The Warning Signs Of A Brain Aneurysm
The symptoms and signs of a ruptured aneurysm include:
- A severe headache that comes out of nowhere
- Blurred vision
- Drooping eyelids
- Passing out
An unruptured aneurysm might not initially have any symptoms, but that usually changes as it grows larger. The warning signs that indicate a person has developed an unruptured brain aneurysm include:
- Pain behind or above an eye
- Double vision
- Numbness on one side of the patient’s face
Patients are advised to seek immediate medical attention if:
- They have a severe headache that is incomparable in pain to past headaches suddenly occurs
- They have a seizure
- They lose consciousness
What Is The Difference Between An Aneurysm And Stroke
The main difference between an aneurysm and stroke has to do with how the two conditions affect blood vessels. An aneurysm is a bulging of a blood vessel that may rupture. Conversely, a stroke is caused when oxygen and nutrients cannot get to parts of the brain because a vessel breaks or because of a blockage in the vessel. Despite the differences, an aneurysm and stroke have several characteristics in common. Both an aneurysm and stroke have to do with blood vessels and blood flow, and both can be fatal.
Both aneurysms and strokes have to do with blood vessels and how they carry blood. An aneurysm can occur with many arteries but most commonly is associated with the aorta, the primary artery that transports blood from the heart into the rest of the body. An aneurysm occurs when a part of the artery becomes weak and bulges. Over time, blood pressure and other factors can cause the bulge to become bigger and weaker. Should it rupture, an aneurysm can cause internal bleeding and death.
How Are Brain Aneurysms Treated
Surgery and/or endovascular therapy are the treatment for brain aneurysms, whether they are ruptured or unruptured.
Open surgical clipping
During this procedure, your surgeon cuts a small opening in your skull to access the aneurysm. Using a tiny microscope and instruments, your surgeon attaches a small metal clip at the base of the aneurysm to pinch it off. This blocks blood from flowing into the aneurysm. The surgery can stop a brain bleed or keep an intact aneurysm from breaking open. Recovery time is different for ruptured and unruptured aneurysms. This procedure is considered to be durable with a low recurrence rate.
For this procedure, your surgeon doesnt need to create an opening in your skull. Instead, a doctor inserts a catheter in a blood vessel, usually in the groin or wrist, and threads it to your brain.
Through the catheter, your doctor places a ball of wires , most often made of platinum, in the aneurysm, sometimes with the help of small stents or balloons. Recently another small device , which looks like a mesh ball, made of nickel titanium, also became available, and works in a similar fashion as coils. Both methods result in blood clot formation around and inside the wire ball or web device, and block blood flow into the aneurysm, reducing or eliminating the risk of rupture.
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What Are The Complications Of A Ruptured Cerebral Aneurysm
Aneurysms may rupture and bleed into the space between the skull and the brain and sometimes into the brain tissue . These are forms of stroke called hemorrhagic stroke. The bleeding into the brain can cause a wide spectrum of symptoms, from a mild headache to permanent damage to the brain, or even death.
After an aneurysm has ruptured it may cause serious complications such as:
- Rebleeding. Once it has ruptured, an aneurysm may rupture again before it is treated, leading to further bleeding into the brain, and causing more damage or death.
- Change in sodium level. Bleeding in the brain can disrupt the balance of sodium in the blood supply and cause swelling in brain cells. This can result in permanent brain damage.
- Hydrocephalus. Subarachnoid hemorrhage can cause hydrocephalus. Hydrocephalus is a buildup of too much cerebrospinal fluid in the brain, which causes pressure that can lead to permanent brain damage or death. Hydrocephalus occurs frequently after subarachnoid hemorrhage because the blood blocks the normal flow of cerebrospinal fluid. If left untreated, increased pressure inside the head can cause coma or death.
- Vasospasm. This occurs frequently after subarachnoid hemorrhage when the bleeding causes the arteries in the brain to contract and limit blood flow to vital areas of the brain. This can cause strokes from lack of adequate blood flow to parts of the brain.
What Are The Potential Complications Of Aneurysm Treatment
Until the aneurysm is safely and completely treated, theres always the risk it may re-bleed and cause more brain damage. If normal blood vessels are damaged, it could also result in more brain damage.
What follow-up is required after aneurysm treatment? Depending on the type of treatment, the two follow-up procedures are:
- Surgical clipping.After this type of surgery, a post-operative angiogram is usually performed during the hospital stay to make sure the surgical clip has completely treated the aneurysm.
- Neurointerventionalist/neuroradiologist.After coiling an aneurysm, a routine follow-up angiogram is usually performed six to 12 months after the procedure to make sure the aneurysm remains blocked off
Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff.
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Stroke Types & Treatments
Catholic Health uses the latest and most advanced diagnostic technologies to identify if your type of stroke is a hemorrhagic stroke or an ischemic stroke. Several Catholic Health hospitals use telestroke video to give neurologists quicker access to diagnose and prescribe life-saving treatments.
An ischemic stroke happens when an artery in the brain is blocked by a blood clot. This blockage reduces blood flow and oxygen to the brain, which leads to damage or loss of brain cells.
Stroke patients may get a medicine called a thrombolytic to dissolve a clot and improve blood flow to the brain if they get to a hospital within four-and-a-half hours of initial stroke symptoms.
A hemorrhagic stroke occurs when a blood vessel bursts in the brain. Blood then accumulates in the tissues around the burst vessel, leading to pressure on the brain and loss of blood in the surrounding areas.
Treatments include endovascular procedures in which a physician inserts a long tube through a major artery in an arm or leg. They then thread the tube to the site of the break in the blood vessel and install a device, such as a coil, to repair the damage or prevent more bleeding.
Hemorrhagic strokes can also be treated with surgery to insert a metal clip to stop the bleeding.
What Is The Usual Damage To The Brain After An Aneurysm Bleeds
Once an aneurysm bleeds, the chance of death is about 40% and the chance of some brain damage is about 66 %, even if the aneurysm is treated. If the aneurysm isnt treated quickly enough, another bleed may occur from the already ruptured aneurysm.
Vasospasm is a common complication following a ruptured aneurysm. This can lead to further brain damage. Other problems may include hydrocephalus , difficulty breathing that requires a mechanical ventilator, and infection.
Why is the damage so extensive after bleeding? After blood enters the brain and the space around it, direct damage to the brain tissue and brain function results. The amount of damage is usually related to the amount of blood. Damage is due to the increased pressure and swelling from bleeding directly into the brain tissue, or from local cellular damage to brain tissue from irritation of blood in the space between the brain and the skull.
Blood can also irritate and damage the normal blood vessels and cause vasospasm . This can interrupt normal blood flow to the healthy brain tissue and can cause even more brain damage. This is called an ischemic stroke.
Will treating a ruptured aneurysm reverse or improve brain damage? Once an aneurysm bleeds and brain damage occurs, treating the aneurysm will not reverse the damage. Treatment helps prevent more bleeding.
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Is It A Stroke Or An Aneurysm
The terms stroke and aneurysm are sometimes used interchangeably, but these two serious conditions have some important differences.
Keep reading to learn more about identifying and treating strokes and aneurysms.
How Can I Decrease My Risk Of A Stroke Or Aneurysm
There are a few ways to help reduce the risk of developing either condition. The two most important lifestyle changes are quitting smoking and controlling high blood pressure, Dr. Segal says. Other important health changes are controlling cholesterol and getting regular physical exercise. Hypercholesterolemia and regular physical exercise appear to decrease the risk of aneurysm formation.
For aneurysm, a few other lifestyle changes can help. Patients should avoid smoking, heavy alcohol consumption, stimulant medications, illicit drugs, and excessive straining, Dr. Segal says.
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What Is The Difference Between A Ruptured Brain Aneurysm And A Stroke
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Burst Brain Aneurysms Or Hemorrhagic Stroke
If there is a hemorrhage or a brain aneurysm has burst, the doctor will usually refer a person to a specialist neurology center.
- immediate drug treatment with nimodipine
- surgery can close the aneurysm or prevent blood from pushing into it
Two different types of surgery are available:
- neurosurgical clipping
- endovascular coiling
Clipping involves the surgeon finding the aneurysm in the brain and applying a small metal clip. The clip is usually placed directly across the bulging part of the artery.
For coiling, the brain is reached with a catheter rather than through an opening in the skull. This is inserted at the groin or leg and travels up to the brain in an artery. Coils made of platinum are placed in the aneurysm to prevent blood from entering.
This reduces the risk of losing blood supply to any part of the brain and improves the chances of a better outcome.
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How Is An Aneurysm Diagnosed
Special imaging tests can detect a brain aneurysm. In the CTA , patients are placed on a table that slides into a CT scanner. A special contrast material is injected into a vein, and images are taken of the blood vessels to look for abnormalities such as an aneurysm. In the second test, called MRA , patients are placed on a table that slides into a magnetic resonance scanner, and the blood vessels are imaged to detect a cerebral aneurysm.
The most reliable test is called a diagnostic cerebral angiogram. In this test, the patient lies on an X-ray table. A small tube is inserted through a blood vessel in the leg and guided into each of the blood vessels in the neck that go to the brain. Contrast is then injected, and pictures are taken of all the blood vessels in the brain. This test is slightly more invasive and less comfortable.
Beforeanytreatment is considered, a diagnostic cerebral angiogram is usually performed to fully map a plan for therapy.
If one aneurysm forms, will others form? Having one aneurysm means theres about a 20 % chance of having one or more other aneurysms.
What Is Cerebrovascular Disease
Cerebrovascular diseases are brain blood vessel blockages, bleeding, or other problems which disrupt the regular flow of blood to the brain. This deprives the brain of necessary oxygen, which can then cause damage to the brain. Brain aneurysms, stroke, and vascular malformations are all types of cerebrovascular disease.
|A cerebrovascular event such as a stroke or hemorrhage is a medical emergency and patients should be treated immediately. At UNC, we have adopted an open-access policy requiring that we will be able to open a bed for any patient in the state of North Carolina requiring emergent treatment for cerebrovascular disease, including spontaneous intracranial hemorrhage from an aneurysm or hypertensive crisis, and stroke.|
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Aneurysm Vs Stroke: Which Is Worse
Aneurysms and strokes are brain conditions that require immediate medical attention. When your brain has become damaged and isn’t receiving blood and oxygen in the right proportions, it begins to affect your thoughts, speech, and ability to stay conscious. Both of these related conditions could cause permanent damage or even death.
Risk Factors Beyond Your Control
The brain aneurysm and stroke risk factors that you cant control are:
- Age: Although theyre more common in people who are 40 or older, anyone can experience an aneurysm at any age. Aneurysms are rare among children, and most aneurysm ruptures occur between the ages of 30 and 60. Likewise, the older you are, the more likely it is that youll have a stroke. However, as many as one in seven strokes occur in adolescents.
- Heredity: Youre more likely to have an aneurysm or stroke if an immediate family member has had one.
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What Is The Difference Between A Stroke And An Aneurysm
Strokes and aneurysms are similar in some ways, but also different. While both have potentially disabling consequences because they directly affect the brain, strokes and aneurysms have different symptoms and are caused by separate events.
Both strokes and aneurysms are serious conditions. Knowing more about them prepares you to understand and identify the symptoms faster so you can get medical help quickly.
How Do Aneurysms Form Are People Born With An Aneurysm
People usually arent born with aneurysms. Most develop after age 40. Aneurysms usually develop at branching points of arteries and are caused by constant pressure from blood flow. They often enlarge slowly and become weaker as they grow, just as a balloon becomes weaker as it stretches. Aneurysms may be associated with other types of blood vessel disorders, such as fibromuscular dysplasia, cerebral arteritis or arterial dissection, but these are very unusual. Some aneurysms are due to infections, drugs such as amphetamines andcocaine or direct brain trauma from an accident.
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What Is The Prognosis For Stroke And Aneurysm
The prognosis for an ischemic stroke is highly variable and depends on where the clot occurs in the brain, how long the clot remains before it is treated, and how effective the treatment is. Consequently, ischemic strokes may vary in prognosis from good to poor, depending upon the above conditions and how well the patient responds to treatment and/or rehabilitation. Hemorrhagic strokes more often have a poorer prognosis and have a higher mortality rate than ischemic strokes.
The prognosis for brain aneurysms is usually good as long as they dont leak or burst open. Prophylactic treatment of brain aneurysms is still controversial because there is a chance that any attempt to use endovascular treatments or surgical clipping actually may cause aneurysm to begin bleeding. Some procedures have a mortality rate of 3%. If the brain aneurysm leaks, the prognosis is poor and mortality is high unless acute neurosurgical or neurointerventional treatment is successful.
How Are Strokes And Aneurysms Diagnosed
Sharing your symptoms and personal medical history with your doctor will help them form a diagnosis and treatment plan.
CT and MRI scans can help your doctor diagnose an aneurysm or stroke. A CT scan shows the location of bleeding in the brain and areas of the brain affected by poor blood flow. An MRI can create detailed images of the brain. In some cases, your doctor may order both an MRI and a CT scan, as well as other imaging tests.
Your doctor will determine the best treatment based on the severity of your stroke or aneurysm and your medical history.
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What Treatments Are Available
- Medical therapy. Small, unruptured aneurysms that arent creating any symptoms may not need treatment unless they grow, trigger symptoms or rupture. Its very important to have annual check-ups to monitor blood pressure, cholesterol and other medical conditions.
- Neurosurgery.Depending on a persons risk factors, open surgery may be recommended. Patients are placed under general anesthesia, and the neurosurgeon places a surgical clip around the base of the aneurysm.
- Neurointerventionalist/neuroradiologist.Depending on the aneurysms size, location and shape, it may be treatable from inside the blood vessel. This minimally invasive procedure is similar to the cerebral angiogram. However, in addition to taking pictures, a catheter is directed through the blood vessels into the aneurysm itself. Then, using X-ray guidance, the endovascular surgeon carefully places soft platinum micro-coils into the aneurysm and detaches them. The coils stay within the aneurysm and act as a mechanical barrier to blood flow, thus sealing it off
How Is A Diagnosis Made
When a person is brought to the emergency room with a suspected ruptured aneurysm, doctors will learn as much as possible about his or her symptoms, current and previous medical problems, medications, and family history. The person’s condition is assessed quickly. Diagnostic tests will help determine the source of the bleeding.
- Computed Tomography scan is a noninvasive X-ray to view the anatomical structures within the brain and to detect blood in or around the brain . A CT angiography involves the injection of contrast into the blood stream to view the arteries of the brain.
- Lumbar puncture is an invasive procedure in which a hollow needle is inserted in the low back to collect cerebrospinal fluid from the spinal canal. The CSF is examined to detect blood from a suspected hemorrhage.
- Angiogram is an invasive procedure in which a catheter is inserted into an artery and passed through the blood vessels to the brain. Once the catheter is in place, contrast dye is injected into the bloodstream and x-rays are taken.
- Magnetic Resonance Imaging scan is a noninvasive test that uses a magnetic field and radio-frequency waves to give a detailed view of the soft tissues of the brain. An MRA involves the injection of contrast into the blood stream to examine the blood vessels in addition to structures of the brain.
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