Brain Aneurysms
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Finding out you have a brain aneurysm is scary. You may know it’s in your brain and can be serious. But you might not know exactly what an aneurysm is, what it means for you, and what might happen. You have lots of questions and you’re not sure where to find the answers.
That’s where we come in. We have a whole team of experts on caring for brain aneurysms. We’ll help you understand what it means and how to protect your health.
What Is a Brain Aneurysm?
Blood vessels are tubes that carry blood between the heart and rest of the body. An aneurysm is when the sides of a tube get weak and bulge or balloon out. An aneurysm in the brain is called a brain aneurysm, cerebral aneurysm, or intracranial aneurysm.
An unruptured brain aneurysm is one that hasn’t opened while a ruptured brain aneurysm is one that has burst.
Unruptured Brain Aneurysms
Most unruptured brain aneurysms don’t cause symptoms. Most people find out they have a brain aneurysm when they get imaging for another reason and it shows up on the scan.
A larger brain aneurysm can press on the brain tissue and nerves and cause:
- Pain above or behind one eye
- One dilated pupil
- Double vision or other vision changes
- Numbness on one side of the face
We’ll look at several factors to find the best way to handle your unruptured brain aneurysm, including:
- The size, location, and type of aneurysm
- How likely it is to rupture (break open)
- Your age and health
- Risks of treatment
We use these tests to learn more about your aneurysm:
Understanding Brain Aneurysms
UVA Health neurosurgeon Min Park, MD, breaks down everything you need to know about living with an unruptured brain aneurysm: what it is, what it means, when you might need treatment, and what treatment looks like.
Get the FactsAn aneurysm is a blister that forms off the side of a blood vessel. There are certain risk factors for harboring cerebral aneurysms, patients with long-standing hypertension, poorly controlled blood pressure, smokers definitely have predilection not only to have cerebral aneurysms, but also have worse outcomes if an aneurysm were to cause bleeding in the brain.
On occasion, we do see aneurysms run within families. If there are two first degree relatives with a cerebral aneurysm, we become more concerned that there might be involved within the rest of the members of the family.
People with unruptured cerebral aneurysms generally won't have any symptoms at all. They're often discovered incidentally, they might have headaches which over time starts to affect their quality of life, and they'll go see their regular doctor to help manage that, and the doctor will order some type of scan, like a CT scan or an MRI scan. And during the course of the workup for this other condition, they'll find the aneurysm.
The top concerns that individuals have when faced with an aneurysm is, what are the chances that this aneurysm is going to bleed? What's the chances of the aneurysm rupturing? That discussion relies on multiple factors, such as the size of the aneurysm, the shape of the aneurysm, and the location of the aneurysm, as well as patient specific factors, such as their age and their general health status. That helps us decide whether or not we need to treat it.
Certain aneurysms are more amenable to having surgical clipping, while other aneurysms are more amenable to treatment with endovascular techniques, such as coiling. Clipping of aneurysms is a surgical procedure where we attempt to exclude the aneurysm from the normal circulation. That involves making an incision along the scalp and removing a small portion of the bone. We place a little titanium clip right where the aneurysm arises off of the blood vessel. In that way we can keep the aneurysm from filling with blood, which drastically reduces its chances of causing a bleeding event in the future.
Another way to treat aneurysms is to do something called coiling. In that procedure we actually go through really long small catheters and we can access either the wrist or down in the hip area and navigate catheters all the way from out in that area up to the vessels in the brain. From there, we can enter into the aneurysm and deploy tiny little platinum coils, and what they do is they fill up the aneurysm so that the blood flow can't get into it, and thus it drastically reduces the chance of having a bleeding event in the future.
If the risks of surgery outweigh the risk of your aneurysm rupturing, we’ll recommend watchful waiting. That means we’ll get new scans on a regular schedule to see if the aneurysm gets bigger and needs surgery.
To lower the risk of your brain aneurysm rupturing, we can also help you with quitting smoking and controlling high blood pressure.
If your aneurysm is at risk of bursting, you may need surgery. Learn about brain aneurysm treatments.
Screening & Genetic Counseling
Brain aneurysms run in families.
Ask us about screening if you have 2 or more blood relatives who have or had a brain aneurysm. Remember, that could also be a kind of bleeding stroke called a subarachnoid hemorrhage.
We may recommend seeing one of our genetic counselors if you have a brain aneurysm and 1 of these:
- Aneurysm in another body part, like an aortic aneurysm
- Signs or diagnosis of certain syndromes, like Ehlers-Danlos or Loeys-Deitz
- Multiple cysts in your kidneys (polycystic kidney disease)
- Family history of any of the above
A genetic counselor can help you decide if genetic testing is right for you.
Ruptured Brain Aneurysms
When a brain aneurysm ruptures, the blood vessel wall breaks and blood spills into the brain.
Sometimes a brain aneurysm opens and leaks a small amount of blood (sentinel bleed). You may have warning headaches for days or weeks before a large rupture. If you know you have a brain aneurysm, let you doctor know right away if you start having frequent headaches.
A ruptured brain aneurysm is called a subarachnoid hemorrhage, a type of hemorrhagic (bleeding) stroke, and is a life-threatening emergency. The main symptom of a ruptured brain aneurysm is a sudden, severe headache that people often call the “worst headache of my life.” If you think someone is having a subarachnoid hemorrhage, dial 911 right away. Read about our stroke services.