Most brain aneurysms don’t cause symptoms until they burst. When an aneurysm ruptures, it often causes bleeding in the brain, which is a medical emergency. Bleeding in the brain usually leads to a very severe headache. Brief loss of consciousness, nausea and vomiting, changes in vision, or neck stiffness may accompany the headache. For people with HHT, large vessel aneurysms are rare, but have been reported in the aorta, iliac, coronary, splenic, and hepatic arteries.
Aneurysms are unpredictable and may not show any symptoms until they rupture. Large or ruptured aneurysms will usually show definite symptoms and require emergency medical care. The following are symptoms and warning signs of an aneurysm or a ruptured aneurysm:
- headache or pain behind or above the eye (can be mild or severe)
- dilated pupils
- drooping eyelids
- sensitivity to light
- blurred or double vision
- weakness or numbness on one or both sides of the body
- trouble speaking or a change in awareness and mental state
- trouble walking or dizziness
- nausea or vomiting
- seizure (convulsion)
Treatments and Diagnosis
Computerized tomography (CT) and magnetic resonance imaging (MRI) scans take pictures of the brain tissues and arteries. CT scans are usually better at revealing any cranial bleeding that may already be present. A spinal tap, where a doctor draws fluid from the spine, can check for signs of bleeding in the brain. Cerebral angiograms can also check for bleeding and any abnormalities in the brain arteries.
The two surgical treatments for aneurysms are called microvascular clipping and occlusion. For both procedures, the patient is put under general anesthesia and a neurosurgeon temporarily removes part of the skull bone to get access to the aneurysm.