Headaches are a common recurring problem for most people. People may experience headaches brought by fever, stress, migraine, etc. The pain and discomfort may vary, but a sudden and extremely painful headache that can only be described as the worst headache could be a sign that you have a ruptured brain aneurysm.

 

What is a Ruptured Brain Aneurysm?

A brain aneurysm is a berry-like ballooning of a blood vessel in the brain. When it ruptures, it will cause bleeding in the brain (hemorrhagic stroke) and an extremely painful and sudden headache. A ruptured brain aneurysm could be a fatal condition if not treated properly.

 

Causes

The causes of ruptured brain aneurysms remain unknown but may develop from certain conditions. One of them is the thinning of blood vessel walls in the brain, leaving them more vulnerable to ruptures. Others could develop from head injuries or blood infections.

 

Risk Factors

Even though the primary cause of an aneurysm is unknown, several risk factors can leave a person more vulnerable to it. One of them is that aneurysms are more common in women than men. Other risk factors that develop over time are:

-          Old age

-          Cigarette Smoking

-          High Blood Pressure

-          Cocaine usage

-          Heavy alcohol consumption

Other risk factors are present at birth:

-          Inherited connective tissue disorders that weaken blood vessels like Ehlers-Danlos syndrome.

-          Polycystic Kidney Disease. People with this inherited kidney disease have increased blood pressure.

-          Narrow Aorta (coarctation of the aorta).

-          Brain arteriovenous malformation (AVM). Entangled arteries and veins in the brain disrupt the blood flow, leaving the person at risk of aneurysms.

-          Family History. People who have first-degree relatives (parents, siblings, or children) diagnosed with ruptured brain aneurysms are at risk of having it as well.

 

Symptoms

The most telltale symptom of a ruptured brain aneurysm is a sudden and extremely painful headache. In addition, a person may have a ruptured brain aneurysm with the presence of these symptoms:

-          Nausea and vomiting

-          Stiff neck

-          Blurred or double vision

-          Sensitivity to light

-          Seizure

-          Drooping eyelids

-          Loss of consciousness

-          Confusion

Some cases of aneurysms won’t have ruptured blood vessels in the brain. A leaking aneurysm will have blood leaking inside the brain, which still causes severe headaches. Small unruptured brain aneurysms will have little to no symptoms, but larger unruptured aneurysms press on brain tissue and have more telling signs, such as:

-          Pain above and behind one eye

-          Dilated pupil

-          A change in vision or double vision

-          Numbness of one side of the face

 

Complications

Bleeding from the ruptured blood vessel causes direct damage or destruction of brain cells. The bleeding can also result in a pressure increase inside the skull, which can disrupt the brain’s supply of blood and oxygen. When this happens to the brain, the person suffering from a ruptured brain aneurysm may fall unconscious or, much worse, die.

Aside from the complications mentioned above, patients may experience the following complications:

-          Re-bleeding. There is a possibility that the aneurysm can leak blood once more causing further damage to brain cells.

-          Vasospasm. The blood vessels in the brain narrow and contract after a ruptured brain aneurysm. When this happens, the brain will receive limited blood flow, causing more brain cell damage.

-          Hydrocephalus. Blood that leaked from the aneurysm can block other vital fluids that surround the brain and the spinal cord. This blockage results in more pressure in the brain and can cause brain cell damage.

-          Change in Sodium Level. Bleeding caused by an aneurysm disrupts the sodium balance in the blood. This happens when it damages the hypothalamus, which is found near the base of the brain. As a result, the patient will experience swelling and damaged brain cells.

 

Diagnosis

Doctors will conduct the following diagnostic tests to confirm if the patient that is experiencing a sudden and severe headache and other symptoms has a ruptured brain aneurysm:

-           CT Scan

-          Cerebrospinal Fluid Test

-          MRI

-      Cerebral Angiogram

 

Treatments

Once diagnosed, the doctors may conduct the following to treat the patient:

Brain Aneurysm Surgeries

Surgical Clipping. The neurosurgeon removes a section of the skull to locate the blood aneurysm. After locating it, the surgeon will clip the neck of the aneurysm with a tiny metal clip to stop the blood flow.

This procedure poses potential risks, such as bleeding in the brain or loss of blood flow to the brain.

 

Endovascular Treatment. A less invasive procedure compared to surgical clipping, which involves the insertion of a catheter into an artery. Usually, the surgeons insert this in the wrist or groin of the patient, then it will be threaded through the blood vessels in your body until it reaches the aneurysm. Once it reaches the aneurysm, the surgeon uses different devices to destroy the aneurysm from the inside.

Although slightly less invasive and seemingly safer, endovascular treatments pose a slightly higher risk of needing a repeat procedure because of the reopening of the aneurysm.

 

Flow Diversion

Hospitals in the Philippines, like De Los Santos Medical Center (DLSMC), offer a “touchless repair” treatment for brain aneurysms. The procedure is done by Dr. Victor Erwin Jocson, a DLSMC interventional neuroradiologist, to a patient with a brain hemorrhage because of a ruptured brain aneurysm involves inserting a cylindrical mesh stent called a pipeline shield to the parent blood vessel across the brain aneurysm.

Once there, the pipeline shield diverts the blood flow in the aneurysm and remodels the diseased parent artery as it repairs the damaged blood vessel.  

 

Other Treatments

Other ruptured brain aneurysm treatments are used to relieve the patients of other symptoms as well as manage complications.

-          Pain relievers for headaches.

-          Calcium Channel Blockers reduce the chance or delay the vasospasms and other brain injuries.

-          Anti-seizure medications to treat patients who experience seizures.

-          IV injections to prevent a stroke from insufficient blood flow.

-          Ventricular or lumbar drainage catheters and shunt surgery to reduce the pressure on the brain.

-          Rehabilitative therapy to relearn skills, like speech, that may have been affected or forgotten because of the ruptured brain aneurysm.

 

Screening

Screening can help people prevent ruptured brain aneurysms. People who have a family history or a congenital disorder that increases the chance of developing aneurysms can talk to health professionals to detect early signs of a brain aneurysm.

 

Prevention

Although there are no absolute prevention methods for it, simple lifestyle changes can reduce the risk of developing brain aneurysms.

-          Avoid smoking or using recreational drugs.

-          Eat a healthy diet and exercise to control blood pressure.

 

See a doctor immediately if you experience a sudden and extremely severe headache.

 

 

SOURCES

Mayo Clinic. (2022, April 27). Brain aneurysm - Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/brain-aneurysm/symptoms-causes/syc-20361483

De Los Santos Medical Center. (n.d.). Treating Brain Aneurysms with “Touchless Repair.” Retrieved June 20, 2022, from https://www.delossantosmed.ph/news-and-events/treating-brain-aneurysms-with-touchless-repair

What Is a Brain Aneurysm? (2017, January 3). WebMD. https://www.webmd.com/brain/brain-aneurysm