Brain & Spine Emergencies
Understanding Brain Aneurysms: Risks, Warning Signs and Treatment
An aneurysm found on a scan can be alarming. Learn what it is, which signs mean an emergency, and how treatment decisions are usually made.
A 50-year-old woman has an MRI for dizziness. The dizziness turns out to be an inner-ear problem, but the report also mentions "a small aneurysm" in a brain artery. She has no symptoms from it, yet she cannot stop thinking about it. Was she close to a stroke? Should she avoid lifting her grandchild? Many aneurysms today are found by chance like this. Understanding what an aneurysm is, and how doctors decide what to do about one, can replace fear with a clear plan.
Key takeaways
- A brain aneurysm is a bulge in a weakened artery wall; many never rupture.
- High blood pressure, smoking and family history raise risk.
- A sudden, explosive 'worst ever' headache is an emergency: call 112.
- Observation, surgical clipping and endovascular treatment are all options, chosen case by case.
What is a brain aneurysm?
A brain aneurysm is a weak spot in the wall of an artery that balloons outward. Most are small and berry-shaped and form where arteries branch at the base of the brain. Blood pressure pushes against the weakened wall, and in a minority of cases the aneurysm can grow or burst.
Many people live their whole lives with a small unruptured aneurysm that never causes trouble. The challenge is identifying which aneurysms carry a higher risk.
Who is at higher risk?
- People with high blood pressure, especially if poorly controlled
- Smokers, current or past
- Those with a parent, brother or sister who had an aneurysm or aneurysm bleed
- People with certain inherited conditions, such as polycystic kidney disease
- Heavy alcohol use; aneurysms are also somewhat more common in women
Unruptured versus ruptured aneurysms
Unruptured aneurysms usually cause no symptoms. Occasionally a larger one presses on a nerve, causing a drooping eyelid, double vision or pain behind one eye. These signs need prompt medical review.
A ruptured aneurysm bleeds into the space around the brain, called a subarachnoid haemorrhage. This is a life-threatening emergency that needs specialist hospital care without delay.
When this is an emergency
Call 112 or go to the nearest emergency department immediately if someone develops:
- A sudden, explosive headache, often described as "the worst headache of my life", reaching full intensity within seconds to a minute
- Vomiting, neck stiffness or discomfort with bright light along with that headache
- Fainting, confusion, a seizure or sudden drowsiness
Do not wait to see whether a painkiller works. Early diagnosis with a CT scan can be lifesaving.
How aneurysms are assessed and treated
Doctors study an aneurysm with CT angiography, MR angiography or a catheter angiogram (DSA), which shows its exact size, shape and neck. Decisions then consider the aneurysm's size, location and shape, the patient's age and health, and any history of previous bleeding.
- Observation: some small, low-risk aneurysms are monitored with periodic scans while blood pressure and smoking are controlled.
- Surgical clipping: a neurosurgeon places a small metal clip across the aneurysm's neck through an opening in the skull.
- Endovascular treatment: coils or other devices are placed from inside the artery through a thin tube passed from the groin or wrist.
The most suitable approach is decided by the treating team and hospital after reviewing each case. You can learn more on our pages about brain aneurysm care and cerebrovascular neurosurgery.
Living with an unruptured aneurysm
If you are advised observation, the most useful steps are within your control: keep your blood pressure well managed, stop smoking, limit alcohol and attend follow-up scans. Most everyday activities can continue, but ask your doctor about heavy straining or specific sports. It is also wise to tell close family members about the aneurysm, so they know which warning signs to act on without delay.
If an aneurysm has been reported on your scan and you would like it explained, you can book a consultation with Dr. Naresh Panwar at Sarvodaya Hospital in Faridabad. Bring the scan CD as well as the printed report.
Frequently asked questions
Does every unruptured aneurysm need treatment?
No. Many small aneurysms are simply monitored, especially in people without additional risk factors. The decision weighs the estimated risk of rupture against the risks of treatment.
Dimag ki nas phoolna kya hota hai aur kya yeh khatarnaak hai?
This is the common way people describe a brain aneurysm, a ballooning of a weak artery wall. Many are never dangerous, but a burst aneurysm is an emergency, so any aneurysm found should be reviewed by a specialist.
Should my family members be screened?
Screening is sometimes suggested when two or more close relatives have had aneurysms, or with certain inherited conditions. Discuss your family history with your doctor before arranging tests.
This article is general health information for patients and families. It is not a diagnosis. Please consult a qualified doctor about your own symptoms. See our medical disclaimer.
Keep reading
Appointments
Your brain and spine health deserve a carefully considered plan.
Request a consultation with Dr. Naresh Panwar at Sarvodaya Hospital, Sector 8, Faridabad. Bring your MRI or CT scans and reports, and the care team will help you prepare.