Every 18 Minutes, a Brain Aneurysm Ruptures

Published May 3, 2017

By Andrew P Gard, MD, Neurosurgeon
Published

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Andrew P Gard, MD

It is estimated that a brain aneurysm ruptures every 18 minutes*.  Aneurysms are abnormal enlargements of the blood vessel wall. This fragile wall is at risk of rupturing and bleeding into the subarachnoid space, the fluid filled space that surrounds the brain and spinal cord. Symptoms of a ruptured brain aneurysm include severe sudden headache (often described as the “worst headache of my life” by survivors), nausea, vomiting, increased sleepiness/lethargy and unresponsiveness or coma.

Brain aneurysms are common – 1 in 50 people has an unruptured brain aneurysm*. Women are more commonly affected than men. Smoking, high blood pressure, drug use, family history of brain aneurysms, and certain genetic conditions (e.g. polycystic kidney disease) increase the risk of developing a brain aneurysm.

Bleeding from a brain aneurysm is a unique type of stroke. It represents only 3 - 5 percent of all strokes, but unfortunately it is fatal in 40 percent of people. Several issues arise after a brain aneurysm ruptures. The fluid in and around the brain (cerebrospinal fluid) doesn’t absorb well with blood in it and it can accumulate and cause a dangerous condition called hydrocephalus, which increases brain pressure. Unless the cerebrospinal fluid pressure is relieved with external drainage, it can be a fatal problem. The bloody fluid is irritating to the blood vessels and causes blood vessels to spasm or close which risks starving the brain of oxygenated blood and further stroke.

A ruptured aneurysm has a significant risk of bleeding again unless treated. The risk of re-bleeding from an aneurysm is highest near around the time of the initial hemorrhage. The risk of re-bleeding is approximately 1 in 5 at two weeks after the initial hemorrhage. Therefore, securing the aneurysm against re-bleeding is a priority. 

Aneurysm treatment is accomplished by either open or endovascular techniques. The open approach involves making an incision on the scalp and elevating a window of skull to provide access to the brain. Dissection between the lobes of the brain provide access to cerebral blood vessels. Endovascular treatment is generally achieved from a small incision at the groin site. Long tubes (catheters) are navigated up to the aneurysm. Either approach involves eliminating the blood flow into the aneurysm and thereby protecting against re-rupture.

To schedule an appointment with a brain aneurysm specialist at Nebraska Medicine, call 800.922.0000.

*Statistics from Brain Aneurysm Foundation.