‘It can happen to anyone’

Legendary rapper, producer and record executive Dr. Dre is back home and in the studio, healing fast after being admitted to the Intensive Care Unit (ICU) of a California hospital Jan. 4, 2021, for a ruptured brain aneurysm. The news has many people wondering: What exactly is a brain aneurysm? Who is most at risk? And what are the warning signs?

The ‘silent killer’

According to the Brain Aneurysm Foundation, an estimated 6.5 million Americans, or 1 in 50 people, are walking around with an unruptured brain aneurysm.

A brain aneurysm is a weak bulge on the wall of a blood vessel, resembling a thin balloon. Unruptured brain aneurysms are usually small and present no symptoms. Sometimes, unruptured aneurysms are found accidentally during screening for other conditions.

The danger arises when an aneurysm bursts. Around 30,000 people in the United States – about one every 18 minutes – suffer a ruptured aneurysm each year. The sudden blow causes bleeding into the space around the brain, known as a hemorrhagic stroke.

Similar to a heart attack, there are usually no warning signs that a brain aneurysm might rupture.

“A brain aneurysm is essentially the neurological equivalent to a sudden heart attack,” said Ricardo Hanel, MD, PhD, neurosurgeon and co-director of the Baptist Stroke & Cerebrovascular Center. “It can happen to anyone, even young and healthy people. Someone can seem perfectly fine up until that singular moment.”

Reduce the risks

While there aren’t any telltale signs someone will experience a ruptured brain aneurysm, there are risk factors to keep in mind.

“First, check your family history, as it is the highest predictor of developing an aneurysm,” said Dr. Hanel. “If your family has a strong history of brain aneurysms, you should get screened right away. Anyone who has two or more relatives with an aneurysm should be checked.”

Those who have a family member with a brain aneurysm are at increased risk of having one themselves. The risk doubles for those who have two family members with an aneurysm. Additionally, anyone who has previously had an aneurysm has a 15% to 20% chance of developing another one.

“Two of the biggest modifiable ways to prevent brain aneurysms are avoiding smoking cigarettes and having good control of your blood pressure,” said Dr. Hanel. “These factors are associated with weakened arterial walls, which can lead to blood vessels ballooning.”

Additional risk factors for a brain aneurysm include:

• Age (especially people older than 50)
• High blood pressure
• Uncontrolled diabetes
• Alcohol or drug abuse
• Head injury
• Infection in a blood vessel
• Hardened or narrowed arteries (atherosclerosis)
• Gender (women are at higher risk than men)
• Fibromuscular dysplasia (vascular disease that causes abnormal cell development in the walls of one or more arteries)
• Polycystic kidney disease

Early detection of an aneurysm can save lives. For people at higher risk, a magnetic resonance angiogram (MRA) scan is noninvasive and can look specifically at the body’s blood vessels to determine whether an aneurysm is present. Those interested should consult their primary care physician, who can then order the test or refer to a brain aneurysm expert.

Know the symptoms

Over time, an unruptured aneurysm may grow larger and press on delicate nerves and tissue in the brain. Symptoms of a larger, unruptured brain aneurysm include:

• A drooping eyelid
• A dilated pupil
• Pain above or behind one eye
• Double vision
• Numbness or weakness in one side of the body, such as the face, an arm or a leg

Luckily, most aneurysms are treatable. Dr. Hanel and his colleagues, Eric Sauvageau, MD, neurosurgeon and co-medical director of the Baptist Stroke & Cerebrovascular Center, and Amin Nima Aghaebrahim, MD, neurointerventionalist and primary stroke director of the Baptist Stroke & Cerebrovascular Center, have repaired many types of aneurysms without complex open-brain surgery, which had long been the norm.

While the details about the exact treatment Dr. Dre received are unknown, Dr. Hanel said many aneurysms can be treated by going through a blood vessel in the leg and navigating up to the brain.

The highly specialized team employs advanced noninvasive treatments, such as flow diverter technology, in which a braided cylindrical mesh is inserted into the aneurysm to slow the flow of blood and allow the diseased vessel to heal. The neurosurgeons can also fill the aneurysm with coils, which causes it to dry up over time.

“While endovascular treatment has been demonstrated to be safer for patients with a ruptured aneurysm, it’s still very important to have all tools available,” said Dr. Hanel. “Medical centers with expertise in clipping and coiling, like we have here at Baptist Stroke & Cerebrovascular Center, offer the best results for patients.”

Time is of the essence

If a brain aneurysm does rupture, immediate emergency medical care is required.

Ruptured brain aneurysms are fatal in about half of cases, with 15% of patients dying before they even reach a hospital. Of those who survive, 66% have some sort of permanent neurological deficit.

A ruptured brain aneurysm is usually signaled by a sudden, severe headache – often described as the worst headache of one’s life. Other symptoms can include:

• Nausea and vomiting
• Stiff neck
• Sensitivity to light
• Seizures
• Loss of consciousness
• Cardiac arrest

“Many people can live with asymptomatic, or unruptured, brain aneurysms without any problems,” said Dr. Hanel. “But circumstances can change in an instant. We want people to know and understand the symptoms of a ruptured aneurysm so they can take immediate action. This is a condition where every second counts.”

Baptist Stroke & Cerebrovascular Center is the most comprehensive stroke center in the region. If you or a loved one has been diagnosed with a brain aneurysm, please visit baptistjax.com/brain or call 904.861.0316. To learn more about aneurysm risk factors, symptoms and treatment, please visit baptistjax.com/aneurysm.

Source: Brain Aneurysm Foundation