Brain Aneurysms – what are they and how can they affect me?

Tom Sizemore, actor known for his role in Saving Private Ryan was diagnosed with a brain aneurysm recently. How much do we know about brain aneurysms?

According to the NHS, in the UK approximately 2-3% of people have a brain aneurysm – they are pretty rare.

A brain aneurysm is when the blood vessels in the brain swell, causing risks of rupture and bleeding (a brain haemorrhage).

The symptoms of a brain aneurysm can include agonising headaches known as a ‘thunderclap’ headache. Other symptoms include vomiting, pain, visual and speech issues.

Depending on the extent of a brain aneurysm, it could be present for a long time without causing any symptoms at all, so you might not even know it is there. Some are found incidentally when undergoing a head scan for an unrelated reason. Others are identified when the aneurysm enlarges.

Is a brain aneurysm dangerous?

A brain aneurysm has the potential to be dangerous if the vessels swell to such an extent that they rupture, causing a bleed in the brain. It is a serious medical emergency.

This can result in a brain injury and there is a risk of sustaining permanent neurological issues.

In order to prevent this risk from happening, surgeons will consider the best course of action when faced with a brain aneurysm.

Sometimes, if there isn’t a high risk of rupture, the surgeons will monitor the aneurysm regularly to make sure that it does not enlarge to an extent that it becomes dangerous. This is known as the ‘watch and wait’ approach.

Or the surgeon might recommend surgery to treat the aneurysm such as ‘endovascular coiling’ or ‘clipping’. Coiling is generally considered to be less invasive as it involves tiny coils being passed through a catheter into the aneurysm. Clipping is where a surgeon accesses the brain in surgery and the aneurysm is sealed using a tiny metal clip.

What are the positives and negatives of screening for a brain aneurysm?

If you may be at greater risk of a brain aneurysm, you may be offered screening to check for this by way of a CT scan or Magnetic Resonance Angiography (MRA).

This is usually offered if you have close relatives with the condition, who have suffered from bleeding.

Some of the positives of undergoing screening include:

• You may be reassured if a brain aneurysm is not identified
• Clinicians can keep an eye on a brain aneurysm if it is found
• It may mean that preventative action can be taken if necessary, before a bleed can occur
• CT and MRA scans are relatively straightforward with minimal discomfort to you

But some of the negatives of undergoing screening include:

• Finding out you have a brain aneurysm can be distressing, even if it is not deemed to be dangerous
• MRA scans can be claustrophobic and with a CT scan you will be exposed to a small amount of radiation
• Sometimes small aneurysms may not even be identified on either scan
• If you drive, you must tell the DVLA if you have a brain aneurysm

It can be a difficult decision as to whether to agree to screening or not and this is best discussed with a medical professional.

Living with a brain aneurysm

As outlined above, you could live with a brain aneurysm for many years and not even know that it’s there. You may experience no symptoms from this.

Sometimes the swelling from a brain aneurysm can cause compression of other structures in the brain. This could lead to symptoms that could include double vision, weakness on one side of your body (depending on where the compression is) or problems with speech for example.

If a brain aneurysm ruptures causing a haemorrhage, it can result in a brain injury. Not all brain injuries are the same but symptoms of a brain injury could include fatigue, difficulty concentrating, problems with speech, epilepsy and physical problems.

Whatever type of brain aneurysm you have, you may need care and support from your family and medical professionals.

Some therapies may be helpful such as physiotherapy, occupational therapy or speech and language therapy to help with your condition.

The important thing to note is that you are not alone, and there are many charities, such as Headway that can offer invaluable advice and support.

Our expertise

In the Adult Brain Injury team, we have represented many clients who have suffered a delayed diagnosis of a brain aneurysm. Sometimes, the telling signs are picked up and investigated too late, affecting the chances of having a better outcome.

For all our clients, we advocate for greater awareness of brain injuries, better research and the need for change.