2-Minute Neuroscience: Brain Aneurysms

A brain aneurysm is a weakened area in the lining of a blood vessel in the brain where blood accumulates, causing a bulging of the blood vessel wall. Most brain aneurysms do not cause any symptoms, but a ruptured aneurysm can lead to bleeding into the area surrounding the brain—a dangerous condition known as subarachnoid hemorrhage. In this video, I discuss the characteristics, formation, rupture, and treatment of brain aneurysms.

TRANSCRIPT:

A brain aneurysm is a weakened area in the lining of a blood vessel in the brain where blood accumulates, causing a bulging of the blood vessel wall. While estimates vary, it is thought that brain aneurysms may occur in somewhere between 2 and 5% of the population. Most brain aneurysms, however, do not cause any symptoms, but larger aneurysms may cause symptoms by putting pressure on brain tissue and in a small percentage of cases, an aneurysm may rupture. The rupture of a brain aneurysm can cause bleeding into the area surrounding the brain---a condition known as subarachnoid hemorrhage. Subarachnoid hemorrhage is an extremely dangerous situation with high rates of fatality.

The mechanisms underlying the formation and rupture of brain aneurysms are still not completely understood. It is thought, however, that an aneurysm may typically originate with damage to the wall of a blood vessel, followed by an inflammatory response that ends up further weakening the blood vessel wall. The weakened vessel wall allows blood to accumulate in that section of the blood vessel and increases the risk of the vessel rupturing. There are a number of factors that may influence the likelihood of aneurysm rupture, such as the size, location, and rate of growth of the aneurysm, as well as patient factors such as smoking, alcohol consumption, hypertension, and a family or personal history of aneurysm rupture.

A ruptured aneurysm requires emergency treatment, which typically involves one of two approaches: surgical clipping or endovascular coiling. Clipping involves surgery to open the skull and place a metal clip at the base of the aneurysm to prevent blood flow into the aneurysm. Coiling is a less invasive procedure that involves passing a catheter into an artery and threading it through the body to reach the aneurysm. Tiny platinum coils are then released into the aneurysm to block blood flow into the aneurysm.

REFERENCES:

Brisman JL, Song JK, Newell DW. Cerebral aneurysms. N Engl J Med. 2006 Aug 31;355(9):928-39. doi: 10.1056/NEJMra052760. PMID: 16943405.

"Cerebral Aneurysms Fact Sheet", NINDS, Publication date May 2018.
NIH Publication No. 18-NS-5506

Chalouhi N, Hoh BL, Hasan D. Review of cerebral aneurysm formation, growth, and rupture. Stroke. 2013 Dec;44(12):3613-22. doi: 10.1161/STROKEAHA.113.002390. Epub 2013 Oct 15. PMID: 24130141.

Jung KH. New Pathophysiological Considerations on Cerebral Aneurysms. Neurointervention. 2018 Sep;13(2):73-83. doi: 10.5469/neuroint.2018.01011. Epub 2018 Aug 31. PMID: 30196677; PMCID: PMC6132027.

Thompson BG, Brown RD Jr, Amin-Hanjani S, Broderick JP, Cockroft KM, Connolly ES Jr, Duckwiler GR, Harris CC, Howard VJ, Johnston SC, Meyers PM, Molyneux A, Ogilvy CS, Ringer AJ, Torner J; American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, and Council on Epidemiology and Prevention; American Heart Association; American Stroke Association. Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2015 Aug;46(8):2368-400. doi: 10.1161/STR.0000000000000070. Epub 2015 Jun 18. PMID: 26089327.

Vlak MH, Algra A, Brandenburg R, Rinkel GJ. Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis. Lancet Neurol. 2011 Jul;10(7):626-36. doi: 10.1016/S1474-4422(11)70109-0. PMID: 21641282.

[louiselincoln]

A close friend of mine died because of a brain aneurysm (caused by a cerebral haemorrhage).
I was working with her, on the day she died. She was behaving strangely and crying.

She used to spend a lot of time with me, before she died. She described her symptoms to me. The symptoms are below.

She had headaches. A lot of headaches. That was her main issue but I also think her blood pressure was quite high.

I asked her to go the her doctor. She did.
She reported headaches, but the GP just gave her painkillers.

Those painkillers, or that misdiagnosis, killed her.

She was a beautiful, magnificent and hardworking woman.

She left behind 3 beautiful daughters, who miss their Mum and will never have the opportunity to access her advice and wisdom as they grow up.

She left behind a wonderful husband who now has to try and look after his children alone.

She did not deserve to die like that.

There are many things to learn from this. But one of the most important ones is that pain is useful. Pain is the body telling you that something is wrong. Pain is there to protect us.

We should not ignore pain by giving pain relief. Treating the symptoms is not the same as treating the cause of the symptoms.

[lydiajang]

My mom had a lot of symptoms such as Drooping eyelid, Double vision and dizziness. I took her to ER and the doctor said she has aneurism. Had surgery immediately and mom survived :))

[Rizerr]

I always get freaked out thinking about anuerisms. As if actively thinking about them increases the likelihood of having one rupture. I'm not superstitious at all, but I seem to have an exception for this..

[mehtabalishahpuffgoawayplease]

If you play it at 2x it becomes 1 minute neuroanatomy

[MrBerniemcgovern]

You are providing my new favorite channel! It borders on asmr. Thank you for the relaxing delivery and fantastic diagrams. Yay!

[vaishaliranadive]

I am the ruptured brain aneurysm survivor..coiling is done

[Mancont]

Me sorprende haber sobrevivido a un aneurisma cerebral, tuve la mala suerte de que reventó, sobreviví de puro milagro aunque tengo que hacer rehabilitación porque me dejó una hemiperesia izquierda (pérdida parcial de la capacidad motriz del brazo y de la pierna izquierda), ocurrió en agosto del año pasado y soy una persona sana sin malos hábitos.

[aamirrazak]

Interesting informative and easy to follow, thank you. I’ve heard of clipping but never the platinum coil technique.

[MRM-Wendy]

I have one now. Its 2 mm. I have worse headaches. It scares me alot. Waiting see what my neurologist is wanting to do. Mine still small

[colleenrugg]

Thank you for the information. My Mother died of an aneurysm as did her mother. Thankfully the say that when you have a severe aneurysm that it is painless before death.

[isilvera]

, . Thanks much Dr. Very great. Explanation

[Stolasupremecy]

Whats it called when they poke and break the anyresm and cut it out and take it out?

[clinicalpediatrics]

Graet👍
Complicated Medical topics made with simple mnemonics and animations #Perfect medico

[cheesesyrkyer]

My friend that was healthy died from this in his sleep.

[mr.glizzy]

How do they reach to the aneurysm? To stop the issue in it like blood flow and stuff.

[danielvarela]

Damn, 6 months after covid with NO vaccines! And I fucken have this on my right side aka superficial temporal artery aneurysm… even my kids have this! My youngest is 5yrs. This was caused by an “infection”. Please god help us.. 😭👨‍👩‍👧‍👦🙏🏽❤️‍🩹

[mariam-NKN]

Hello from Greece 🇬🇷💙 I have AVM in thalamus ✌️

[ShadesOfMeme]

My grandma suffered an aneurysm last friday.

[therealjoeyp]

all i did was watch "me edging my brain aneurysm"

[SuperDuperSigmaMale]

I believe I have a brain aneurysm because I can feel fluid in my beain.