A brain aneurysm is a bubble or bulge that forms at a weak spot in the walls of the blood vessels of the brain. It is usually asymptomatic and can be detected by chance during routine check-ups. However, if the aneurysm bursts, a serious brain hemorrhage known as subarachnoid hemorrhage occurs. This can cause life-threatening symptoms such as sudden and severe headache, nausea, loss of vision or loss of consciousness. Brain aneurysms are associated with factors such as genetic predisposition, high blood pressure, smoking and arteriosclerosis. Treatment options include surgical intervention and endovascular procedures, while early diagnosis can be life-saving.
A brain aneurysm is a serious condition but can be managed with regular check-ups and the right lifestyle changes. Especially for individuals with a family history of aneurysms or risk factors such as high blood pressure, early detection of possible aneurysms through routine screenings is of great importance. In addition, habits such as quitting smoking and alcohol use, healthy nutrition and regular exercise help protect vascular health. Stress management and blood pressure control can also significantly reduce the risk of rupture.
Untreated ruptured aneurysms can be fatal or cause severe neurological damage. Therefore, it is essential to seek medical attention immediately when experiencing symptoms such as sudden and severe headaches. Treatment options include surgical clipping and endovascular embolization. With early intervention, the majority of patients can recover and maintain their quality of life. Although living with an aneurysm requires attention and follow-up, patients can lead a normal life with the treatment methods provided by modern medicine.
What are the Causes of Brain Aneurysms?
Brain aneurysms are caused by weaknesses in the walls of the blood vessels of the brain. These weaknesses can occur as a result of a combination of genetic predisposition, lifestyle factors and environmental influences. Although the causes of aneurysms are not fully known, the following factors may increase the risk of their occurrence:
Genetic Predisposition: People with a family history of brain aneurysms have a higher risk. In addition, some genetic conditions such as Marfan syndrome, Ehlers-Danlos syndrome and polycystic kidney disease can also cause weakening of the vessel walls.
High Blood Pressure (Hypertension): Persistent high blood pressure puts excessive strain on the vessel walls and predisposes to aneurysm formation.
Smoking and alcohol use: Smoking weakens the vessel walls and can accelerate the development of an aneurysm. Excessive alcohol consumption also increases the risk factor by creating stress on the vessels.
Head Traumas and Infections: Serious head traumas or certain infections can cause weaknesses in the brain vessels and lead to aneurysm formation.
Arteriosclerosis (Atherosclerosis): Plaque buildup on the lining of blood vessels can reduce the elasticity of the vessel walls, which increases the risk of an aneurysm.
Age and Gender: Aneurysms are more common in individuals over the age of 40. In addition, women are slightly more at risk than men due to hormonal factors.
Congenital Anomalies: Some individuals may have congenital weaknesses or abnormalities in the structure of blood vessels.
The causes of brain aneurysms may differ from person to person. However, adopting a healthy lifestyle, keeping blood pressure under control and avoiding smoking can help reduce the risk of occurrence. It is also vital for individuals at risk to have regular medical check-ups.
What are the symptoms of a brain aneurysm?
Symptoms of a brain aneurysm vary depending on whether the aneurysm has ruptured or not. An unruptured (unruptured) aneurysm is usually asymptomatic and may be detected incidentally during screening for another disease. However, when the aneurysm enlarges or ruptures, various symptoms can occur.
Symptoms of Unruptured Aneurysm
- Headache (usually severe and can be a constant pain)
- Vision problems (blurred vision, double vision or loss of visual field)
- Pain in the eye or a feeling of pressure around it
- Symptoms of facial numbness or mild paralysis
- Loss of balance or difficulty speaking
Symptoms of a Ruptured Aneurysm
A ruptured aneurysm is a serious medical condition and usually presents with the following symptoms
Sudden and Severe Headache: Often described as "the worst headache of my life".
Loss of Consciousness: The person may faint or become unresponsive to their surroundings.
Nausea and Vomiting: Caused by sudden bleeding.
Neck stiffness: May occur as a result of bleeding affecting the membranes around the brain.
Photosensitivity: This condition, known as photophobia, can increase light sensitivity.
Neurological Problems: Symptoms such as weakness on one side of the body, paralysis, loss of speech or vision may occur.
Seizures: Seizures due to disruption of electrical activity in the brain.
A ruptured aneurysm is an emergency and can be life-threatening. If you experience sudden and severe headaches, loss of consciousness or neurological problems, you should seek medical attention immediately. Early intervention plays a critical role in preventing complications and increasing the patient's chances of recovery. It is important not to underestimate the symptoms of unruptured aneurysms and not to neglect routine controls in order to prevent serious consequences.
Brain Tomography and MRI
Brain tomography (CT) and magnetic resonance imaging (MRI) are two important imaging modalities used to diagnose diseases of the brain and nervous system. CT uses X-rays to provide quick and detailed cross-sectional images of the brain, and is particularly preferred for bleeding, skull fractures and emergencies. MRI, on the other hand, works with magnetic fields and radio waves, can visualize soft tissues in more detail and does not involve radiation. MRI is a superior method for diagnosing tumors, nerve damage and abnormalities in brain tissue. While CT offers the advantage of speed in emergencies, MRI is preferred in cases requiring detailed evaluation. The two methods are complementary to each other and their use is determined by the doctor according to the patient's condition.
Brain Angiography
Brain angiography is a specialized medical imaging procedure used to view the blood vessels of the brain in detail. This procedure is performed to diagnose vascular blockages, brain aneurysms, arteriovenous malformations (AVMs) and other vascular diseases. In the conventional method, a catheter is inserted into the vein through the groin or arm, a contrast medium is injected and X-rays are used to image the veins. Alternatively, less invasive techniques such as CT or MR angiography can be used. Brain angiography provides a highly accurate diagnosis, offering the chance for early intervention in the treatment of vascular problems. While the procedure is generally safe, it involves minimal risks and is performed by a team of specialists.
Cerebrospinal Fluid Test
A cerebrospinal fluid test (lumbar puncture) is a medical procedure to examine the fluid surrounding the brain and spinal cord. This test is used to diagnose infections of the central nervous system (meningitis, encephalitis), brain hemorrhages, autoimmune diseases such as multiple sclerosis and some types of cancer. During the procedure, cerebrospinal fluid is taken with a fine needle, usually from the lumbar region, and analyzed in the laboratory. Parameters such as the pressure, protein, glucose and cellular content of the fluid are evaluated. It is generally a safe procedure, but temporary side effects such as headache or mild pain at the needle insertion site may occur. This test is vital for accurate diagnosis and treatment.
Surgical Clipping
Surgical clipping is a method used in the treatment of brain aneurysms and is used to prevent the aneurysm from rupturing or to stop bleeding.
for the treatment of an aneurysm. In this procedure, under general anesthesia, a clip made of titanium is inserted into the neck of the aneurysm to stop blood flow and disable the aneurysm. This method, which is especially preferred for large aneurysms or those with a high risk of rupture, is performed using microscopic surgical techniques. The clips are durable for life and minimize the risk of aneurysm recurrence. Surgical clipping is an effective treatment method with a high success rate in appropriate patients. Endovascular Coiling(H2)
Endovascular coiling is a minimally invasive procedure used to treat brain aneurysms. In this method, a catheter is inserted through the groin into the brain vessels and platinum coils are inserted into the aneurysm. These coils fill the aneurysm, blocking blood circulation and reducing the risk of rupture. Performed under general anesthesia, this procedure is less invasive than surgical clipping and recovery time is usually shorter. Coiling, which is especially preferred for aneurysms that are deeply located or not suitable for surgery, provides an effective treatment while minimizing the risk of complications.
Symptoms of Unruptured Brain Aneurysm
Unruptured Unruptured (unruptured) brain aneurysms are usually not noticed without symptoms. However, some symptoms may occur when the aneurysm grows and presses on the surrounding nerves or brain tissue. These symptoms depend on the size and location of the aneurysm and the area of pressure. Common symptoms include:
Headache: You may have a constant or recurring headache. However, this is usually milder than with a ruptured aneurysm.
Vision Problems: Blurred vision, double vision or loss of visual field.
Pain in the Eye or Face: This occurs when the aneurysm presses on the nerves around the eye.
Neck Pain or Stiffness: This can occur due to stretching of the brain vessels.
Changes in Consciousness: In some cases, memory problems, concentration disorders or mood changes may occur.
Neurological Symptoms: Symptoms such as facial numbness, weakness or balance problems may occur.
Unruptured brain aneurysms can be detected by chance during routine check-ups. If these symptoms are observed, early diagnosis and treatment is crucial to prevent an aneurysm rupture.
Brain Aneurysm Symptoms
Symptoms of a brain aneurysm depend on whether the aneurysm has ruptured or not. An unruptured aneurysm is usually asymptomatic. However, if it grows and presses on surrounding tissues or nerves, the following symptoms may occur:
- Constant or recurrent headache
- Vision problems (blurred or double vision)
- Pain in the face or around the eyes
- Balance problems or signs of mild paralysis
- Concentration and memory problems
Symptoms of a Ruptured Brain Aneurysm
A ruptured aneurysm is an emergency and usually presents with the following serious symptoms
- Sudden, severe headache (which can be described as "the worst headache of my life")
- Nausea and vomiting
- Loss of consciousness or fainting
- Neck stiffness
- Loss of vision or sensitivity to light
- Seizures
- numbness or weakness on one side of the body
When symptoms of a brain aneurysm are recognized, it is vital to seek medical help immediately. Early diagnosis prevents complications and increases the success rate of treatment.
What are the Risk Factors for Brain Aneurysm?
A brain aneurysm can be caused by a combination of several factors, including genetic predisposition, lifestyle habits and environmental influences. While these factors cause weakening of the vessel walls and aneurysm formation, the risk is higher in some individuals. The factors that predispose to aneurysm development are of great importance for early diagnosis and prevention of the disease. Here are the main factors that increase the risk of brain aneurysm:
Genetic Predisposition: Individuals with a family history of brain aneurysm are at higher risk. Also, connective tissue diseases such as polycystic kidney disease, Marfan syndrome or Ehlers-Danlos syndrome are among the risk factors.
Smoking: Smoking causes the vessel walls to lose elasticity and increases the risk of aneurysms.
High Blood Pressure (Hypertension): Continuous high blood pressure can trigger aneurysm formation by creating stress on the vessel walls.
Age and Gender: Women are more at risk than men due to hormonal effects. Aneurysms are more common in people aged 40 and over.
Head Trauma: Severe head injuries can lead to weakened or direct damage to blood vessels.
Excessive Alcohol and Drug Use: Substances that directly affect the blood vessels, especially cocaine, play an important role in the development of aneurysms.
Atherosclerosis (arteriosclerosis): Hardening and loss of elasticity of the vessel walls increases the risk of aneurysm.
People exposed to these risk factors should undergo regular medical check-ups, keep their blood pressure under control and adopt a healthy lifestyle to prevent aneurysm formation.
Types of Brain Aneurysm
Brain aneurysms are bubble or dilatation-shaped structures that form in the vessel walls and are divided into different types according to their causes, location and appearance. The classification of aneurysms is critical to determine the treatment method and possible complications. The type, size and location of the aneurysm directly affect the symptoms the patient may experience, the risk of rupture and the treatment plan. Each type of aneurysm has its own unique characteristics and these characteristics are crucial for doctors to make the right diagnosis and intervention decision. Brain aneurysm types are generally classified according to their shape, size and location. Here are detailed descriptions of these types:
1. Aneurysms by Shape
Saccular Aneurysm (Brain Bubble): The most common type. The aneurysm expands as a bubble in the vessel wall and often looks like a bunch of grapes. It occurs mostly at the base of the brain, at the bifurcation points of large vessels. The risk of rupture is high.
Fusiform Aneurysm: It occurs as an enlargement of the entire vessel and has a symmetrical structure. It is generally more rare and occurs on large vessels. The risk of rupture is lower than saccular aneurysms.
Microaneurysm: They are small aneurysms and usually occur in small blood vessels due to hypertension.
2. Aneurysms by Size
Small Aneurysms Aneurysms smaller than 10 mm. Most of the time they can be recognized without symptoms.
Large Aneurysms: These are aneurysms between 10-25 mm and can often press on nerves and cause symptoms.
Giant Aneurysms: Aneurysms larger than 25 mm. Such aneurysms carry a high risk of rupture and serious complications.
3. Aneurysms by Location
Brain Base Aneurysms (Willis Polygon): Occurs at the bifurcation points of blood vessels. It is the most common location and is usually saccular type.
Carotid Artery Aneurysms: Occurs in one of the main vessels carrying blood to the brain. It can cause vision problems.
Posterior Circulation Aneurysms: It occurs in the vessels at the back of the brain and can have more serious consequences when it ruptures.
4. Aneurysms According to Rupture Status
Ruptured Aneurysms: An aneurysm ruptures, causing bleeding in or around the brain. This condition requires serious and urgent intervention.
Unruptured Aneurysms: The aneurysm has grown but has not yet ruptured. Most of the time it does not give symptoms, but depending on its size and location, it can put pressure on the nerves.
Knowing the type of brain aneurysm is vital to determine the treatment plan. Each type of aneurysm carries different risks and requires expert evaluation.
Complications of Brain Aneurysm
Brain aneurysms can lead to serious complications if left untreated or if they rupture. These complications vary depending on the type, size and location of the aneurysm. Conditions that occur after rupture can be life-threatening and cause long-term health problems. Here are the main complications associated with a brain aneurysm:
1. Subarachnoid Hemorrhage
A ruptured aneurysm usually causes a subarachnoid hemorrhage (bleeding between the brain and the meninges). This is characterized by sudden and severe headache, loss of consciousness and neurological damage. Subarachnoid hemorrhage is a life-threatening condition and requires emergency treatment.
2. Brain Damage
Damage to the brain following bleeding is one of the most serious consequences of an aneurysm rupture. Increased pressure and lack of oxygen to brain tissue can lead to permanent neurological disorders.
3. Vasospasm
After a subarachnoid hemorrhage, narrowing of the brain vessels (vasospasm) may occur. This restricts blood flow, increasing the risk of stroke and can lead to damage to brain tissue.
4. Hydrocephalus
Hydrocephalus can occur when bleeding blocks the flow of cerebrospinal fluid (CSF). This condition is characterized by fluid accumulation inside the brain and increased intracranial pressure.
5. Stroke
A ruptured aneurysm can block blood flow to certain areas of the brain and increase the risk of ischemic stroke. Depending on the size of the bleeding, hemorrhagic stroke may also develop.
6. Permanent Neurological Problems
After a ruptured aneurysm, patients may develop
- Memory problems
- Speech or language disorders
- Loss or impairment of vision
- Decline in mental functioning
- Loss of motor function or paralysis
7. Infection and Other Surgical Risks
Surgical interventions during treatment (e.g. clipping or endovascular coiling) can rarely cause infection, bleeding or vessel damage.
Complications of brain aneurysms are largely preventable with early detection and intervention. Timely treatment of aneurysms at risk of rupture or that have ruptured is vital to reduce the severity of these complications and improve the patient's quality of life. Therefore, individuals at risk of aneurysms should not neglect regular health checks.