What Causes A Cerebral Aneurysm
Cerebral aneurysms form when the walls of the arteries in the brain become thin and weaken. Aneurysms typically form at branch points in arteries because these sections are the weakest. Occasionally, cerebral aneurysms may be present from birth, usually resulting from an abnormality in an artery wall.
Risk factors for developing an aneurysm
Sometimes cerebral aneurysms are the result of inherited risk factors, including:
- genetic connective tissue disorders that weaken artery walls
- polycystic kidney disease
- arteriovenous malformations
- history of aneurysm in a first-degree family member .
Other risk factors develop over time and include:
- untreated high blood pressure
- cigarette smoking
- drug abuse, especially cocaine or amphetamines, which raise blood pressure to dangerous levels. Intravenous drug abuse is a cause of infectious mycotic aneurysms.
- age over 40.
Less common risk factors include:
- head trauma
- brain tumor
- infection in the arterial wall .
Additionally, high blood pressure, cigarette smoking, diabetes, and high cholesterol puts one at risk of atherosclerosis , which can increase the risk of developing a fusiform aneurysm.
Risk factors for an aneurysm to rupture
Not all aneurysms will rupture. Aneurysm characteristics such as size, location, and growth during follow-up evaluation may affect the risk that an aneurysm will rupture. In addition, medical conditions may influence aneurysm rupture.
Risk factors include:
Diagnosis Of A Brain Aneurysm
Johns Hopkins estimates that two percent of people have one or more brain aneurysms. Most aneurysms declare themselves by bleeding in adults between the ages of 45 to 65 years. Children, however, can also have brain aneurysms. In fact, two percent to three percent of patients with aneurysms that we treat at Johns Hopkins are children. We attempt whenever possible to identify and address aneurysms before they bleed.
The type of diagnostic testing performed depends on the location of the aneurysm. In addition to a complete medical history and physical examination, diagnostic procedures for an aneurysm may include one or more of the following tests:
- Computed tomography scan : a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images , both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than standard x-rays.
- Magnetic resonance imaging : a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
- Arteriogram : an x-ray image of the blood vessels used to evaluate various conditions, such as aneurysm, stenosis , or blockages. A dye will be injected through a thin flexible tube placed in an artery. This dye will make the blood vessels visible on the x-ray.
What Are The Symptoms
Unruptured aneurysm Most cerebral aneurysms do not show symptoms until they either become very large or rupture. Small unchanging aneurysms generally will not produce symptoms.
A larger aneurysm that is steadily growing may press on tissues and nerves causing:
- pain above and behind the eye
- paralysis on one side of the face
- a dilated pupil in the eye
- vision changes or double vision.
Ruptured aneurysmWhen an aneurysm ruptures , one always experiences a sudden and extremely severe headache and may also develop:
- double vision
TypeThere are three types of cerebral aneurysms:
- Saccular aneurysm. A saccular aneurysm is a rounded sac containing blood, that is attached to a main artery or one of its branches. Also known as a berry aneurysm , this is the most common form of cerebral aneurysm. It is typically found on arteries at the base of the brain. Saccular aneurysms occur most often in adults.
- Fusiform aneurysm. A fusiform aneurysm balloons or bulges out on all sides of the artery.
- Mycotic aneurysm. A mycotic aneurysm occurs as the result of an infection that can sometimes affect the arteries in the brain. The infection weakens the artery wall, causing a bulging aneurysm to form.
SizeAneurysms are also classified by size: small, large, and giant.
- Small aneurysms are less than 11 millimeters in diameter .
- Large aneurysms are 11 to 25 millimeters .
- Giant aneurysms are greater than 25 millimeters in diameter .
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Are Migraines Linked To Aneurysms
Migraine headaches dont cause aneurysms to form or burst. And they arent a sign that youre about to have a burst aneurysm.
Studies show that some people with an aneurysm that hasnt burst may get migraines in the weeks and months before it bursts. But theres no evidence that migraines and aneurysms happen at the same time.
Some research suggests that people who get migraines have a greater risk for a brain aneurysm, but more study is needed.
What Causes An Aneurysm To Bleed
We usually dont know why an aneurysm bleeds or exactly when it will bleed. We do know what increases the chance for bleeding:
High blood pressure is the leading cause ofsubarachnoid hemorrhage.Heavy lifting or straining can cause pressure to rise in the brain and may lead to an aneurysm rupture.
Strong emotions, such as being upset or angry, can raise blood pressure and can subsequently cause aneurysms to rupture.
*Blood thinners , some medications and prescription drugs , and harmful drugs like cocaine can cause aneurysms to rupture and bleed.
What are the chances that an unruptured aneurysm may bleed? Many factors determine whether an aneurysm is likely to bleed. These include the size, shape and location of the aneurysm and symptoms that it causes. Smaller aneurysms that are uniform in size may be less likely to bleed than larger, irregularly shaped ones. Once an aneurysm has bled, theres a very high chance of re-bleeding.
What happens if an aneurysm bleeds? If an aneurysm ruptures, it leaks blood into the space around the brain. This is called a subarachnoid hemorrhage. Depending on the amount of blood, it can produce:
- a sudden severe headache that can last from several hours to days
- nausea and vomiting drowsiness and/or coma
The hemorrhage may also damage the brain directly, usually from bleeding into the brain itself. This is called a hemorrhagic stroke. This can lead to:
- weakness or paralysis of an arm or leg
- trouble speaking or understanding language
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Can Mri Without Contrast Detect Brain Aneurysm
Even without the intravenous contrast, MRI can detect pathology in most organs and in some cases the pathology is made less visible on a contrast MRI than a non-contrast scan. For example, non-contrast scans provide greater images of blood vessel activity to detect aneurysms and blocked blood vessels.
Similarly, Can non contrast CT show aneurysm?
According to the American Heart Association statement, CT with or without contrast agents is considered too imprecise for adequate diagnosis of brain aneurysms. However, CTA may pinpoint aneurysms as small as 2 to 3 mm.
Additionally, Does brain MRI require contrast? The majority of MRI scans do not require contrast. The doctor and radiologist will decide if contrast is necessary, and a person takes it orally or by injection. Contrast travels to organs and tissue through the bloodstream. The MRI procedure is the same, whether or not it requires contrast.
What Are The Symptoms Of An Aneurysm
The symptoms of an aneurysm depend on where it is and whether it bleeds or bursts .
Sometimes there is a small leak of blood from the aneurysm. This can cause:
- a sudden headache and nausea if it is in the brain
- a sudden pain in the abdomen or back if it is in the abdomen
If the aneurysm bursts, it is very serious and can be fatal. If a brain aneurysm bursts, it can cause a sudden, very severe headache, nausea and vomiting. The person may become unconscious.
If an aortic aneurysms bursts, the person gets sudden pain in the back or belly and feels very weak. They may black out.
Sometimes a burst aneurysm in the brain can cause a stroke.
The main symptoms of stroke can be remembered by using the word ‘FAST’: Face-Arms-Speech-Time is critical.
Face The face may have dropped on one side, the person may not be able to smile or their mouth or eye may have drooped.
Arms The person with the suspected stroke may not be able to lift one or both arms and keep them there because of arm weakness or numbness.
Speech Their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake.
Time is critical It is time to call triple zero immediately to ask for an ambulance if you see any of these signs or symptoms.
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Psoriasis May Raise Risk Of Aneurysms In The Abdomen
Nearly all untreated mycotic aneurysms lead to rupture and can be fatal, which is why timely diagnosis and treatment are key.
Aneurysms that occur in blood vessels in the heart are also categorized as either true, or those that involve all the three layers of the arterial wall, or false , which is marked by a collection of blood that leaks out of the artery but is confined by the surrounding tissue.
Getting Ready For The Treatment Or Surgery
Depending on the analysis results, the doctor will inform about the treatment or the surgical procedure in detail. It is necessary to follow the instructions to ensure that the individual is ready for the treatment or surgery. About 80% of the cases involve correction of the diet and placing the patient under observation. It is because not all aneurysms rupture leading to the requirement of surgery.
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What Are The Complications If You Have A Brain Bleed
When the aneurysm leaks or bursts open, blood flows into or around the brain. The pooling blood irritates brain tissue, which can make the brain swell. The result can be permanent brain damage, stroke or other complications such as:
- Vasospasm, when blood vessels get narrower and less oxygen reaches the brain.
- Hydrocephalus, a buildup of spinal fluid around the brain, sometimes called water on the brain, that puts pressure on the brain.
- Coma, when you lose consciousness for several days to weeks.
- Hyponatremia, when the bloods sodium level changes, which can make brain cells swell and cause brain damage.
- Seizures, or muscle convulsions, which can cause further brain damage.
What Symptoms Should I Look For
Symptoms of an aneurysm vary with each type and location. Its important to know that aneurysms that occur in the body or brain generally dont present signs or symptoms until they rupture.
Aneurysms that occur near the surface of the body may show signs of swelling and pain. A large mass may also develop. The symptoms of ruptured aneurysms anywhere in the body can include:
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What Are Peripheral Aneurysms And What Are The Different Types Of This Aneurysm
A peripheral aneurysm occurs when the wall of a blood vessel in an organ or another part of the body weakens and dilates. The dilation can cause blood clots and interrupt blood flow, and can rupture and cause serious bleeding and compression of adjacent tissues. Peripheral aneurysms are usually genetic and are rare.
A popliteal aneurysm is one that develops in an artery behind the knee. It is the most common type of peripheral aneurysm, accounting for 85 percent of all peripheral aneurysms and is associated with abdominal aortic aneurysms 40 to 50 percent of the time.
Other types of peripheral aneurysms include:
- Splenic Artery Aneurysm An aneurysm that develops near the spleen
- Mesenteric Artery Aneurysm An aneurysm in the artery that transports blood to the intestines
- Femoral Artery Aneurysm An aneurysm that forms in the femoral artery in the groin
- Carotid Artery Aneurysm An aneurysm that occurs in the carotid artery in the neck
- Visceral Aneurysm A bulge of the arteries that supply blood to the bowel or kidneys
Confirming With A Diagnosis
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Posterior Inferior Cerebellar Artery Aneurysms
Brain aneurysms can also be commonly found at the origin of the PICA. Our next case involves a patient who presented with headaches which were found to be related to a subarachnoid hemorrhage.
A posterior inferior artery aneurysm can be seen on this patients CTA scan. However, you would need the entire stack of images from the CTA to recognize that this is an aneurysm!
The aneurysm and its relationship with the PICA are better demonstrated on the maximum intensity projection image from the CTA scan and on a catheter angiography scan.
Figure 7. The posterior inferior cerebellar artery aneurysm is well demonstrated on the maximum intensity projection image from the computed tomography angiography scan and on a catheter angiography scan.
Whats The Difference Between A Ruptured And An Unruptured Brain Aneurysm
A ruptured aneurysm, sometimes called a brain bleed, is when blood breaks through the aneurysms wall and starts bleeding. This causes severe symptoms, such as a very painful headache like youve never felt before, and requires immediate medical care. With rapid, expert treatment, patients can often recover fully.
An unruptured brain aneurysm may cause zero symptoms. People can live with them for years before detection. If a brain aneurysm is unruptured, no blood has broken through the blood vessel walls. This means the balloon in your blood vessel remains intact.
For unruptured brain aneurysms, doctors will treat aneurysms that are more likely to bleed and leave certain others alone.
Once a brain aneurysm bleeds, or ruptures, it requires immediate medical care in a medical center designed to handle emergencies. If you think you are experiencing a ruptured brain aneurysm, dial 911 immediately.
Neurosurgeons use specialized procedures to treat ruptured and unruptured brain aneurysms, when appropriate:
- Microsurgical clipping: Neurosurgeons make a small opening in the skull and then place a titanium clip over the aneurysm to stop blood flow into the aneurysm.
- Endovascular coiling/stenting: In this newer approach, neurosurgeons place a stent, or tube, or other devices, such as coils, inside a blood vessel or aneurysm to divert blood flow away from an aneurysm.
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How Do You Treat An Aneurysm Naturally
11 Tips to Help Reduce Your Risk of an AneurysmMake Healthy Choices in Your Diet. Keep Your Blood Pressure Levels in Check. Lower High Cholesterol. Make Exercise a Part of Your Routine. Take Steps to Reduce and Manage Stress Well. 10 Tips to Help You De-Stress. Treat Obstructive Sleep Apnea. Quit Smoking.More itemsMay 7, 2018
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How Does A Brain Aneurysm Develop
Like most diseases, brain aneurysms develop for reasons that may be congenital or acquired . Although the congenital theory was thought to be more important in the past , it is now thought that acquired reasons are the main ones underlying the development of brain aneurysms. Perhaps the most significant of the acquired reasons are smoking which causes additional stress on the blood vessel wall).
How and why brain aneurysms develop really relate to properties of the wall of the blood vessel. As reviewed elsewhere, the artery wall is made up of a number of layers, each of which plays an important role in the overall strength and resilience of the vessel. In particular, there is only one elastic layer in the brain artery , which itself tends to have many normal openings , and anything that damages this layer will predispose to a brain aneurysm forming in this region of the artery. Also, the smooth muscle layer of brain arteries has certain naturally occurring defects , particularly where artery branch points occur. This makes aneurysms more likely to occur in such regions. In addition, at arterial bifurcations, the forces exerted by the flow of blood tend to be increased relative to other segments along the artery, and any condition which increases blood flow pressure and turbulence will aggravate the tendency for this part of the artery to balloon out as a brain aneurysm.
An aneurysm starts to develop on one side of the arterial wall.
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