How life-threatening is it?

Aneurysms aren’t something we can see just by looking at ourselves in a mirror. Usually, you don’t have any symptoms until something goes catastrophically wrong that threatens your life. So, what is an aneurysm? How does it form? What can you do to treat them? How can you prevent one from occurring?

Definition

An aneurysm is when part of a blood vessel bulges or balloons outward because of a weakening in the wall of the blood vessel. Due to this, it can appear like a berry that is hanging on a stem. They usually form at forks or branches in arteries because these areas tend to be weaker. They can occur anywhere in your body.

If it is on the main blood vessel (aorta) that carries blood from your heart to your body, it is called an aortic aneurysm. Depending on the aneurysm location on the aorta, it can be further classified. A thoracic aortic aneurysm is located in your chest, whereas an abdominal aortic aneurysm is positioned in your abdomen. Aneurysms can form in the blood vessels of your brain (cerebral aneurysms) or other parts of your body (peripheral aneurysms).

The exact cause of aneurysms is unknown. However, certain things can increase your risk of developing them, such as aging, smoking, high blood pressure, drug abuse (especially cocaine), heavy alcohol consumption, and head injuries. Some conditions present at birth increase the chances of having aneurysms, like inherited connective tissue disorders, polycystic kidney disease, narrow aorta, arteriovenous malformation, and a family history of aneurysms.

Aneurysms don’t have symptoms unless they rupture, so you may have one and not even know it. The smaller an aneurysm is, the less likely it is to rupture. When an aneurysm ruptures, it is a life-threatening event. Depending on the aneurysm’s location, the symptoms can vary when it ruptures. Often, the person will have a sudden onset of severe pain in the area of the aneurysm. Since bleeding is internal, it’s not necessarily obvious what is happening.

Typically, the person will begin to display signs of shock since their body doesn’t have enough blood traveling throughout their body to deliver oxygen. These signs can include a rapid heartbeat, quick/shallow breathing, cool/clammy skin, low blood pressure, nausea/vomiting, feeling weak, fatigue, confusion, dizziness, and little/no urine output.

Individuals with a ruptured brain aneurysm can experience slightly different symptoms because the space inside your skull isn’t large, so the signs of shock usually don’t appear before the person starts to have serious complications. Some symptoms they could experience include a sudden/severe headache accompanied by nausea/vomiting, stiff neck, blurred/double vision, sensitivity to light, and confusion. They also might have drooping eyelids and seizures.

If a person has a sudden, severe headache but no other symptoms, they might have a leaking aneurysm, which needs immediate treatment because it frequently turns into a ruptured aneurysm. With brain aneurysms, it’s possible to have symptoms even if they haven’t ruptured because of the pressure the aneurysm puts on the surrounding tissue. Some possible symptoms include pain above/behind one eye, only one pupil is dilated, vision changes to one eye, and numbness to one side of the face.

Treatment

Aneurysm treatment is focused on two main areas. The first is what to do after a rupture. The second is preventing a break if an aneurysm is found before it ruptures. The primary goal of treating a burst aneurysm is to stabilize the person by getting the bleeding under control. One way to reduce the flow of blood from a ruptured aneurysm is to put a clip on the affected artery. To perform this procedure, a neurosurgeon has to remove part of your skull to reach the affected blood vessel.

Another option is endovascular coiling, which involves a vascular surgeon inserting a catheter (hollow, plastic tube) into an artery, usually in your groin, and then threading a guidewire through it and your body to where the aneurysm is located. Once they are in the right spot, the surgeon will place a soft platinum wire inside the aneurysm. The wire will coil and fill up the space inside the aneurysm, causing blood to be diverted from it.

A new option is a flow diverter. It’s a tube-like stent placed inside the artery in the location of the aneurysm and helps to avert blood away from the ruptured aneurysm sac.

All three of these options can also be used to treat an unruptured aneurysm in hopes of preventing a rupture. Several factors must be considered before continuing with any procedure because sometimes the risks of performing it outweigh the benefits. Some of these considerations are the size/location/appearance of the aneurysm, your age/overall health, family history of aneurysms, and congenital conditions that could increase the chances of the aneurysm rupturing. It’s essential to manage your blood pressure because when it is elevated, you are at increased risk for an aneurysm rupture. It is also vital to not smoke because it constricts your blood vessels, increasing your blood pressure.

Prevention

Since the exact cause of aneurysm development is unknown, there aren’t any specific recommendations to prevent their formation. However, there are things that you can do to help reduce the chance of a rupture from occurring. Since most people don’t even know they have an aneurysm until it ruptures, this is especially important.

The number one thing that you need to maintain control of is your blood pressure. When your pressure is elevated, it’s easier for the aneurysm’s weakened blood vessel wall to rupture. You can do several things to control your blood pressure, such as eating a healthy diet low in fat and sodium. Another critical element is to exercise regularly because this helps your heart to function more effectively. Not smoking or using recreational drugs is vital because they can significantly affect your blood pressure.

Aneurysms can be life-threatening, but with quick and appropriate interventions, it is possible to recover from a rupture. If you have any questions or concerns, please speak with your doctor. If you would like more information, please visit the American Heart Association’s Aneurysm page at http://www.heart.org/en/health-topics/aortic-aneurysm/what-is-an-aneurysm

Page last updated 1/11/2023.