Has Someone Had an Aneurysm in Your Family? Get Checked!

Better imaging and procedures help treat brain aneurysms
Has Someone Had an Aneurysm in Your Family? Get Checked!

Aneurysms typically do not cause symptoms, so they are difficult to detect. And, they are not as common as, say, heart disease, so physicians don’t do general public screenings.

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However, there is a clear genetic component. So if you have a strong family history of aneurysms, your doctor will likely want to screen for this defect.

“My current standards are if you have two direct family members who have a history of intracranial aneurysms, then we recommend screenings for everyone in that immediate family,” says neurosurgeon Mark Bain, MD, Program Director for Cleveland Clinic’s Cerebrovascular Neurosurgery Fellowship.

Aneurysms can develop at any age

Patients of any age may develop a ballooning or bulging artery that characterizes an aneurysm. And the stretched and weakened walls of these blood vessels can sometimes rupture, but not very often, Dr. Bain says.

Aneurysms in children are very rare. They are more likely to occur in people between the ages of 35 and 60.

They also develop in elderly patients, but doctors usually don’t treat them in patients who are in their 70s or older.

“They’ve already gotten pretty far, and that aneurysm has probably been there for many years,” Dr. Bain says. “So a lot of times we won’t treat them, unless they’re pretty large.”

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Once a person has an aneurysm, it’s fairly rare that they would have a second, he says.

However, your doctor is likely to monitor the condition for the rest of your life, as a precaution. Approximately 20 percent of patients have multiple aneurysms, according to Dr. Bain.

Are you putting yourself at risk?

The four key risk factors that cause aneurysms include:

  1. Cigarette smoking: “If you look at studies, smoking definitely damages the blood vessels over time,” says Dr. Bain. “And that definitely leads to the growth of aneurysms and to aneurysms rupturing.”
  2. Hypertension and high blood pressure: “That makes sense, because the wear and tear on the blood vessels with the high pressure can cause aneurysms to form,” he says.
  3. Connective tissue diseases: Conditions such as Marfan Syndrome affect the connective tissues of your blood vessels and make them weaker.
  4. Illegal drug use: Drugs such as cocaine or methamphetamine may cause blood vessel weakness and can also raise your blood pressure while you use them, which can cause aneurysms to rupture, Dr. Bain says.

The key is to prevent ruptures

The primary goal for physicians and patients is to prevent aneurysms from rupturing, Dr. Bain says.

Roughly 25 percent of ruptures are almost immediately fatal, he says. And of the patients who get to a hospital, about half will be severely disabled. These patients often have to live in a nursing facility for the rest of their lives. About 25 percent of patients will make a significant, if not full, recovery.

However, Dr. Bain emphasizes that ruptures do not occur often.

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“Because of the potential fatality from a rupture, people have a lot of anxiety and fear about aneurysms,” he says. “But overall, aneurysms don’t rupture at a high rate. The only ones that do are the real giant ones.”

Dr. Bain says physicians today use much more powerful diagnostic imaging equipment to find aneurysms. And if they detect a potentially dangerous aneurysm, there are excellent treatment options.

Two main treatment options for surgeons

Surgeons usually treat an aneurysm that looks like it could rupture with brain surgery. During the procedure, the surgeon places a titanium clip around the base of the aneurysm to prevent blood from flowing into the weakened part of the artery.

A surgeon also may take an endovascular approach, Dr. Bain says. The surgeon inserts a catheter into an artery in the groin and moves up into the blood vessels of the brain. There, he or she inserts a small platinum coil that closes the aneurysm from the inside so blood can’t enter into it.

“There are pluses and minuses to each procedure, but both of them work very, very well to prevent an aneurysm from rupturing,” Dr. Bain says.

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