The human brain is a large organ that gets almost 25% of all the blood supply. It is energy-hungry organ. Even short disruption in its oxygen supply is life-threatening. Fortunately, brain diseases are not frequent. Nonetheless, the risk of vascular diseases increases with age.
A brain aneurysm is a bulging of a blood vessel inside the skull. Due to some reason, a part of the blood vessel may become weakened. This weakened part may get inflated like a balloon, as blood rushes under high pressure in the brain. This bulging/aneurysm is most common in aorta or brain.
A brain aneurysm is a life-threatening condition, even if there are no symptoms. Reason? This weak and bulging part of the blood vessel is at high risk of bursting. Thus it can cause an acute power failure in the brain, something that can be fatal.
Identifying brain aneurysm is not easy. In the majority of cases, it may not produce any symptom at all (an unruptured aneurysm). While in other cases symptoms are too vague. It is not rare for such conditions to be identified only through MRI (magnetic resonance imaging). Quite often a person would be sent for brain imaging for unexplained and chronic headaches or some other mild symptoms.
One of the studies done in the UK shows that a large number of individuals with an aneurysm were not aware of it, and condition was diagnosed incidentally through MRI.
A ruptured aneurysm is an acute condition and has visible symptoms. Once ruptured it would cause hemorrhagic stroke. It is an acutely life-threatening condition.
Considering the risk posed by an aneurysm, it is vital to learn to identify its early signs and symptoms. It is also necessary to know the health conditions that increase the risk of such a disease.
Who is at risk of a brain aneurysm?
A brain aneurysm develops slowly over the years. Therefore, it is more common in older adults. The incidence of a brain aneurysm starts increasing after the age of 50. Another reason for higher age-related risk is the frequent presence of other diseases in older adults.
When it comes to gender, among the young people, both males and females are at equal risk. However, in the older population, women seem to be at a higher risk due to fall in estrogen levels.
Some of the well-identified risk factors for a brain aneurysm are family history (genetics), autosomal dominant polycystic kidney disease (ADPKD), brain tumor, and atherosclerosis.
Among the preventable causes of a brain aneurysm is smoking. Nicotine is toxic for blood vessels, especially at high doses. Chain smokers are at higher risk of the disease. Smoking cause damage to the wall of blood vessels.
Almost one-third of adults have high blood pressure. Higher pressure in blood vessels means increased risk of bulging of weaker parts. Thus overweight individuals, those who consume more salt, do not exercise regularly, drink lots of alcohol, are at higher risk.
To live longer learn to identify signs of an aneurysm. Here we present some of the most common symptoms. Some of them would be more common in an unruptured aneurysm; others occur if it ruptures.
In an unruptured aneurysm, symptoms occur when bulging or balloon-like structure protruding from blood vessel starts putting pressure on nerves and brain structures.
Here are top 15 signs and symptoms that may point to a brain aneurysm:
Vision disturbances
some may experience a sudden worsening of vision. Quite often this worsening of sight would be fast, and difficult to explain. Moreover, there may be other symptoms present like unexplained headaches, dizziness, doubling of vision.
It not rare for a person to lose vision completely, resulting in sudden blindness.
Falling visual acuity is a significant symptom, especially when other signs of brain disease are also present. Research shows that such visual changes occur much before aneurysmal rupture.
Moreover, the presence of visual symptoms may also speak about the location and severity of a brain aneurysm. Clinical experience demonstrates that visual symptoms occur when an aneurysm is quite large (above 15mm).
Quite often, when visual symptoms like falling eyesight occur, the aneurysm is visible in MRI. If treated early enough, most individuals can expect to regain visual function. However, in some cases, a person may be diagnosed too late, and by that time irreversible changes have occurred.
The blurring of vision, doubling, dilation of the pupil
these are also visual symptoms. In some individual visual acuity may not suffer much, but may have other visual symptoms. Visual disturbances are common in aneurysm of a cerebral artery or anterior communication artery. A large number of those living with an aneurysm may have intra-ocular hemorrhages.
Headache
Headaches- are frequent, thus diagnosing aneurysm based on them it difficult. Headaches would be present in the majority of individuals with an aneurysm . However, the problem with headaches is that they are not specific to an aneurysm and may get neglected. There are few ways to differentiate a migraine or other-cause headaches from an aneurysm.
Most people may report mild, episodic headaches. If not due to aneurysm of migraine, headaches may not return in most cases, and medications like acetaminophen may help well.
Migraines, on the other hand, are entirely different; they are moderate to severe headaches. Migraines cannot be neglected. However, migraines are frequently episodic, and a person can clearly say what exacerbates them. Some may develop a headache in a particular season, while others may have headaches after a specific type of food. A migraine is characterized by aura, that is a person can say that he or she would soon have a headache.
Despite the presence of aura and episodic nature, migraines and headaches due to an aneurysm are difficult to differentiate. Both types of pains are severe; visual changes may also occur in migraine.
Headaches due to an aneurysm, unlike migraine, are not episodic. They may worsen over the short time. Visual changes are also progressive. Quite often pain would worsen on coughing. MRI examination would help in final diagnosis in most cases.
Headaches in ruptured aneurysm differ. People would define it as the worst headache ever. However, such headache will soon be followed by paralytic changes and even loss of consciousness. So if you have a sudden and extremely severe headache with other neurological symptoms, it may be a medical emergency.
Weakness or numbness in one side of the face
it happens when a bulging aneurysm presses one of the facial nerves. It may either result in numbness in some parts of the face or even paralysis. It is not among the typical symptoms. Nonetheless, research shows that it may be present in about 20% of all cases of a brain aneurysm.
It is common to confuse this symptom with stroke as many may have a severe headache too. However, unlike stroke progress would be slow. It means that facial numbness or paralysis may occur over a prolonged period. Whereas in stroke, it may happen abruptly, and the untreated person may get worse very quickly.
Drooping of eyelids
yet another symptom of cranial nerve being under pressure. It is a very unspecific symptom and may be present in numerous other conditions that affect the brain.
Difficulty speaking
not a common symptom of a brain aneurysm, however, may occur in some cases. Complete loss of voice is sporadic in a brain aneurysm. What may happen is difficulty in speaking due to damage to various brain centers. In most cases, a person would be able to talk. However, the speech would be blurry and difficult to understand. Loss of voice is more common in aneurysm of aorta leading to vocal cord palsy.
Changes in gait or difficulty in maintaining balance
not a very typical symptom of a brain aneurysm, but still it may occur. Changes in gait are frequent due to other vascular conditions, which results in micro infarctions of the brain. Nonetheless, it is worth remembering that those living with diseases of blood vessels of the brain are at higher risk of developing an aneurysm.
Maintaining balance is quite a complex mechanism. Perfect balance is achieved via perfect synchronization among various brain centers. Vestibular apparatus, visual information, all have their roles. Thus in a brain aneurysm, the problem of maintaining balance may occur for many reasons. Some individuals may see changes in gait; it may be to compensate for the ability to balance, or due to direct damage to some part of the brain.
Difficulty concentrating and mental health issues
it is one of the neglected symptoms of an aneurysm. It is often difficult to identify. The decline in cognitive function may occur due to direct or indirect effects of a brain aneurysm. Thus a person living with an aneurysm may have multiple and chronic health issues. Research shows that a brain aneurysm increases the risk of anxiety and depression.
The problem in concentrating or other health issues would be more common in those already diagnosed with the condition. The severity of the disease has lots to do about it. Individuals know that an aneurysm is a life-threatening illness. Treatment is primarily surgical, but no surgical procedure is without risk. The old age of individuals living with an aneurysm is another contributing factor.
Neck stiffness
if present, it could be a reason for alarm. Stiff neck is typical after a rupture. Therefore, for those living with a brain aneurysm, it is a symptom to remember. If it occurs, urgent medical advice should be sought.
Feeling of being sick
though most in most cases of an un-ruptured aneurysm, a person may feel more or less well. Nonetheless, due to the chronic nature of the condition, many may feel sick all the time.
Sudden confusion
is a reason to worry, it is an alarm. It indicates that an aneurysm has ruptured causing a brain hemorrhage. Along with sudden confusion, a person may develop a severe headache. It is worth knowing the severity of symptoms may vary among the individuals. Moreover, lots would depend on the location of an aneurysm.
In some cases, headache and confusion may be mild. Nevertheless, one should be immediately hospitalized in such case, as things would get worse very quickly. Slowly after the rupture, inflammation of various brain centers begins.
Fits or seizures
it is an under-recognized symptom of a brain aneurysm. Even many physicians are not aware that sometimes people living with a brain aneurysm may have symptoms similar to epilepsy. Usually, if a person has fits, a doctor would think about epilepsy, and small aneurysm may not be visible in MRI scan.
There are very few clinical reports that looked into the association between epileptic fits/seizures and brain aneurysm. Nonetheless, one study reported such an association. In the survey five patients living with epilepsy were found to have a brain aneurysm. Four of them were treated for an aneurysm. After treatment, two patients became completely normal, and in other two frequency of fits came down.
Because of involvement of brain, the aneurysm may present atypically in many cases. In one clinical report, 60-year-old women had epileptic fits along with nausea, lightheadedness, and hallucinations. 60-year women reported seeing a woman on the table nearby, though others present in the room did not see anything like that.
Nausea or vomiting
may occur in any stage of a brain aneurysm. It may be the result of minor pressure caused by bulging artery on the brain tissue. Individual sensitivities also play a significant role. Sudden and challenging to control nausea along with recurrent vomiting may also indicate rupture of an aneurysm.
Weakness on one side of the body
it is more frequently found in stroke, though in some cases it may occur in a brain aneurysm too. A very large aneurysm may put pressure on some parts of the brain leading to paralysis or weakness on one side of the body. If such symptoms occur, it is a reason for worry. In most cases, MRI would help differentiate an aneurysm with other conditions like stroke or tumor.
Loss of consciousness
Loss of consciousness – another alarming symptom that may point to brain hemorrhage due to rupture of an aneurysm. Stroke is another frequent cause that may mimic the condition.
In conclusion, it is essential to know that small brain aneurysms may remain asymptomatic in most cases. While in other instances vague symptoms like moderate headaches, recurrent nausea may occur. Severe symptoms like visual disturbances, seizures, weakness on one side, mental problems are less frequent. MRI remains the golden standard in the diagnosis/differential diagnosis of many brain diseases including an aneurysm.