Overview of an aneurysm.pdf

Overview of an aneurysm
● Causes and risk factors
● Symptoms
● Diagnosis
● Treatments
● Prevention
● Summary
What is an aneurysm?
An aneurysm occurs when an artery’s wall weakens and causes an
abnormally large bulge.

Arteries are blood vessels that carry blood from the heart to the rest of the
body, while veins bring blood back to the heart and lungs. This bulge can
rupture and cause internal bleeding. Although an aneurysm can develop in
any part of your body, they’re most common in the:
● Brain. Aneurysms in the brain are called cerebral aneurysms. These
often form in the blood vessels that lie deep within the brain. They also
may not present any symptoms. You may not even know you have an
aneurysm. Cerebral aneurysms may affect 3 to 5 percent
● Trusted Source
● of people during their lifetime.
● Aorta. Aneurysms in the chest cavity are called thoracic aortic
aneurysms. Abdominal aortic aneurysms are the most common type. In
rare cases, arterial damage can affect both the chest and abdomen.
The aorta is the largest blood vessel in the body. It begins at the left ventricle
of the heart and travels down the abdomen where it splits off into both legs.
The aorta is a common site for arterial aneurysms.

VIEW GALLERY
2
Other more common areas where an aneurysm may occur include the:
● legs
● spleen
● behind your knee
● intestines

According to the National Heart, Lung and Blood Institute, aortic aneurysms
are responsible for about 13,000 deaths
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each year in the United States.
What causes an aneurysm?
Although the exact cause of an aneurysm is unclear, certain factors contribute
to the condition.
For example, damaged tissue in the arteries can play a role. Blockages, such
as fatty deposits, can harm the arteries. These deposits can trigger the heart
to pump harder than necessary to push blood past the fatty buildup. This
added stress due to the increased pressure can damage the arteries.

Atherosclerotic disease
Atherosclerotic disease can also lead to an aneurysm. People with
atherosclerotic disease have a form of plaque buildup in their arteries. Plaque
is a hard substance composed of cholesterol, fat, and other substances that
damages the arteries and prevents blood from flowing freely.
High blood pressure
High blood pressure may also cause an aneurysm. The force of your blood as
it travels through your blood vessels is measured by how much pressure it
places on your artery walls. If the pressure increases above a normal rate, it
may enlarge or weaken the blood vessels.
Blood pressure for an adult is considered normal at or below 120/80 mm Hg,
or millimeters of mercury.

A significantly higher blood pressure can increase the risk for heart, blood
vessel, and circulation problems. However, higher-than-normal blood pressure
doesn’t necessarily put you at risk for an aneurysm.
Other risk factors
The type of aneurysm that can affect you depends on specific risk factors.
Males are more likely
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to have aneurysms than females. People 65 and older
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are also at a higher risk. Other factors may include:

● a diet high in fats and cholesterol
● Trusted Source
●
● a family history of heart conditions, including heart disease and heart
attack
● smoking
● obesity
● pregnancy, which may increase your risk of having an aneurysm of the
spleen
What symptoms should I look for?
Symptoms of an aneurysm vary with each type and location. It’s important to
know that aneurysms that occur in the body or brain generally don’t present
signs or symptoms until they rupture.
Symptoms of a ruptured aneurysm

Aneurysms that occur near the surface of the body may show signs of
swelling and pain. A large mass may also develop. The symptoms of ruptured
aneurysm vary, based on its location.
Cerebral aneurysm
Symptoms of a ruptured aneurysm in the brain begin with a sudden and
excruciating a headache. Other symptoms may include:
● vision problems, such as double vision
● sensitivity to light
● nausea and vomiting
● loss of consciousness
Aortic aneurysm
Symptoms of an aortic aneurysm

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depend on whether it occurs in the chest or the abdomen.
When a thoracic aortic aneurysm ruptures, symptoms may include:
● sudden and severe chest pain
● sudden back pain
● significant drop in blood pressure
● numbness in the limbs
An abdominal aortic aneurysm that ruptures may cause the following
symptoms:
● sudden and severe pain in the abdomen or lower back
● rapid heart rate
● dizziness or lightheadedness
● shortness of breath

● cold sweat
MEDICAL EMERGENCY
Serious complications from aneurysms can cause death if you don’t get
emergency care. Call 911 or have someone drive you to the nearest
emergency room if you experience the following symptoms:
● bleeding
● increased heart rate
● sudden chest pain
● sudden abdominal pain
● feeling dizzy or light-headed
This is especially important if you know you have an aneurysm. If you’ve been
diagnosed with a cerebral aneurysm that hasn’t burst, you should have a
procedure to prevent sudden rupture. In some cases, aneurysms in the aorta

and elsewhere in the body may be treated with medications and monitored if
they don’t appear to be at high risk of rupturing soon.
What is a leaking aneurysm?
Blood can escape an aneurysm without it rupturing. A leaking aneurysm
occurs when a small amount of blood is discharged through the thinning wall
of the artery. This event is sometimes known as a “sentinel bleed
Trusted Source
” because it often precedes a more significant aneurysm rupture.
Symptoms of a leaking aneurysm are similar to those of a ruptured aneurysm,
though they may not be as severe. A leaking aneurysm in the brain can
sometimes trigger what is called a “sentinel headache,” a warning sign that a
potentially fatal cerebral hemorrhage may be developing soon.

How is an aneurysm diagnosed?
The diagnostic tools used to find arterial damage often depend on the location
of the problem.
Most cerebral aneurysms
Trusted Source
are found incidentally, often when brain imaging is used to look for other
conditions, such as a concussion. Your doctor may refer you to a specialist
like a cardiothoracic or vascular surgeon.
A CT scan and ultrasound are common imaging tests used to diagnose or find
blood vessel irregularities. CT scans use X-rays to examine the inside of your
body. This allows your doctor to see the condition of the blood vessels, as well
as any blockages, bulges, and weak spots that may be inside the blood
vessels.

How is an aneurysm treated?
Treatment typically depends on the location and type of aneurysm.
For example, a weakened area of a vessel in your chest and abdomen may
require a type of surgery called an endovascular stent graft. This minimally
invasive procedure may be used over traditional open surgery because it
involves repairing and reinforcing damaged blood vessels. The procedure also
reduces the chance of infection, scarring, and other problems.
Other treatments can include medications that treat high blood pressure and
high cholesterol. Certain types of beta-blockers may also be prescribed to
lower blood pressure. Lowering your blood pressure may keep your aneurysm
from rupturing.
Is there any way to prevent an
aneurysm?

Eating a nutrient-rich diet containing plenty of fruits, whole grains, and
vegetables may help prevent an aneurysm from forming. Meat and poultry low
in saturated fat and cholesterol are also good protein options. Low fat dairy
products are also beneficial.
Incorporating regular exercise into your routine, especially cardio, can
encourage healthy blood circulation and blood flow through the heart, arteries,
and other blood vessels.
If you smoke tobacco products, consider quitting. Eliminating tobacco can
decrease your risk of an aneurysm. Quitting can be challenging, but a
healthcare professional can help you build a cessation plan that works for you
and connect you with other supportive resources.
Scheduling annual checkups is another way to be proactive about helping
prevent an aneurysm. It’s also a way to help promote overall health and
well-being.
Takeaway

An aneurysm is a bulge that forms in the thinning wall of an artery. Two of the
most common and potentially life threatening locations for an aneurysm are
the brain (cerebral aneurysm) and the aorta, the largest blood vessel in the
body.
If an aneurysm ruptures, it is a medical emergency. Though an aneurysm
can’t always be prevented, taking steps such as maintaining a healthy blood
pressure, quitting smoking, and scheduling annual checkups can help lower
your risks.
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Last medically reviewed on November 10, 2021

11 sources
expanded
Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research
institutions, and medical associations. We avoid using tertiary references. You can learn more about
how we ensure our content is accurate and current by reading our editorial policy.
● Aneurysm. (n.d.).
nhlbi.nih.gov/health-topics/aneurysm
● Aortic aneurysm. (2021).
cdc.gov/heartdisease/aortic_aneurysm.htm
● Atherosclerosis. (n.d.).
nhlbi.nih.gov/health-topics/atherosclerosis
● Cerebral aneurysms fact sheet. (2020).
ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Cerebral-Aneurysms-Fact-
Sheet
● Climent E, et al. (2018). Diabetes mellitus as a protective factor of abdominal aortic
aneurysm: Possible mechanisms.
pubmed.ncbi.nlm.nih.gov/29580664/
● Hashimoto K. (2018). The effect of a high-fat diet on the development of abdominal aortic
aneurysm in a vascular hypoperfusion-induced animal model.
ncbi.nlm.nih.gov/pubmed/29393228
● Jersey A. (2021). Cerebral aneurysm.
ncbi.nlm.nih.gov/books/NBK507902/
● Kairys, N. (2021). Acute subarachnoid hemorrhage.
● Rask-Madsen C, et al. (2012). Hyperinsulemia does not change atherosclerosis
development in apolipoprotein E null mice.
ncbi.nlm.nih.gov/pmc/articles/PMC3640325/

● What is an aneurysm? (n.d.).
heart.org/en/health-topics/aortic-aneurysm/what-is-an-aneurysm
● What is high blood pressure? (2018).
heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/what-is-h
igh-blood-pressure
FEEDBACK:
Medically reviewed by Seunggu Han, M.D. — Written by Brindles Lee Macon
and James Roland — Updated on November 10, 2021
What Is a Brain
Aneurysm?

● Symptoms
● Causes
● Types
● Risk factors
● Diagnosis
● Treatment
● Complications
● Outlook
● Summary
A brain aneurysm is a deformity of an artery where a spot in the arterial wall in
the brain bulges and fills with blood. It may also be called an intracranial
aneurysm or cerebral aneurysm.

Illustration by Sophia Smith
A brain aneurysm is a potentially life threatening condition that can affect a
person at any age. If a brain aneurysm bursts, or ruptures, it’s an emergency
situation that can result in a stroke, brain damage, and even death if not
treated immediately.
Below, we’ll explore more about brain aneurysms, including their symptoms,
causes, and potential treatment options.

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What are the symptoms of a brain
aneurysm?
Brain aneurysms are unpredictable and may not show any symptoms until
they grow large or rupture. Large or ruptured aneurysms will usually show
definite symptoms and require emergency medical care.
The symptoms and warning signs of a brain aneurysm vary based on whether
it has ruptured or not.
Unruptured aneurysms

Small aneurysms don’t typically cause any noticeable signs. However, an
aneurysm that becomes large may start to press on surrounding nerves and
tissues, leading to symptoms.
It’s estimated that only 10 to 15 percent of unruptured aneurysms cause
symptoms. When present, the symptoms of an unruptured brain aneurysm
can include:
● headache or pain behind or above the eye
● weakness or numbness that impacts one side of your face
● blurred or double vision
● a dilated pupil
Contact your doctor as soon as possible if you experience any of these
symptoms.
Leaking aneurysms

It’s possible for an aneurysm to leak and release a small amount of blood into
the brain. If you have a brain aneurysm that’s leaking, you may experience a
sudden, severe headache. This is called a sentinel headache.
Sentinel headaches may develop in the days or weeks before a brain
aneurysm completely ruptures. If you experience a sudden, severe headache,
particularly if it occurs with other aneurysm symptoms, seek immediate
medical care.
Ruptured aneurysms
The symptoms of a ruptured brain aneurysm can include:
● a sudden, severe headache that may feel like the worst one you’ve ever
had
● neck stiffness
● blurry or double vision
● sensitivity to light
● a drooping eyelid
● trouble speaking or a change in awareness or mental state
● trouble walking or dizziness

● nausea or vomiting
● seizures
● loss of consciousness
A ruptured aneurysm is life threatening. Seek emergency medical attention
right away if you experience one or more of these symptoms.
What causes a brain aneurysm?
Brain aneurysms happen due to structural changes in the walls of an artery in
the brain. These changes cause the walls of the artery to get weaker and
become thin. The deformity can happen due to thinning of the wall, but
sometimes inflammation or trauma can cause the deformity without thinning.
It’s still unclear what exactly causes aneurysms to form. However, it’s believed
that one or a combination of the following factors may promote their
development:

● a break down of elastic tissue within the artery
● stress from blood flow through the artery
● tissue changes in the artery due to increases in inflammation
Brain aneurysms are also more likely to happen where an artery branches into
different directions. This is because arteries are naturally weaker at these
locations.
It’s possible for aneurysms to be present from birth. However, they most often
develop over the course of your lifetime. This can be due to a variety of risk
factors that we’ll discuss below.
What does a brain aneurysm look
like?
Brain aneurysms can take several forms. About 90 percent are saccular, or
“berry,” aneurysms. This type forms a sac outside the artery that looks like a
berry attached to a vine.

A fusiform aneurysm is a rarer type of aneurysm that affects a longer section
of the artery wall, causing the artery to bulge all the way around. It’s estimated
that 3 to 13 percent
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of brain aneurysms are fusiform.
What are the risk factors for a
brain aneurysm?
Brain aneurysms can affect anyone. However, some factors can increase your
risk.
There are different risk factors for aneurysm development and rupture.

Risk factors for aneurysm formation
There are several risk factors that can increase your risk of developing a brain
aneurysm. These include:
● Age. Most aneurysms are diagnosed in individuals who are over the age
of 40.
● Sex. Women are more likely to get aneurysms than men.
● Family history. If aneurysms run in your immediate family, your risk of
having one is higher.
● High blood pressure. Untreated high blood pressure, or hypertension,
can place additional pressure on the walls of your arteries.
● Smoking. Smoking can increase your blood pressure and cause
damage to the blood vessel walls.
● Alcohol and drug misuse. Alcohol and drug misuse, specifically cocaine
or amphetamine use, can increase blood pressure and lead to
inflammation in your arteries.
● Head injury. In rare cases, a severe head injury can damage blood
vessels in your brain, leading to the formation of an aneurysm.
● Genetic conditions. Certain genetic conditions can damage arteries or
impact their structure, increasing the risk of an aneurysm. Some
examples include:
○ autosomal dominant polycystic kidney disease (ADPKD)
○ Ehlers-Danlos syndrome
○ Marfan syndrome

● Congenital conditions. It’s possible that weaknesses in blood vessels
can be present from birth. Additionally, congenital conditions like
arteriovenous malformations or narrowing of the aorta, called
coarctation, can also raise the risk of aneurysms.
● Infections. Some types of infections can damage artery walls and
increase aneurysm risk. These are called mycotic aneurysms.
Risk factors for aneurysm rupture
Some aneurysms will never rupture. However, there are also risk factors that
can increase the chance of a ruptured aneurysm.
Some risk factors for rupture are associated with the characteristics of the
aneurysm itself. Risk of rupture is raised in brain aneurysms that are:
● large
● have grown larger over time
● located in certain arteries, specifically the posterior communicating
arteries and the anterior communicating arteries

Individual factors that increase the risk of rupture include:
● having a personal or family history of ruptured aneurysms
● having high blood pressure
● smoking cigarettes
Additionally, some events may encourage an aneurysm to rupture. An older
2011 study
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assessed the relative risk of certain events in 250 individuals who had
previously experienced a ruptured aneurysm. It found that the following were
associated with the rupture of an existing aneurysm:
● excessive exercise
● coffee or soda consumption
● straining during bowel movements

● nose blowing
● experiencing intense anger
● being startled
● sexual intercourse
How is a brain aneurysm
diagnosed?
Unless an aneurysm ruptures, it may be difficult to diagnose. Doctors can use
certain tests to locate brain aneurysms in people who have a family history of
the condition, risk factors, and inherited aneurysm-related health issues.
It’s also possible for an aneurysm to be detected during tests for unrelated
health conditions, such as headaches or seizures.
Diagnosis of brain aneurysms relies on imaging that can visualize brain
tissues and arteries, which may detect the presence of an aneurysm.

Imaging tests may include one or more of the following:
Magnetic resonance imaging (MRI)
An MRI scan works by using radio waves and magnetic fields to create
images of your brain. It’s particularly useful for detecting and evaluating
unruptured aneurysms.
A type of MRI called magnetic resonance angiography can make detailed
images of brain arteries to help pinpoint the location, size, and shape of an
aneurysm.
Computed tomography (CT)
A CT scan takes several X-rays to produce horizonal images of the brain.
Images from a CT scan are often utilized to find bleeding in your brain due to
a leaking or ruptured aneurysm.

A type of CT scan called CT angiography uses a special dye to help your
doctor more effectively see how blood is flowing in the arteries of your brain.
Digital subtraction angiography (DSA)
With DSA, a thin, flexible tube called a catheter is inserted into an artery in the
groin. The catheter is then threaded up to the brain.
Once in the brain, a special dye is released through the catheter. A computer
then uses X-ray images from before and after the application of the dye to
produce images. These images include only blood vessels and none of the
other surrounding structures, such as bone.
Cerebrospinal fluid (CSF) tests
Sometimes, imaging may not clearly show bleeding due to an aneurysm. In
this situation, your doctor may order a test of your CSF, which is collected
using a lumbar puncture. The presence of blood in a CSF sample can indicate
bleeding in the brain.

A lumbar puncture can be risky for some people because it can lead to brain
herniation due to changes in spinal fluid pressure. This test may be done with
caution during an evaluation for a brain aneurysm, but sometimes it’s not
recommended in these situations.
How is a brain aneurysm treated?
Treatment for a brain aneurysm can vary based on several factors, including:
● the location and size of the aneurysm
● your age and overall health
● your personal and family medical history
● whether the aneurysm is at risk of rupturing or has already ruptured
It’s possible that small, unruptured aneurysms that don’t have any risk factors
associated with rupture won’t require immediate treatment. Instead, your
doctor may recommend periodically monitoring the aneurysm using imaging
technology to detect any changes.

When treatment is necessary, it can involve both surgical and lifestyle
approaches, which we’ll explain in more detail below.
Surgery
If the brain aneurysm is accessible, surgery can repair or cut off blood flow to
the aneurysm. This can prevent growth, rupture, or recurrence.
Surgical clipping is a type of procedure in which the blood flow to an
aneurysm is cut off using a tiny metal clip. This seals off the aneurysm,
preventing further growth or rupture. Surgical clipping requires open brain
surgery and is performed under general anesthesia.
Endovascular coiling is another surgical procedure used for aneurysms. It’s
less invasive than surgical clipping.
During endovascular coiling, a catheter is inserted into an artery in your groin
and threaded to your aneurysm. The catheter then releases tiny coils of wire
into the aneurysm, helping to block blood flow.

Brain aneurysms treated using this method can sometimes recur, so
endovascular coiling may need to be performed more than once.
Flow diverters
Another newer option for treating a brain aneurysm is the placement of a flow
diverter. These devices are similar to the stents that are used for artery
blockages in the heart.
Flow diverters can be used when an aneurysm is large or cannot be treated
using the surgical techniques discussed above. Like endovascular coiling,
placing a flow diverter is less invasive than procedures like surgical clipping.
To place a flow diverter, your doctor will first insert a catheter into an artery in
your groin, threading it to the area of the aneurysm. When the catheter is in
place, the flow diverter is positioned into the artery in which the aneurysm
formed.

Once in place, the flow diverter works to redirect blood away from the
aneurysm. This helps to prevent it from growing or rupturing.
Flow diverters are generally safe and effective for treating brain aneurysms.
A 2013 clinical trial of 106 large or giant aneurysms found that flow diversion
completely blocked blood flow to the aneurysm in 73.6 percent of cases.
A 2019 meta-analysis of flow diverters in 2,614 people with small or medium
aneurysms observed complete diversion of blood flow in 74.9 percent of
cases.
Lifestyle changes
Making certain lifestyle changes may help you manage aneurysms and
prevent them from rupturing. These changes include:

● taking steps to treat high blood pressure
● quitting smoking
● eating a well-balanced diet that focuses on:
○ fresh fruits and vegetables
○ whole grains
○ lean meats
○ low fat dairy products
● exercising regularly, but not excessively
● managing your weight if you are overweight or have obesity
● reducing caffeine and alcohol intake
● avoiding the use of drugs like cocaine or amphetamines
What are complications of brain
aneurysms?
A ruptured brain aneurysm can lead to a hemorrhagic stroke. This happens
when blood leaks into the brain itself or into the area between the skull and
brain (subarachnoid space).
Bleeding from a ruptured aneurysm can lead to several life threatening
complications. If left untreated, they can cause brain damage and coma.
Death can occur in some cases.

The potential complications of a ruptured brain aneurysm include:
● Seizures. Seizures can happen during or shortly after an aneurysm
ruptures.
● Vasospasm. This occurs when your brain’s blood vessels suddenly
become narrow, cutting off blood flow to parts of the brain. The risk of
vasospasm is highest within 24 hours of an aneurysm rupture.
● Hydrocephalus. This happens when CSF circulation is impaired and
accumulates in the brain, leading to swelling. Hydrocephalus can occur
within days of a ruptured brain aneurysm and can also be a long-term
complication of a ruptured brain aneurysm, sometimes requiring the
placement of a shunt.
Additionally, after a brain aneurysm ruptures, it can rupture again at any time,
even after treatment.
What is the outlook for someone
with a brain aneurysm?

Not all aneurysms will rupture. According to the Brain Aneurysm Foundation,
about 6.5 million people in the United States have brain aneurysms that
haven’t ruptured. In fact, an estimated 50 to 80 percent of all brain aneurysms
never rupture in a person’s lifetime.
According to the National Institute of Neurological Disorders and Stroke, about
30,000 individuals
Trusted Source
in the United States experience ruptured aneurysms each year. When a brain
aneurysm ruptures, the outlook is poor, with about 50 percent
Trusted Source
of individuals dying within 3 months.

Because of this, it’s important to be vigilant in monitoring existing aneurysms
as well as taking steps to prevent them from rupturing. It’s possible that your
doctor may recommend surgical treatment for aneurysms that are large or at
an increased risk of rupturing.
If you notice signs of rupture, it’s vital to seek immediate medical care to
increase your chance of survival and recovery.
After a rupture, recovery can take weeks to months, and it’s likely that you’ll
need physical, occupational, or speech therapy during this time. It’s also
possible that you may never fully recover, depending on the severity of the
damage.
The bottom line
A brain aneurysm occurs when the wall of an artery in the brain becomes
deformed, usually due to weakness or thinning. This can cause the arterial
wall to bulge out and fill with blood. If an aneurysm ruptures, it can lead to life
threatening bleeding in the brain.

It’s important to pay attention to the warning signs of a brain aneurysm,
particularly if you have any risk factors. If you’re having concerning symptoms
that are consistent with a brain aneurysm, contact your doctor immediately.
In some cases, an unruptured brain aneurysm may be managed through
monitoring and lifestyle changes. However, larger unruptured brain aneurysms
or those at a high risk of rupturing need to be addressed as soon as possible
once they’re discovered.
Leaking or ruptured brain aneurysms are a medical emergency and require
critical care management from experienced physicians in order to ensure the
best possible outcome.
Last medically reviewed on December 22, 2021
12 sources
expanded

● Ajiboye N, et al. (2015). Unruptured cerebral aneurysms: Evaluation and management.
● Barletta EA, et al. (2018). Fusiform aneurysms: A review from its pathogenesis to treatment
options.
● Becske T, et al. (2013). Pipeline for uncoilable or failed aneurysms: Results from a
multicenter clinical trial.
pubs.rsna.org/doi/10.1148/radiol.13120099
● Brain aneurysm. (2018).
nhs.uk/conditions/brain-aneurysm/
● Brain aneurysm: Overview. (2018).
Sheet
● Fiorella D, et al. (2019). How safe and effective are flow diverters for the treatment of
unruptured small/medium intracranial aneurysms of the internal carotid artery? Meta-analysis
for evidence-based performance goals.
jnis.bmj.com/content/12/9/869
● Jersey AM, et al. (2021). Cerebral aneurysm.
● Jung K-H. (2018). New pathophysiological considerations on cerebral aneurysms.
● Statistics and facts. (n.d.).
bafound.org/about-brain-aneurysms/brain-aneurysm-basics/brain-aneurysm-statistics-and-fa
cts/
● Toth G, et al. (2018). Intracranial aneurysms: Review of current science and management.
journals.sagepub.com/doi/10.1177/1358863X18754693
● Vlak MHM, et al. (2011). Trigger factors and their attributable risk for rupture of intracranial
aneurysms.
ahajournals.org/doi/10.1161/strokeaha.110.606558

FEEDBACK:
Medically reviewed by Heidi Moawad, M.D. — Written by Brindles Lee Macon
and Jill Seladi-Schulman, Ph.D. — Updated on December 22, 2021
Brain Aneurysm Repair
● Symptoms
● Risks of surgery
● Preparation
● Treatments

● Follow-up
Brain aneurysm repair
Brain aneurysm repair is a surgical procedure used to treat a bulging blood
vessel in the brain that’s at risk of rupturing or tearing open.
An aneurysm occurs when the wall of a blood vessel becomes thin and bulges
or balloons out. Many aneurysms remain undetected because someone may
not experience any symptoms until they rupture.
A brain aneurysm could lead to stroke or brain damage if it’s not treated. If
your doctor finds an aneurysm that hasn’t ruptured, they will likely recommend
repairing it as quickly as possible.

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What are the symptoms of a brain
aneurysm?
When a blood vessel becomes thin or weak and develops an aneurysm, it can
tear or rupture at any time. If a blood vessel in your brain ruptures, it can
cause bleeding in the brain or stroke. This could lead to brain damage or even
death. Even an aneurysm that hasn’t ruptured is considered a serious medical
condition.
Before an aneurysm ruptures, you could have headaches, eye pain, neck
pain, or you may have no symptoms at all. Because an aneurysm can happen
and show no symptoms, they’re often found by chance when your doctor is
looking for something else. An aneurysm may appear on an imaging test like
an MRI or CT scan.

Symptoms most often arise after an aneurysm ruptures. These symptoms
may include:
● a severe headache
● seizures
● impaired speech
● double vision
● numbness in the body
● muscle weakness
● decreased level of alertness
● coma
Not all brain aneurysms need to be repaired immediately. The likelihood of a
brain aneurysm rupturing depends on your age, medical history, the size of
the aneurysm, and its location. Generally, smaller aneurysms and aneurysms
found in the arteries toward the front side of the brain are less likely to rupture.
Those smaller than 7 millimeters are considered less likely to rupture. Your
doctor will still likely recommend close follow-up to make sure the aneurysm is
not getting larger.
Risks of brain aneurysm repair

Any medical procedure carries certain risks. Since aneurysm repair is brain
surgery, it does involve significant risk.
Potential risks of brain aneurysm repair include:
● behavior changes due to neurological injury
● blood clots
● brain swelling
● confusion
● infection
● seizures
● speech and vision problems
● stroke
● weakness
Some neurological problems, such as those affecting memory, coordination,
or other functions may be present after surgery. They can vary in severity and
they’re not always permanent.

The surgery requires that you undergo general anesthesia. This means you’ll
be put into a deep sleep. If you’ve ever had a reaction to anesthesia, like
breathing problems, make sure to tell your doctor.
In almost all cases, the risk of not having brain aneurysm repair greatly
outweighs the risks associated with the surgery.
How to prepare for brain
aneurysm repair
Brain aneurysm repair is done on an emergency basis so there’s often little
time to prepare for it. If your doctor catches your aneurysm before it becomes
an emergency, there are some important steps to take:
● Tell your doctor about any medications you’re taking, including
over-the-counter drugs and nutritional supplements.
● Quit smoking if you smoke.
● Don’t eat or drink anything eight hours before the procedure.
● Take any medications your doctor gives you.
● Stop taking any medications your doctor instructs you not to take.

● Follow all other instructions from your doctor.
How a brain aneurysm repair is
performed
There are several ways surgeons can correct a brain aneurysm. The method
the surgeon uses depends on the size, shape, and location of the aneurysm,
among other factors.
Clipping
During this procedure, your surgeon will make an incision into your scalp and
create a small hole in your skull. The surgeon will then place a small metal clip
at the base of the aneurysm to prevent it from rupturing. They will then close
your skull and stitch your scalp.
Endovascular repair

During an endovascular repair, your surgeon will insert a small wire into an
artery in your groin. Your surgeon will guide a small wire through that incision
and through the artery that leads to the aneurysm in your brain. A catheter,
which is a thin tube, follows the wire. Through this tube, your surgeon will
install thin metal wires into the aneurysm. The wire will coil into a ball and
initiate a blood clot. This clot will prevent the aneurysm from rupturing.
After brain aneurysm repair
Your hospital stay may only be a few days if there was no bleeding in your
brain before surgery. Your stay could be one to two weeks if there were
complications.
Brain aneurysm repair typically doesn’t involve any other surgeries, but your
doctor may want to repeat CT scans or MRI of your brain in following
appointments to ensure there aren’t any other concerns.
Your treatment following surgery will focus on the underlying cause of the
aneurysm, such as hardening of the arteries or high blood pressure.

Last medically reviewed on May 1, 2017
5 sources
expanded
● Aneurysm in the brain. (2016, May 30). Retrieved May 31, 2012, from
nlm.nih.gov/medlineplus/ency/article/001414.htm
● Brain aneurysm repair. (2016, May 9). Retrieved May 31, 2012, from
nlm.nih.gov/medlineplus/ency/article/007372.htm
● Frequently asked questions of aneurysm patients. (n.d.)
bafound.org/treatment-options-8
● Mayo Clinic Staff. (2015, September 1). Brain aneurysm
mayoclinic.org/diseases-conditions/brain-aneurysm/basics/definition/con-20028457
● Rukovets, O. (2011, June 16). FDA approves new system for brain aneurysm repair.
Neurology Today, 11(12), 24-25
journals.lww.com/neurotodayonline/Fulltext/2011/06160/FDA_Approves_New_System_for_B
rain_Aneurysm_Repair.8.aspx
FEEDBACK:

Medically reviewed by Seunggu Han, M.D. — Written by Brian Krans — Updated
on July 8, 2017
Berry Aneurysms: Know
the Signs
● Symptoms
● Causes and risk factors
● Diagnosis
● Treatment

● Prevention
● Outlook
What is a berry aneurysm
An aneurysm is an enlarging of an artery caused by weakness in the artery’s
wall. A berry aneurysm, which looks like a berry on a narrow stem, is the most
common type of brain aneurysm. They make up 90 percent of all brain
aneurysms, according to Stanford Health Care. Berry aneurysms tend to
appear at the base of the brain where the major blood vessels meet, also
known as the Circle of Willis.
Over time, pressure from the aneurysm on the already weak artery wall can
cause the aneurysm to rupture. When a berry aneurysm ruptures, blood from
the artery moves into the brain. A ruptured aneurysm is a serious condition
that needs immediate medical treatment.

Keep in mind that, according to the American Stroke Association, only 1.5 to 5
percent of people will develop a brain aneurysm. Among people who have a
brain aneurysm, only 0.5 to 3 percent will experience a rupture.

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Do I have a berry aneurysm?
Berry aneurysms are typically small and symptom free, but larger ones
sometimes put pressure on the brain or its nerves. This can cause
neurological symptoms, including:
● a headache in a particular area
● large pupils

● blurred or double vision
● pain above or behind the eye
● weakness and numbness
● trouble speaking
Contact your doctor if you experience any of these symptoms.
Ruptured aneurysms usually cause blood from the affected artery to move into
the brain. This is called a subarachnoid hemorrhage. Symptoms of a
subarachnoid hemorrhage include those listed above as well as:
● a very bad headache that comes on quickly
● unconsciousness
● nausea and vomiting
● stiff neck
● sudden change in mental state
● sensitivity to light, also called photophobia
● seizures

What causes berry aneurysms?
There are certain factors that make some people more likely to get a berry
aneurysm. Some are congenital, meaning people are born with them. Others
are medical conditions and lifestyle habits. In general, berry aneurysms are
most common in adults over 40 and women.
Congenital risk factors
● connective tissue disorders (e.g., Ehlers-Danlos syndrome, Marfan
syndrome, and fibromuscular dysplasia)
● polycystic kidney disease
● an abnormal artery wall
● cerebral arteriovenous malformation
● family history of berry aneurysms
● blood infections
● tumors
● traumatic head injury
● high blood pressure
● hardened arteries, also called atherosclerosis
● lower levels of estrogen
● smoking

● drug use, especially cocaine
● heavy alcohol use
Medical risk factors
Lifestyle risk factors
How do I know if I have a berry
aneurysm?
Your doctor can diagnose a berry aneurysm by performing several tests.
These include computerized tomography (CT) and magnetic resonance
imaging (MRI) scans. While doing either of these scans, your doctor may also
inject you with dye to better see the blood flow in your brain.
If those methods don’t show anything, but your doctor thinks you still may
have a berry aneurysm, there are other diagnostic tests they can perform.

One such option is a cerebral angiogram. This is performed by inserting a thin
tube containing dye into a large artery, usually the groin, and pushing it up to
the arteries in your brain. This allows your arteries to easily show up in an
X-ray. However, this imaging technique is rarely used today given its invasive
nature.
How are berry aneurysms
treated?
There are three surgical treatment options for both unruptured and ruptured
berry aneurisms. Each option comes with its own set of risks of possible
complications. Your doctor will consider the size and location of the aneurysm
as well as your age, other medical conditions, and family history to choose the
safest option for you.
Surgical clipping
One of the most common berry aneurysm treatments is surgical clipping. A
neurosurgeon removes a small piece of the skull to get access to the

aneurysm. They place a metal clip on the aneurysm to stop blood from flowing
into it.
Surgical clipping is an invasive surgery that usually requires a few nights in
the hospital. After that, you can expect four to six weeks of recovery. During
that time, you should be able to care for yourself. Just make sure to limit your
physical activity to allow your body time to recover. You can slowly start
adding in gentle physical activity, such as walking and household tasks. After
four to six weeks, you should be able to return to your pre-surgery levels of
activity.
Endovascular coiling
The second treatment option is endovascular coiling, which is less invasive
than surgical clipping. A small tube is inserted into a large artery and pushed
up into the aneurysm. This process is similar to that of the cerebral angiogram
your doctor may use to get a diagnosis. A soft platinum wire goes through the
tube and into the aneurysm. Once it’s in the aneurysm, the wire coils and
causes the blood to clot, which seals the aneurysm.

The procedure usually only requires a one-night hospital stay, and you can
return to your usual level of activity within days. While this option is less
invasive, it does come with the risk of future bleeding, which may require
additional surgery.
Flow diverters
Flow diverters are a relatively new treatment option for berry aneurysms. They
involve a small tube, called a stent, which is placed on the aneurysm’s parent
blood vessel. It redirects blood away from the aneurysm. This immediately
reduces blood flow to the aneurysm, which should close completely in six
weeks to six months. In patients who aren’t surgical candidates, a flow
diverter can be a safer treatment option, since it doesn’t require entering the
aneurysm, which increases the risk of the aneurysm rupturing.
Symptom management
If the aneurysm hasn’t ruptured, your doctor may decide it’s safest to just
monitor the aneurysm with regular scans and manage any symptoms you
have. Options for managing symptoms include:

● pain relievers for headaches
● calcium channel blockers to keep blood vessels from narrowing
● anti-seizure medications for seizures caused by ruptured aneurysms
● angioplasty or an injection of a drug that increases blood pressure to
keep blood flowing and prevent a stroke
● draining excess cerebrospinal fluid from a ruptured aneurysm using a
catheter or shunt system
● physical, occupational, and speech therapy to address brain damage
from a ruptured berry aneurysm
How to prevent berry aneurysms
There’s no known way to prevent berry aneurysms, but there are lifestyle
changes that can lower your risk. These include:
● quitting smoking and avoiding secondhand smoke
● avoiding recreational drug use
● following a healthy diet that’s low in saturated fats, trans fats,
cholesterol, salt, and added sugar
● doing as much physical activity as you can
● working with your doctor to treat high blood pressure or high cholesterol
if you have them

● talking with your doctor about risks associated with oral contraceptives
If you already have a berry aneurysm, making these changes can still help
you to prevent the aneurysm from rupturing. In addition to these changes, you
should also avoid unnecessary straining, such as lifting heavy weights, if you
have an unruptured aneurysm.
Are berry aneurysms always
fatal?
Many people with berry aneurysms go their entire life without knowing they
have one. When a berry aneurysm becomes very large or ruptures, however,
it can have serious, lifelong effects. These lasting effects depend mostly on
your age and condition, as well as the size and location of the berry
aneurysm.
The amount of time between detection and treatment is very important. Listen
to your body and seek immediate medical attention if you think you might
have a berry aneurysm.

Last medically reviewed on September 22, 2017
8 sources
expanded
● Brain aneurysm basics. (n.d.).
bafound.org/about-brain-aneury sms/brain-aneurysm-basics/
● Brain aneurysm statistics and facts. (n.d.).
cts/
● Flow diversion for aneurysms with stents. (n.d.).
hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/aneurysm/treatment/flow-diver
sion.html
● Mayo Clinic Staff. (2015). Brain aneurysm.
mayoclinic.org/diseases-conditions/brain-aneurysm/basics/definition/con-20028457
● Novitzke J. (2008). The basics of brain aneurysms: A guide for patients.
● Post-treatment and outcome. (n.d.).
bafound.org/about-brain-aneurysms/treatment/post-treatment-and-outcome/
● Warning signs/symptoms. (n.d.).
bafound.org/about-brain-aneurysms/brain-aneurysm-basics/warning-signs-symptoms/
● What is a brain aneurysm? (n.d.).
stanfordhealthcare.org/medical-conditions/brain-and-nerves/brain-aneurysm.html

FEEDBACK:
Medically reviewed by Andrew Gonzalez, M.D., J.D., MPH — Written by Ian
Franks — Updated on September 29, 2018
Is It a Stroke or an
Aneurysm?
● Causes
● Symptoms
● Risk factors

● Diagnosis
● Treatment
● Outlook
● Reduce risk
The terms “stroke” and “aneurysm” are sometimes used interchangeably, but
these two serious conditions have some important differences.
A stroke occurs when there’s a ruptured blood vessel in the brain or blood
supply to the brain has been blocked. An aneurysm is the result of a
weakened artery wall.
Aneurysms cause bulges in your body, which may also rupture and
subsequently bleed. They can affect any part of the body, including the brain
and heart.

Keep reading to learn more about identifying and treating strokes and
aneurysms.

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What causes strokes and
aneurysms?
There are two main types of stroke: ischemic stroke and hemorrhagic stroke.
They each have a distinct cause.
An aneurysm in the brain, or cerebral aneurysm, usually stems from damage
to the artery. It can be caused by trauma, an ongoing health condition such as

high blood pressure or drug abuse, or a vascular problem that you’ve had
since birth.
Ischemic stroke
An ischemic stroke is the most common type of stroke, accounting for about
87 percent
Trusted Source
of all strokes. It occurs when an artery in the brain or an artery carrying blood
to the brain becomes blocked. The blockage may be a blood clot or a
narrowing of the artery due to plaque buildup.
Plaque in an artery is made up of fats, cells, and low-density lipoprotein (LDL).
LDL is also known as “bad” cholesterol.

When arteries anywhere in the body become narrowed by plaque or become
rigid because of high blood pressure or other health problems, the condition is
called atherosclerosis. You may have heard it described as “hardening of the
arteries.”
When this happens, blood flow either stops completely or is reduced to the
point where the organs and tissue relying on that blood supply become
starved and injured.
Hemorrhagic stroke
A hemorrhagic stroke isn’t related to blockage in an artery. It’s a bleeding
event in which an artery ruptures. Blood either stops flowing altogether
through that artery, or blood flow is reduced as blood leaks out through the
new opening in the artery wall.
A hemorrhagic stroke may occur due to an irregular formation of blood
vessels. This is called an arteriovenous malformation (AVM). These irregular
blood vessels can rupture and spill blood into the brain.

The most common cause of a hemorrhagic stroke is the bursting of a small
artery due to high blood pressure. It can also be caused by a cerebral
aneurysm. A blood vessel wall becomes weak because it’s bulging outward.
Eventually, an aneurysm can burst.
The hole in the artery wall means blood flow is reduced farther downstream.
That causes blood to spill into the tissue surrounding the artery.
Any time blood flow to a part of the brain is disrupted, the event is called a
stroke.
Cerebral aneurysm
In addition to an AVM, other genetic health conditions, such as connective
tissue disorders, can lead to an aneurysm in the brain. An aneurysm can also
develop when the arterial wall is damaged.

High blood pressure and smoking both strain blood vessels. Atherosclerosis,
infections, and trauma to the head, such as concussion, can also lead to an
aneurysm.
What are the symptoms of a
stroke and an aneurysm?
Both a stroke and an aneurysm that bursts can come on suddenly without any
warning. The symptoms will vary. The kind of emergency treatment you
should receive will also depend on whether it’s a stroke or an aneurysm.
Regardless of the cause, a fast response to symptoms is essential.
Stroke symptoms Aneurysm symptoms

sudden, intense headache headache (worst headache of
life)
numbness or tingling on one side of the face or
body
numbness in one or both
limbs
weakness in arms or legs or face, especially on
one side
weakness in one or both
limbs
trouble with balance or coordination memory issues

vision problems vision problems or hearing
problems
confusion nausea
dizziness vomiting
language issues and slurring of words N/A
Not all of the stroke symptoms will be present. If one or a few signs develop
quickly, you should assume you are having a stroke. Call 911 immediately if
you suspect you’re having a stroke.

You won’t usually have symptoms if you have an aneurysm unless the
aneurysm bursts. If an aneurysm bursts, you’ll get a sudden and terrible
headache. You may also get sick to your stomach and vomit. The event may
also make you very tired or can even cause you to go into a coma.
What are the risk factors for
strokes and aneurysms?
Strokes and aneurysms share many of the same risk factors:
● When high blood pressure is uncontrolled, you’re at increased risk for a
stroke and an aneurysm.
● Smoking is also a major risk factor for strokes and aneurysms, because
of the damage it does to your blood vessels.
● A previous history of stroke or heart attack also increases your odds of
having a cerebrovascular event.
● Women have a slightly higher risk than men of developing a cerebral
aneurysm or a stroke.
● Advancing age increases your risks for both events.
● A family history of aneurysms or strokes may also put you at a higher
risk for these events.

If you’ve had one aneurysm, your odds of having another are also higher.
How are strokes and aneurysms
diagnosed?
Sharing your symptoms and personal medical history with your doctor will
help them form a diagnosis and treatment plan.
CT and MRI scans can help your doctor diagnose an aneurysm or stroke. A
CT scan shows the location of bleeding in the brain and areas of the brain
affected by poor blood flow. An MRI can create detailed images of the brain.
In some cases, your doctor may order both an MRI and a CT scan, as well as
other imaging tests.
How are strokes and aneurysms
treated?

Your doctor will determine the best treatment based on the severity of your
stroke or aneurysm and your medical history.
Ischemic stroke
If you had an ischemic stroke and made it to the hospital within a few hours of
symptoms starting, you may receive a medication called tissue plasminogen
activator (TPA). This drug helps break up a clot. Your doctor can also remove
a clot from a blood vessel.
Hemorrhagic stroke
For a hemorrhagic stroke, you may need surgery to repair the damaged blood
vessel. Your surgeon may use a special clip to secure the part of a blood
vessel that ruptured. They can do this during open surgery, which involves
cutting into your skull and working on the artery from the outside.
Cerebral aneurysm

If you have a small aneurysm that hasn’t ruptured, your doctor may treat it
with medications and a watch-and-wait approach. This means they take
images of the aneurysm periodically to make sure it hasn’t grown. If it has,
then you may need a procedure.
What is the outlook for strokes
and aneurysms?
A ruptured aneurysm is a life-threatening condition, with high mortality rates,
particularly in the first days of the event. Many people who survive a ruptured
aneurysm have effects that linger for the rest of their lives. Brain damage due
to bleeding is irreversible.
Aneurysms that have not ruptured may still need treatment — based on their
size, location, and shape — as these factors determine the likelihood of
rupturing in the future.
The outlook for people who have a stroke is much more varied. An ischemic
stroke can be either be devastating or relatively mild. Some ischemic stroke
survivors have few if any long-term symptoms. A hemorrhagic stroke, on the

other hand, is more likely to be deadly or leave a person with cognitive or
physical disabilities.
The location of the stroke and time that goes by before blood flow is restored
makes a difference in your recovery. Rapid treatment may make the difference
between being able to walk and talk normally or requiring a walker and years
of speech therapy.
How can you reduce your risk for
strokes and aneurysms?
A foolproof way to prevent an aneurysm or stroke doesn’t exist. You can,
however, make sure your blood pressure is under control. Here are some
ways to help control your blood pressure:
● Maintain a healthy weight.
● Add regular exercise to your daily routine.
● Follow a healthy diet.
● Take medications as prescribed by your doctor.

If you smoke, talk with your doctor about strategies to quit smoking.
Living a healthy lifestyle can reduce your risk for strokes or aneurysms, but if
you or a loved one has recently dealt with one of these life-altering situations,
help is available.
Check for rehab facilities in your area. Many of them offer physical therapy
and lifestyle education to help with the healing process.
Last medically reviewed on September 2, 2021
7 sources
expanded

● Brain aneurysm statistics and facts. (n.d.).
cts
Sheet
● Hemorrhagic strokes (bleeds). (n.d.).
stroke.org/en/about-stroke/types-of-stroke/hemorrhagic-strokes-bleeds
● Stroke symptoms. (n.d.).
stroke.org/en/about-stroke/stroke-symptoms
● Stroke. (n.d.).
nhlbi.nih.gov/health-topics/stroke
● Types of stroke and treatments. (n.d.).
stroke.org/en/about-stroke/types-of-stroke
● What you should know about cerebral aneurysms. (2018).
stroke.org/en/about-stroke/types-of-stroke/hemorrhagic-strokes-bleeds/what-you-should-kno
w-about-cerebral-aneurysms
FEEDBACK:
Medically reviewed by Dr. Payal Kohli, M.D., FACC — Written by James Roland
— Updated on September 10, 2021

Ascending Aortic
Aneurysm
● Symptoms
● Causes
● Diagnosis
● Treatment
● Outlook
What is an ascending aortic
aneurysm?
The aorta is the largest blood vessel in the body. It leaves the heart and forms
an arch.

The arch’s downward portion, called the descending aorta, is connected to a
network of arteries that supplies most of the body with oxygen-rich blood. The
upward part of the arch, which is the section closest to the heart, is called the
ascending aorta.
The part of the aorta in the chest is called the thoracic aorta. The portion
further down in your trunk is called the abdominal aorta.
An aneurysm is a bulge that forms in the wall of an artery. It happens when
the artery wall weakens. Aneurysms anywhere in the body are dangerous
because they can rupture and cause massive internal bleeding. An ascending
aortic aneurysm is especially serious. A rupture in this part of the body can be
life-threatening.

Some ascending aortic aneurysms never rupture or cause any noticeable
symptoms. They’re often discovered by accident, when a chest X-ray or other
screening reveals a bulge in the aorta.
If symptoms are present, they may include:
● dull pain or tenderness in the chest
● cough or hoarseness
● pain in the back, jaw, or neck
If the aorta ruptures, you’ll feel a sudden, sharp pain in your chest that
extends to your back, between your shoulder blades.
Causes and risk factors
It’s still not well understood why some people develop an aortic aneurysm
while others don’t. Different factors may increase your risk, including:

Heart disease: The most common cause of aortic aneurysms is
atherosclerosis, also known as hardening of the arteries. You’re also at higher
risk of an ascending aortic aneurysm if you have aortic valve disease. The
aortic valve releases blood from the heart into the aorta. Most people have an
aortic valve with three flaps or leaflets that open and close with each
heartbeat. If you were born with a bicuspid valve (aortic valve with two flaps),
you have a higher risk of an ascending aortic aneurysm.
Older age: An ascending aortic aneurysm usually forms in people in their 60s
and 70s.
Family history: About 20 percent of all thoracic aneurysms develop in people
with a family history of thoracic aneurysms. These cases tend to develop in
younger people.
Genetics: Certain inherited conditions are linked to a higher risk of ascending
aortic aneurysms, including:
● Marfan’s syndrome
● Loeys-Dietz syndrome
● Turner syndrome

● Ehlers-Danlos syndrome
These are called connective tissue disorders, and they can lead to many
complications in addition to aortic aneurysms.
Infection: Sometimes, certain infections can also weaken artery walls,
including those in the aortic arch. These infections include syphilis and
salmonella.
How it’s diagnosed
An ascending aortic aneurysm is often found during a routine checkup or an
examination ordered for another condition. For example, a chest X-ray can
show a bulging aorta. Other imaging tests that can detect an aortic aneurysm
include:
● An echocardiogram, which uses sound waves to create images of the
heart. It can also show a change in the aorta.

● A CT scan, which creates layered images of the heart or other internal
organ. Sometimes, doctors insert a dye into an artery to reveal possible
blood flow problems on the CT scan.
● Magnetic resonance angiography (MRA), which is a type of magnetic
resonance imaging (MRI). It uses a dye injected into your blood vessels
to make them easier to see. This test uses a magnetic field and radio
waves to create images of the body part being examined.
Once an aneurysm is discovered, the decision to treat it usually depends on
its size or rate of growth. Usually, surgical repair is necessary once an
aneurysm reaches 5 centimeters (cm) in diameter.
Treatment options
An aneurysm that is less than 5 cm may be monitored without surgery.
However, your doctor may recommend surgical repair of a small aneurysm
that’s growing more than 0.5 cm per year. Likewise, a small aneurysm that’s
causing symptoms should also be repaired.

If you have Marfan’s syndrome, your ascending aortic aneurysm should be
repaired once it reaches 4.5 cm in diameter. An aneurysm that size should
also be repaired if you’re going to have aortic valve surgery.
Methods of treatment include the following.
Watch-and-wait
If you and your doctor agree that a watch-and-wait approach is best, you may
be placed on medications to help lower your blood pressure and cholesterol.
Medications to bring down your blood pressure include beta blockers, which
also slow your heart rate, and angiotensin receptor blockers (ARBs). ARBs
are also prescribed to people with Marfan’s syndrome regardless of their
blood pressure.
Statins are medications that can help lower your LDL cholesterol.

Open surgery
In this procedure, a surgeon opens up your chest and replaces the damaged
portion of your aorta with a synthetic tube called a graft. In some cases, they
also replace the aortic valve with a synthetic valve.
Endovascular surgery
In this procedure, the weakened portion of the aorta remains in place. Your
doctor inserts a tiny, flexible catheter into an artery in your leg and guides the
tube up to your aorta. The catheter then deploys a graft that surrounds the
vulnerable part of the aorta to strengthen it.
Emergency surgery
Emergency surgery can sometimes be done to repair an aneurysm that
ruptures, though it must be done fast. The risk of a fatal bleeding event is high
if bleeding is not treated promptly. Even with surgery, there’s a high risk of
complications following a rupture.

What’s the outlook for an
ascending aortic aneurysm?
Open surgery to repair an aneurysm can require a recovery time of about a
month. Your age and overall health are also factors that affect your recovery
speed. The recovery time for a less-invasive endovascular procedure is
shorter than for an open surgery. However, regular monitoring must be done
to look for leaks through the graft.
If you have an aneurysm, be sure to follow your doctor’s advice about
medications and follow-up exams. An aneurysm can grow without you
knowing it, so don’t take any chances. Untreated, a rupture can be fatal.
And if surgical repair is advised, don’t put it off. The long-term outlook for
someone with an ascending aortic aneurysm is good if it’s repaired before it
ruptures. Elective surgery to repair an aneurysm has only a 5 percent
mortality rate.
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Last medically reviewed on August 29, 2017
5 sources
expanded
● Ascending and aortic arch aneurysms. (2017).
upmc.com/services/heart-vascular/conditions-treatments/pages/ascending-aortic-arch-aneur
ysm.aspx
● Eagleton M. (2017). Thoracic aortic aneurysm.
vascular.org/patient-resources/vascular-conditions/thoracic-aortic-aneurysm

● Mayo Clinic Staff. (2016). Thoracic aortic aneurysm: Treatment.
mayoclinic.org/diseases-conditions/thoracic-aortic-aneurysm/diagnosis-treatment/treatment/t
xc-20122075
● Prakash P, et al. (2011). Ascending aortic aneurysms: Pathology and indications for surgery.
escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-10/Ascending-aortic-aneurys
ms-pathophysiology-and-indications-for-surgery
● Thoracic aortic aneurysm: Symptoms and diagnosis. (2017).
my.clevelandclinic.org/health/articles/thoracic-aortic-aneurysm/symptoms-diagnosis
FEEDBACK:
Medically reviewed by Alana Biggers, M.D., MPH — Written by James Roland —
Updated on August 30, 2017
READ THIS NEXT

●
● Everything You Need to Know
About High Blood Pressure
(Hypertension)
●
● Medically reviewed by Jenneh Rishe, RN
● High blood pressure is often associated with few or no symptoms. Many
people have it for years without knowing it. Learn more.
● READ MORE

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● High Blood Pressure
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Begin?
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● Most people don’t experience the life-threatening complications of
atherosclerosis (hardening of the arteries) until middle age. For others…
● READ MORE

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● 17 Effective Ways to Lower
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● Abdominal Aortic Aneurysm

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