What Is the Prognosis Of Brain Aneurysms?

What can you expect if you have a brain aneurysm?

If you or a loved one has been told that you have a brain aneurysm, you probably do not know what to expect. Here are answers to your most common questions about brain aneurysms.

What is a brain aneurysm?

An aneurysm is an abnormally shaped blood vessel with a bulging area. The out-pouching is often a weaker, more delicate section in the blood vessel wall.

Aneurysms can occur in any blood vessel throughout the body, and a brain aneurysm is an aneurysm located in the brain.

Brain aneurysms range in size, with some being small (millimeters) and some quite large (centimeters). Some brain aneurysms cause noticeable neurological symptoms, such as vision changes, double vision, headaches, or seizures, while many brain aneurysms do not cause any symptoms at all. Brain aneurysms that do not cause any pain or neurological symptoms are called asymptomatic brain aneurysms.

What is the significance of a brain aneurysm?

A brain aneurysm is a health concern because the out-pouching in the wall of the blood vessel may actually rip, tear, or rupture, leaking blood slowly or even pouring blood rapidly into the surrounding brain regions.

Brain aneurysm bleeds are generally called subarachnoid hemorrhages or hemorrhagic strokes.

Sometimes brain aneurysms cause symptoms even if they do not rupture.

This happens when a brain aneurysm presses on a nearby nerve of structure of the brain, causing symptoms.

Will I die from a brain aneurysm?

Most brain aneurysms do not cause death, but when a large brain aneurysm ruptures, it may cause a severe disability, or even death. Most people who have brain aneurysms survive, but unfortunately, death is a real possibility when it comes to brain aneurysms.

What Will Happen With My Brain Aneurysm?

A brain aneurysm may remain unchanged for the rest of your life, may grow slowly, may grow rapidly, or may rupture of bleed. If you have a brain aneurysm, it is not possible to know for sure exactly which path it will follow over the course of the next few years, or over the course of your whole life.

According to a long-term study that followed people living with brain aneurysms for 21 years, there is about a 1.1% chance of aneurysm rupture per year, on average. The chance of aneurysm rupture was higher for people who had larger aneurysms, who smoked or who drank alcohol.

A scientific research study published in the Journal of the American Medical Association noted a higher chance of brain aneurysm rupture among people who had neurological symptoms such as seizures than among people with asymptomatic aneurysms.

Do I need surgery for my brain aneurysm?

This is a very individual high-level decision that you will make with the advice of your neurologist, your neurosurgeon and possibly a neuro-interventional radiologist. Brain aneurysm surgery is one of the most delicate surgical procedures, and it requires careful planning. Surgery may be the best way to prevent bleeding from brain aneurysms that are likely to rupture due to their size, location or due to another risk factor.

Brain aneurysm surgery involves placing a metal coil or a clip on the aneurysm in order to shrink the  aneurysm by diminishing blood flow. Then, once the out pouching is no longer part of the blood vessel, the blood vessel should heal and resume blood flow. 

Can I stay active if I have a brain aneurysm?

There are some activities than can increase the likelihood of brain aneurysm rupture. Head trauma can trigger bleeding of a brain aneurysm. Extremely high blood pressure, often triggered by recreational drugs such as methamphetamine and cocaine, can trigger a brain aneurysm rupture. Some surgical procedures can also increase the risk of brain aneurysm rupture.

What is the long-term plan with a brain aneurysm?

A research study from UCLA followed people living with brain aneurysms and found that those whose aneurysms grew in size over time were much more likely to experience a ruptured aneurysm.

Follow-up brain imaging is recommended if you have a brain aneurysm. Follow up imaging studies may include Brain MRI, Brain MRA, Brain CT scan, Brain CTA or an angiogram. Which of these is the best follow up study for you depends on the size and location of your brain aneurysm.

You should make every effort to keep your actual brain scan or images of the scans for later comparison (in case you change doctors or hospitals) because the key to follow up lies in whether the aneurysm changes or grows over time.

Can a brain aneurysm get better?

Yes, brain aneurysms can shrink or even disappear. This is more likely with smaller aneurysms than with larger aneurysms. Over time, unruptured aneurysms become more stable and less likely to rupture or bleed.

A Word From Verywell

A brain aneurysm is not a simple, routine diagnosis, and therefore, it might sound scary. However, if you or a lowed one has a brain aneurysm, you should know that there is effective treatment and that there are very knowledgeable medical teams who are experienced in brain aneurysm care.

No one can predict your prognosis with exact certainty, but there are some factors that make a brain aneurysm rupture more or less likely, including the size, the location, and the symptoms. And if you are in a high risk group, or even if you are in a low risk group, a number of well- studied interventions can significantly reduce the chances of a brain aneurysm rupture.

Sources:

Management of aneurysmal subarachnoid hemorrhage: State of the art and future perspectives, Grasso G, Alafaci C, Macdonald RL, Surg Neurol Int. 2017 Jan 19;8:11

Natural history of asymptomatic unruptured cerebral aneurysms evaluated at CT angiography: growth and rupture incidence and correlation with epidemiologic risk factors, Villablanca, JP, Duckwiler GR, Jahan R, Tateshima S, Martin NA, Frazee J, Gonzalez NR, Sayre J, Vinuela FV, Radiology, October 2013

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