What Is an Intracranial Aneurysm?
An intracranial aneurysm (also called a brain aneurysm) is a weakened, bulging area in the wall of a blood vessel in the brain. Over time, the pressure of blood flow can cause the aneurysm to enlarge and possibly rupture, leading to bleeding in the brain (a subarachnoid hemorrhage), which is a life-threatening medical emergency.
What Causes an Intracranial Aneurysm?
The exact cause is often unknown, but several factors can contribute to the development of a brain aneurysm:
- High blood pressure
- Atherosclerosis (hardening of arteries)
- Genetic factors or family history of aneurysms
- Smoking
- Head injury or trauma
- Infections
- Drug use, particularly cocaine or amphetamines
- Certain medical conditions, such as polycystic kidney disease or connective tissue disorders (e.g., Ehlers-Danlos syndrome, Marfan syndrome)
What Are the Symptoms of an Intracranial Aneurysm?
Most unruptured aneurysms do not cause symptoms and are discovered incidentally. However, larger aneurysms may press on nearby nerves or tissues, causing:
- Headaches
- Blurred or double vision
- Pain above or behind the eye
- Dilated pupil
- Drooping eyelid
- Facial numbness or weakness
Symptoms of a Ruptured Aneurysm:
- Sudden, severe headache (often described as “the worst headache of my life”)
- Nausea and vomiting
- Stiff neck
- Sensitivity to light
- Seizures
- Loss of consciousness
- Sudden confusion or difficulty speaking
How Is an Intracranial Aneurysm Diagnosed?
If a brain aneurysm is suspected, the following tests may be used:
- CT Scan – quick and useful for detecting bleeding
- CT Angiography (CTA) – shows detailed blood vessels
- MRI or MRA (Magnetic Resonance Angiography) – used to locate and assess aneurysms
- Cerebral Angiography – provides a detailed view of blood flow in the brain and can confirm the diagnosis
How Is an Intracranial Aneurysm Treated?
Treatment depends on the aneurysm’s size, location, and whether it has ruptured.
For Unruptured Aneurysms:
- Monitoring with regular imaging if small and low-risk
- Lifestyle changes to reduce risk (e.g., quitting smoking, controlling blood pressure)
- Surgical options if there’s a high risk of rupture:
- Surgical clipping – placing a metal clip around the base of the aneurysm
- Endovascular coiling – filling the aneurysm with coils through a catheter to prevent rupture
For Ruptured Aneurysms:
- Immediate hospitalization and intensive care
- Surgical clipping or endovascular coiling to stop bleeding
- Managing complications, such as brain swelling, hydrocephalus (fluid buildup), and vasospasm (blood vessel narrowing)
- Rehabilitation – including physical, speech, and occupational therapy after recovery
Can Intracranial Aneurysms Be Prevented?
While not all aneurysms can be prevented, reducing risk factors can help:
- Control high blood pressure
- Quit smoking
- Avoid recreational drugs
- Limit alcohol intake
- Maintain a healthy diet and exercise
- Regular check-ups if you have a family history or genetic predisposition
Is an Intracranial Aneurysm Dangerous?
Yes, especially if it ruptures. A ruptured brain aneurysm can cause:
- Stroke
- Coma
- Permanent brain damage
- Death
Unruptured aneurysms can also cause serious problems if left untreated and are at risk of rupture over time.