Aneurysms

You may go for years — your whole life — not even knowing you have a weakened artery wall. However, if your aneurysm grows — or ruptures — you will develop symptoms that differ depending on the area in which the aneurysm exists.

Brain (cerebral):

• Pounding, sudden, severe headache
• Blurred vision
• Pain behind one eye
• Dilated pupil
• Numbness in one side of the face
• Paralysis

Nausea and vomiting combined with a sudden, intense headache indicate an emergency. If a brain aneurysm ruptures, you will feel lightheaded from your blood flow drastically slowing down, have low blood pressure with an increased heart rate, and you can go into shock.

Chest and stomach (thoracic and abdominal):

• Sharp pain in your jaw, neck, back, chest, or abdomen
• Irregular heartbeat
• Shortness of breath
• Hoarseness or trouble swallowing
• Clamminess
• Nausea or constipation
• Lightheadedness

Leg or other (peripheral):

• Weakness in the affected area
• Pain or swelling
• Discoloration

Any ruptured aneurysm is an emergency, because the internal bleeding and subsequent drop in blood pressure can bring on shock, where your internal organs are not receiving the oxygen and nutrients they need to function.

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An aneurysm might be present at birth, or one might develop in an already-weak area as a result of disease or injury.

Those over 55 are more likely to develop an aneurysm. Factors that you can control, however, are tobacco and illegal drugs; use of these substances puts you at higher risk. High blood pressure and atherosclerosis (hardening of the arteries because of plaque build-up) also put you at risk. Family history can be an indicator as well.

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If you have an aneurysm, your best course of action is to do as much as possible to keep your blood vessels healthy. That means stop smoking (if you do), eat a healthy diet that prevents the buildup of bad cholesterol, control high blood pressure if you have it, and exercise moderately. You may benefit from incorporating relaxation exercises and meditation into your daily routine.

If you have experienced functional loss or impairment as a result of a brain bleed, you may want to enlist the help of the physical, occupational, and speech therapists on your team to help regain your abilities.

Your physician at St. Luke’s might also recommend that you go in for regular screenings, perhaps ultrasounds (depending on the location of the aneurysm) to make sure that the aneurysm stays in check.

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At St. Luke’s Center for Neuroscience, your physician may use any of several tests to check for the presence, precise location or extent of a suspected aneurysm. A thorough physical exam will be performed and your complete medical history, including family information, will be taken down. Abdominal and chest aneurysms have a higher rate of being hereditary. Your doctor will ask specific questions regarding any symptoms you have and how long you’ve had them.

Additional tests performed may depend on the pain or other symptoms you’ve been experiencing and the location of the site. An ultrasound or echocardiography can detect the presence and size of an aortic aneurysm. A computed tomography (CT) scan, with or without dye, conveys similar information in a more detailed way. Magnetic resonance angiography (MRA) and magnetic resonance imaging (MRI) scans help to pinpoint the details, and are important alternatives to CT scans that reduce exposure to radiation for patients who receive frequent screenings. An angiography can show the insides of your arteries and give your physician a better understanding of their condition.

If a brain aneurysm is suspected but a CT scan does not show bleeding, your physician may elect to perform a cerebrospinal fluid test. Brain aneurysms can rupture in spaces between the brain and the tissue that protects it, resulting in something called a subarachnoid hemorrhage. This test checks for the appearance of red blood cells in your fluid, which would indicate the aneurysm.

There are also other, more detailed tests that your doctor may choose to perform if more information is needed or the conventional tests do not yield enough data.

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The treatment plan you and your team at St. Luke’s Center for Neuroscience arrive at will depend on your age and medical history, the size and location of the aneurysm and any symptoms you are experiencing.

The primary goal is to keep the aneurysm from rupturing or dissecting. If you have an aortic aneurysm below a certain size, your doctors may just want to do routine testing using ultrasounds to make sure it doesn’t grow. However, if indicated, treatment of an aneurysm can include surgery.

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