Aneurysm

Who is at risk for an aneurysm?

Different types of aneurysms affect different groups. Brain aneurysms affect people AFAB more than those AMAB. Aortic aneurysms more often affect people AMAB.

Abdominal aortic aneurysms occur most often in people who are:

Assigned male at birth.

Over the age of 60.

Smokers.

White, although they affect people of any race.

What causes an aneurysm?

In some cases, people are born with aneurysms. They can also develop at any point during your life. Although the cause of an aneurysm is often unknown, some possible causes include:

Atherosclerosis (narrowing of the arteries).

Family history of aneurysms.

High blood pressure.

Injury to your aorta.

What are the symptoms of an aneurysm?

In many cases, people don’t know they have an aneurysm. If an aneurysm ruptures (bursts), it’s a medical emergency that requires immediate treatment. Call 911 if you or someone you're with shows signs of a ruptured aneurysm. Symptoms of a ruptured aneurysm come on suddenly. You may feel:

Lightheaded.

Rapid heartbeat.

Sudden, severe pain in your head, chest, abdomen or back.

Sudden loss of consciousness following a severe headache.

When an aneurysm causes symptoms, the signs depend on its location. You might notice signs of shock, such as a drop in blood pressure, feeling clammy and “out of it,” and having a pounding heart. Other symptoms of an aneurysm can include:

Confusion or dizziness.

Difficulty swallowing.

Fatigue.

Headache.

Nausea or vomiting.

Pain in your abdomen, chest or back.

Pulsating abdominal mass or swelling in your neck.

Rapid heart rate.

Vision changes.

What are the complications of an aneurysm?

If an aneurysm ruptures, it causes internal bleeding. Depending on the location of the aneurysm, a rupture can be very dangerous or life-threatening. An aneurysm in your neck can cause a blood clot that travels to your brain. If the clot cuts off blood flow to your brain, it causes a stroke. When a brain aneurysm ruptures, it causes a subarachnoid hemorrhage. Some people call this type of stroke a brain bleed. Typically people have what they call the worst headache of their life and then develop other symptoms like limb weakness, headache and trouble speaking.

How is an aneurysm diagnosed?

Many aneurysms develop without causing symptoms. Your healthcare provider may discover it by accident during a routine checkup or other screening.

If you have symptoms that may indicate an aneurysm, your provider will do imaging tests. Imaging tests that can find and help diagnose an aneurysm include:

CT scan.

CT or MRI angiography.

Ultrasound.

How will my healthcare provider classify an aneurysm?

Your provider will classify an aneurysm by how large it is and how it forms. The different classifications include:

Fusiform aneurysm bulges out on all sides of your artery.

Saccular aneurysm causes just one side of your artery to bulge.

Mycotic aneurysm develops after an infection (typically in your heart valves) has weakened an artery wall.

Pseudoaneurysm or false aneurysm occurs when just the outer layer of your artery wall expands. This can occur after injury to the inner layer of your artery called dissection.

How is an aneurysm treated?

If your provider discovers that you have an unruptured aneurysm, they'll monitor your condition closely. The goal of treatment is to prevent the aneurysm from bursting.

Depending on the aneurysm’s type, location and size, treatment can include medication or surgery. Your provider may prescribe medications to improve blood flow, lower blood pressure or control cholesterol. These treatments can help slow aneurysm growth and reduce pressure on the artery wall.

Large aneurysms at risk of bursting may require surgery. You'll also need surgery if an aneurysm bursts. Types of surgery may include:

Endovascular aneurysm repair (EVAR): During endovascular surgery, your provider inserts a catheter (thin tube) into the vessel. Through the catheter, the surgeon inserts a graft (section of specialized tubing) to reinforce or repair the artery. For thoracic aneurysms, this procedure is called thoracic endovascular aneurysm repair (TEVAR). If your surgeon has to make a special graft with custom openings, the procedure may be fenestrated endovascular aneurysm repair (FEVAR).

Open surgery: In some cases, a surgeon may perform the graft or remove the aneurysm through an incision (open surgery).

Endovascular coiling: This procedure treats cerebral aneurysms. The surgeon inserts multiple coils (a spiral of platinum wire) through a catheter to pack the aneurysm. This reduces blood flow to the aneurysm and eliminates the risk of rupture.

Microvascular clipping: This type of open brain surgery treats cerebral aneurysms. The surgeon places a metal clip at the base of the aneurysm to cut off blood supply.

Catheter embolization: This procedure cuts off blood supply to the aneurysm. The surgeon inserts a catheter into the affected artery, using the tube to place medication or embolic agents that prevent bleeding.