatment options may include:

• Surgical clipping - a procedure that involves placing a metal clip on the blood vessel that is funneling blood into the surrounding tissue through the aneurysm
• Endovascular coiling - a platinum wire is inserted into the blood vessels to locate the aneurysm. The wire coils up and causes the blood to clot, sealing off the artery

Unruptured Brain Aneurysms can also be treated by the methods stated above. However, the risks may outweigh the benefits, which may have to be considered by the healthcare professional.

How can Brain Aneurysm be Prevented?

The risk of developing a Brain Aneurysm (or rupturing a preexisting one) may be decreased by considering the following factors:

• Stopping tobacco use
• Managing high blood pressure through exercise, diet, and medication. Avoid activities and foods that can increase blood pressure, such as strenuous exercise and caffeine
• Reducing alcohol consumption
• Addressing the root cause of the arteriosclerosis and availing suitable treatments through medication/surgery to mitigate the condition
• Eating a healthy diet and regularly exercising

What is the Prognosis of Brain Aneurysm? (Outcomes/Resolutions)

The prognosis of a Brain Aneurysm depends on the state of the aneurysm; whether the aneurysm has ruptured or not.

• A ruptured aneurysm can lead to permanent brain damage depending on how severe the bleeding is, and the time elapsed before treatment administration
• A delayed diagnosis and late treatment of Brain Aneurysm can result in death
• The best outcome following a ruptured Brain Aneurysm is the resumption of previous activities without limitations

Additional and Relevant Useful Information for Brain Aneurysm:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/common-procedures/procedures-surgical/aneurysm-repair