Roughly six million Americans are walking around with brain aneurysms — bulging spots on the wall of a blood vessel in the brain, similar to the thin, stretched skin of a balloon or a weak spot in an inner tube. Many of these people are unaware of their condition and may never even learn of it, unless their healthcare provider finds it while looking for something else — or worse, if the aneurysm ruptures.
While it is relatively uncommon for small aneurysms to rupture (50 to 80 percent never will), large ones often do. According to the Brain Aneurysm Foundation, it happens about once every 18 minutes in this country.
When it does, the consequences are serious, even fatal. Ruptured brain aneurysms account for 3 to 5 percent of strokes, and about 40 percent of people whose brain aneurysms rupture will die. Worldwide, ruptured aneurysms are responsible for nearly 500,000 deaths each year, with half the victims younger than age 50.
Of those people who don’t die following a rupture, 66 percent suffer some type of neurological damage when blood seeps into the brain. Four out of seven of those survivors will have permanent disabilities.
While aneurysms can develop at any age, they are more likely to occur in people over the age of 40 and are most prevalent between the ages of 35 and 60. The median age when aneurysmal hemorrhagic strokes occur is 50. These typically happen without warning.
So, how do you know if you are among the 1 in 50 Americans living with a brain aneurysm? While small aneurysms rarely have any symptoms, larger ones may press on the brain or nerves stemming from the brain, signaling a problem.
Here’s what to watch out for: localized headaches; dilated pupils; blurred or double vision; pain above and behind the eye; weakness and numbness; or difficulty speaking. If you experience these symptoms, have them checked out by your provider.
When to Get Help
The Brain Aneurysm Foundation recommends you seek immediate attention if you experience any of the following: a sudden severe headache that feels like “the worst headache of your life”; loss of consciousness; nausea or vomiting; a stiff neck; sudden blurred or double vision; sudden pain above or behind the eye or difficulty seeing; a sudden change in mental status or awareness; sudden trouble walking or dizziness; sudden weakness and numbness; sensitivity to light; a seizure; or a drooping eyelid.
Should you experience any of these symptoms, call 911. Do not try to drive yourself to the emergency room or even have someone else drive you. This is a medical emergency and may require paramedics to deliver immediate, life-saving procedures.
Who’s at Risk
While you may not be able to detect an aneurysm, it is possible to take steps to reduce your risk of developing one. Common risk factors that contribute to the formation of brain aneurysms include smoking, high blood pressure, drug use (particularly cocaine), infections and traumatic head injuries. Other risk factors include a family history of brain aneurysms, abnormalities in your artery walls, being over the age of 40 and the presence of tumors.
Some groups are at higher risk for brain aneurysms due to gender, race or ethnicity. For example, women are at higher risk than men, and African Americans and Hispanics are twice as likely to have an aneurysm rupture as Caucasians.
Having a disorder such as Ehlers-Danlos Sydrome, polycystic kidney disease, Marfan syndrome and Fibromuscular Dysplasia (FMD) also places you at higher risk for a brain aneurysm.
Testing & Treatment
Screening for unruptured aneurysms is recommended for people who have a family history of ruptured aneurysms. If your provider suspects you have an aneurysm, you will need a thorough neurologic evaluation that may include a CT scan, an MRI and/or a lumbar puncture, or spinal tap, in which fluid around the brain and spinal cord will be collected.
Once detected, aneurysms should be monitored for any change in size and may be treated with surgery or other procedures under the care of a neurologist. According to the Brain Aneurysm Foundation, treatments have advanced greatly in recent years. Aneurysms once considered inoperable may now be treated more effectively and less invasively due to new technologies — such as coiling, which is done using a catheter.
However, don’t panic if the only symptom you are experiencing is a pounding headache. While research shows that one of the leading fears of people who come to the emergency room with headaches is that they are experiencing bleeding in the brain from a ruptured aneurysm, it rarely turns out to be the case. Studies show that a subarachnoid hemorrhage (SAH) is responsible for less than four percent of all emergency room headache visits.