Sharon Stone had emergency surgery for a brain aneurysm in 2001 at age 43. She’s said she knew something was terribly wrong when she experienced severe head pain that felt like a bullet to the brain. And while she recalls that post-surgery she had to “learn to walk, hear, write, talk, remember and everything all over again,” she told Oprah’s Master Class in 2014 that she’s done just that.
An aneurysm is a bulge or ballooning in the wall of a blood vessel; if it bursts, it causes internal bleeding. It can happen in the aorta, the major blood vessel from your heart that supplies blood to the rest of your organs; in a section of the aorta that runs through your abdomen (an abdominal aneurysm) or through your chest (thoracic aortic aneurysm); in blood vessels in your legs, groin or neck (peripheral aneurysm); or in the blood vessels supplying blood to your brain.
The bulge in the blood vessel usually happens in the space between the brain and the thin tissues that cover it. If a brain aneurysm ruptures (bursts), it produces a subarachnoid hemorrhage, and pooling blood pushes on the brain. That can cause a sudden, severe headache, blurred vision, light sensitivity, a stiff neck, seizure, confusion or loss of consciousness. Not only does the hemorrhage increase pressure on the brain, but the area of the brain that would have received oxygen-rich blood is shortchanged, resulting in a stroke. Forty percent of the time, a ruptured brain aneurysm is fatal.
Sometimes, however, a brain aneurysm doesn’t rupture; it leaks, causing sentinel (warning) headaches, which can be sudden and severe. These usually happen between a week to a month before the aneurysm ruptures.
But most brain aneurysms don’t rupture or leak; in fact, they may not cause symptoms and are detected only through tests for some other issue. However, if an unruptured brain aneurysm presses on brain tissue or nerves, it may trigger pain behind or above an eye, a dilated pupil, blurred vision or numbness and weakness on one side of the face. If you experience any of these symptoms, see your doctor immediately.
Risk factors for a brain aneurysm
They mostly happen in folks 35 to 60 and are most common in women older than 40. They’re associated with smoking; hypertension; a congenital defect in an artery wall; a family history of aneurysms; and other conditions, such as an infection, a tumor, a traumatic head injury or use of cocaine. Most ruptures, however, are attributed to smoking and high blood pressure.
Treatment for an unruptured brain aneurysm
Observation or surgery? The decision is made on an individual basis, depending on how doctors assess the short- and long-term risks of a rupture compared with the risks of intervention.
The Cleveland Clinic’s Cerebrovascular Center says that your age, your overall health and the location of the aneurysm determine treatment options. A craniotomy, or open surgery, goes in through the skull, allowing docs to tie off the ballooning part of the blood vessel, hopefully reducing the risk of rupture. Endovascular surgery, performed through a flexible tube threaded through the blood vessels, allows the surgeon to coil a platinum wire inside the ballooning pouch, triggering a blood clot that protects the aneurysm from rupturing.
Treatment for ruptured brain aneurysm
If the aneurysm ruptures, doctors will try to ease pain, evacuate the blood and prevent complications such as seizures and vasospasms, while they repair the tear.