What is a brain aneurysm and how do you diagnose it?
Aman*, a business development executive, was recently diagnosed with a brain aneurysm. The afternoon before the diagnosis, Aman was at work, when he was struck by a sudden, severe pain in his head, accompanied by nausea, dizziness and vomiting. His co-workers rushed him to the hospital, where a CT scan revealed the diagnosis. So what exactly is a brain aneurysm and could Aman have prevented it in any way? Read on to find out.
Definition:
A brain aneurysm (AN-yoo-riz-um) indicates a bulge or ballooning of a blood vessel in the brain. It occurs when a weak spot in the brain’s arterial walls bulges and fills with blood. This is a life-threatening condition because if an aneurysm breaks, it can lead to strokes, brain damage and even death, if not treated in time.
However, most brain aneurysms do not rupture – in fact, 50% to 80% of aneurysms never rupture during a person’s lifetime, according to the Brain Aneurysm Foundation.
Symptoms:
Aneurysms generally have no symptoms. Sometimes, symptoms may manifest as seizures, double vision, dizziness, mild/severe headaches or pain above or behind the eye. However, if an aneurysm ruptures, it almost always produces distinct symptoms including:
- Sudden, severe headache- “the worst headache of my life”
- Blurry/double vision
- Seizures
- Vomiting and nausea
- Dizziness
- Trouble speaking/walking
- Unconsciousness
A friendly reminder here: Many of these symptoms, such as a severe headache, nausea, dizziness, etc. could be attributed to many other causes, including common conditions like migraines. Do not panic if you experience any of these symptoms, always check with a reputed doctor first.
Who is at risk? Precautions to take:
Brain aneurysms can happen to anyone - however, they are more common in adults. Plus, studies show that women are more likely to get aneurysms than men due to low estrogen levels after menopause. The risk of a brain aneurysm rupturing increases significantly for patients with a history of hypertension, drug and alcohol abuse and smoking. Brain injury can also lead to aneurysms. An important precaution to take? If brain aneurysms exist in the family, that is, two or more blood relatives also suffer from the same condition, it is important to get yourself screened so you can take preventive measures. Other inherited conditions like autosomal dominant polycystic kidney disease (ADPKD) and Marfan syndrome can also increase the risk of brain aneurysms, as can congenital problems.
Diagnosis and screening tests:
While diagnosing aneurysms may be tough unless it has ruptured, doctors do perform screening tests for high-risk patients. Here are the tests commonly advised:
Computerized Tomography (CT) scan: A CT scanner is a powerful X-ray machine, that takes cross-sectional images of the brain – this is the first test performed to detect bleeding from a ruptured aneurysm.
CT Angiography: This is like a normal CT scan, the only difference being the injection of a dye into the veins that makes it easier to observe blood flow and indicate the presence of an aneurysm. Read this article for more information.
Magnetic Resonance Imaging (MRI): An MRI scanner uses a powerful magnetic field and radio waves to create detailed images of the brain. While choosing an imaging centre, make sure you choose one with a 3T MRI machine, since it produces images of the best quality.
Read this article to know more about MRI and CT scans.
MRA: To check the arteries in detail, a special kind of MRI test, called an MRI Angiography, may be recommended. The procedure is same as an MRI scan, except a special dye may be injected into your body before the scan, in order to produce clearer images.
In case the CT scan comes negative for a ruptured aneurysm, but your symptoms suggest otherwise, a lumbar puncture test may be performed where a needle is inserted into the lower part of your spine to remove a sample of the fluid that surrounds and supports the brain and spinal cord.
Other diagnostic tests include an angiogram or arteriogram.
Treatment:
The treatment options for a brain aneurysm hinge on a combination of factors, including but not restricted to size, location, severity of the aneurysm and whether it has ruptured or not. Surgery is a common treatment and involves either surgical clipping of the aneurysm, endovascular coiling which is less invasive than surgical clipping and includes a coil of wire being placed inside the aneurysm to disrupt blood flow; and newer treatments like flow diverters, where stent-like implants divert blood supply away from the aneurysm.
Other lifestyle changes, like quitting the use of cigarettes and drugs and following a healthy diet and exercise schedule, can help lower the risk of aneurysm ruptures.
Finally, be informed about your condition to make the right health choices, but don’t panic or self-diagnose – always consult with reputed doctors before taking action.
For more information on MRI, CT and other scans, feel free to reach out to us on 020 4132 2222 / 4122 2222. Star Imaging offers the world’s most advanced technology, including a 3T MRI scanner that minimises claustrophobia, a 128 Slice CT scanner; and is Pune’s leading Second Opinion clinic.
*Name changed to protect identity
Other Posts
