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Aneurysms

Aneurysms are bulges (or outpouchings) of blood vessels in areas where the blood vessel wall has become weak. They can be found in the abdomen, in the kidneys, in the heart, and in the brain, and the most feared outcome is that they suddenly rupture. A ruptured aneurysm can lead to a tremendous degree of blood loss and the blood can damage the surrounding tissues. This can lead to death or significant disabilities, depending on the location of the ruptured aneurysm. Even if an aneurysm doesn’t rupture, it can still cause symptoms if its bulge is pressing on nearby structures.

Aneurysms typically occur in older adults, but they can occur at any age including in young children. The types of aneurysms that children get differ from those of adults, typically.

Symptoms

The symptoms of an aneurysm depend on its size and location. Importantly, aneurysms often have no symptoms at all if they have not ruptured. Still, some symptoms can include:

  • Feeling pressure
  • Pain
  • A pulsating or pounding sensation
  • Feeling weak

Brain aneurysms are some of the most feared aneurysms, and they can have some additional symptoms:

  • Loss of balance
  • Loss of ability to speak
  • Inability to move normally
  • Headaches
  • A very stiff neck
  • Vision changes

Causes

The cause of an aneurysm differs by location. Brain aneurysms in adults are usually due to atherosclerosis (plaque build-up in the arteries because of high cholesterol in the blood). Brain aneurysms can also be caused by accidents, injuries, and physical trauma. Brain aneurysms in children are usually due to vasculitis (inflammation of the blood vessels), in a disease known as Kawasaki disease.

Heart aneurysms typically occur after heart attacks, as the heart remodels and blood vessel walls weaken. Abdominal aneurysms are usually due to either atherosclerosis, infection, or trauma. Aneurysms in the kidney can be due to genetic disorders or certain diseases.

Risk Factors

Risk factors for aneurysms include:

  • Smoking – Smoking is a major risk factor for aneurysms, as it can lead to increased blood pressure. Over time, this can weaken the walls of blood vessels, leading to aneurysms.
  • Obesity and diabetes – Obesity and diabetes can both increase the risk of aneurysms. Both are associated with increased atherosclerosis, which is a major cause of aneurysms, especially in the brain.
  • High blood pressure – High blood pressure weakens blood vessel walls and is a major risk factor for aneurysm development.
  • Older age – The majority of aneurysms occur in older people, and increasing age is a risk factor for aneurysm formation and rupture.
  • Certain genetic disorders – Some genetic conditions like Ehlers Danlos syndrome, Marfan syndrome, and ADPKD (Autosomal Dominant Polycystic Kidney Disease) lead to weak blood vessel walls and a high risk for aneurysms.

Diagnosis

Aneurysms can be diagnosed incidentally (accidentally) or on purpose. Incidental aneurysm diagnosis usually occurs when you are getting a scan (CT, MRI, X-ray, etc) for some purpose and a doctor notices the aneurysm in the scan.

If you are experiencing symptoms of an aneurysm, a doctor will usually perform a CT-scan or MRI on you to visualize its exact location.

Treatment

Aneurysms have three typical treatment protocols, depending on their size and location. The first is watchful waiting, which means doing nothing but observing the growth of the aneurysm over time. This is usually chosen if the aneurysm is small or not in a dangerous location.

The second treatment is medication, typically pills to reduce blood pressure. High blood pressure is a major risk factor for aneurysms, and it can usually be well controlled with medicine.

The third treatment for aneurysms is surgery, and this is usually done if the aneurysm has ruptured or is very large and about to rupture.

 
 
 

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