An aneurysm is a bulge or ballooning in a blood vessel, similar to a weak spot that expands in a tire. This weakening occurs in the wall of an artery. If an area in an artery wall weakens, the force of blood pumping through can cause it to bulge. While aneurysms often remain without symptoms, a rupture can be a medical emergency, underscoring the importance of understanding their nature and potential indicators.
Understanding Aneurysms
Aneurysms can develop in any artery, though they are most frequently observed in the aorta and the blood vessels of the brain. The aorta, the body’s largest artery, extends from the heart through the chest and abdomen. Aneurysms in the chest are thoracic aortic aneurysms (TAA), while those in the abdomen are abdominal aortic aneurysms (AAA).
Cerebral aneurysms affect arteries within the brain. The specific signs of an aneurysm depend on its location and whether it has ruptured. An unruptured aneurysm may not produce symptoms, especially if it is small. However, larger aneurysms can press on surrounding tissues or nerves, leading to various manifestations.
Recognizing the Signs
The signs of an aneurysm vary significantly depending on its location and whether it has burst. An unruptured cerebral aneurysm, if small, often goes unnoticed. However, a larger unruptured cerebral aneurysm might cause symptoms such as pain above or behind one eye, vision changes including double vision, a dilated pupil, or numbness on one side of the face. Headaches, difficulty speaking, loss of balance, or problems with concentration and short-term memory can also occur.
If a cerebral aneurysm ruptures, it typically leads to a sudden, extremely severe headache, often described as the “worst headache of my life.” This rupture can also cause nausea, vomiting, a stiff neck, sensitivity to light, seizures, or loss of consciousness. A drooping eyelid, confusion, or weakness and numbness may also be present. Such a rupture results in bleeding around the brain, a condition known as a subarachnoid hemorrhage.
Abdominal aortic aneurysms (AAA) frequently present without symptoms until they are close to rupturing. If symptoms do emerge, they might include a deep, constant pain in the abdomen or side, or a pulsing sensation near the navel.
A ruptured AAA is a medical emergency, characterized by sudden, intense, persistent pain in the abdomen or lower back. Other indicators can include shortness of breath, a rapid heart rate, low blood pressure, dizziness, fainting, nausea, vomiting, or clammy skin.
Thoracic aortic aneurysms (TAA) often develop without noticeable symptoms. When symptoms occur, they may include pain in the chest or back, hoarseness, difficulty swallowing, or shortness of breath.
A ruptured TAA or an aortic dissection (a tear in the aorta’s wall) is a medical emergency. These events typically cause sudden, sharp, and severe pain in the chest or upper back. Other signs can include dizziness, lightheadedness, a fast heart rate, heavy sweating, confusion, trouble speaking, vision loss, or weakness or paralysis on one side of the body.
Immediate Steps for Suspected Aneurysm
Immediate action is paramount if an aneurysm is suspected. If you or someone else experiences symptoms indicative of an aneurysm, especially a sudden, severe headache or intense chest, back, or abdominal pain, seek prompt medical attention. Call emergency services without delay.
Self-diagnosis is not appropriate due to the life-threatening potential of a ruptured aneurysm. Avoid driving oneself to the hospital. Rapid medical evaluation and intervention can significantly improve outcomes.
Confirming an Aneurysm Diagnosis
Medical professionals utilize various imaging techniques to confirm an aneurysm’s presence and characteristics. A computed tomography (CT) scan is frequently the initial test, especially if a ruptured brain aneurysm is suspected. A CT angiogram (CTA) provides more detailed images of blood vessels, showing the size, location, and shape of both unruptured and ruptured aneurysms.
Magnetic resonance imaging (MRI) is another common diagnostic tool. Magnetic resonance angiography (MRA) specifically visualizes blood vessels and is often used to detect unruptured brain aneurysms. For abdominal aortic aneurysms, ultrasound can also be employed. These imaging tests help doctors assess the aneurysm’s size, exact location, and overall condition, which is important for determining the appropriate course of action.