Living With a Brain Aneurysm

Brain aneurysms are treated differently depending on whether they have ruptured. A ruptured brain aneurysm is potentially life-threatening and can result in a poor prognosis.

If you are living with an unruptured brain aneurysm, on the other hand, the aneurysm’s presence may be undetectable and cause no symptoms. However, living with an unruptured brain aneurysm has its own challenges and requires careful medical observation once discovered. If you or a loved one has been diagnosed and treated for a brain aneurysm, this is a must-read article. 

A brain aneurysm forms when the wall of one of the brain’s blood vessels has a weakness. This part of the vessel wall will stretch out like a balloon and fill with blood. People can live out their lives normally for years without knowing they have an unruptured brain aneurysm.

When the aneurysm does rupture, it can cause severe symptoms and a hemorrhagic stroke. Because an unruptured brain aneurysm may show no symptoms, it is frequently discovered only when your physician is trying to diagnose another condition. 

An unruptured brain aneurysm may go undetected for some time. You may experience very mild symptoms at first, or no symptoms at all. When an unruptured brain aneurysm causes symptoms, it is usually because the aneurysm has grown very large or is pressing against the brain or other nerves. You may experience any or all of the following symptoms:

• Change in vision or double vision
• Pain around or above the eye
• Dilated pupils
• Squinting

Personality or behavior is not typically affected by an unruptured brain aneurysm. However, knowing that you have an aneurysm in the brain that can potentially rupture can certainly be a cause for anxiety and stress, which may have downstream effects on how you go about your daily life.

Survival and life expectancy are not typically affected by an unruptured aneurysm, however, if the aneurysm ruptures, this can be a different story. While most patients (70%) survive the initial rupture event, only half may go on to survive in the next 24 hours.

This survival continues to drop in the first month, with several individuals experiencing significant neurological deficits or complications that can alter the way that they behave and prevent them from returning to their normal routines.

Thus, the risk of observation versus treatment will have to be discussed thoroughly in the context of your individual risk of aneurysm rupture. Since rupture is a significant and potentially fatal event, deciding whether to treat the aneurysm will be a critical conversation with your healthcare team.

Once your doctor discovers an unruptured brain aneurysm, they will help you to decide if and how to treat it. If observation is determined to be the best approach, the aneurysm will not be treated surgically but rather closely monitored. Here are some things you may expect during the observation period:

If your unruptured brain aneurysm is very small and not causing symptoms, your doctor may recommend a nonsurgical approach. An observation plan with scheduled follow-up visits will be set up. During those visits you will have diagnostic imaging tests, such as computed tomography (CT) scans, magnetic resonance imaging (MRI), or angiograms. Your doctor will look for any changes in the size or shape of the aneurysm. If it grows significantly, your doctor will likely recommend a surgical treatment.

While monitoring an unruptured brain aneurysm, your doctor will make several lifestyle recommendations that may help keep the aneurysm from growing or a new one developing. These recommendations may include:

• Following a healthy diet
• Engaging in consistent and moderate exercise (no excessive lifting)
• Giving up cigarettes
• Avoiding alcohol and drugs, particularly stimulants like cocaine or methamphetamine
• Participating in drug and alcohol treatment programs for substance misuse disorders
• Controlling blood pressure through lifestyle changes and/or medications

During the period when your medical team observes your unruptured brain aneurysm, any growth or other changes in the aneurysm will be observed closely. However, the observation period can be mentally and emotionally taxing for the patient. Here are some challenges that you may experience while your unruptured brain aneurysm is being monitored.

Between visits, especially as the date approaches for a new imaging appointment and follow-up visit with your doctor, you may experience increased anxiety. A counselor or therapist can help you cope with the roller coaster of emotions you face between appointments.

You may also want to find a support group in your area or online with other people living with an unruptured aneurysm or facing similar medical challenges.

On the day of the follow-up appointment, it is not uncommon for patients to have even higher anxiety levels than usual. Be aware of how you are feeling, be sure to get a good night’s rest, and bring someone with you to the appointment who can provide emotional support.

Ideally, this person can keep track of information conveyed to you during the visit in case you are too stressed to remember many details. Also, if you feel extremely uncomfortable or upset on the day of your appointment, consider bringing along someone who can drive for you. 

Living with a ruptured aneurysm is a challenging and life-altering experience, both for the patient and their caretaker. It requires immense strength, resilience, and a strong support system. Let us explore the various aspects of living with a ruptured aneurysm, from the initial diagnosis to the long-term recovery, providing guidance and support for both patients and caretakers.

A ruptured aneurysm requires immediate medical attention and treatment to control the bleeding and prevent further complications. An endovascular or open surgical treatment may be performed to obliterate the aneurysm.

Patients may experience severe headaches, loss of consciousness, and other neurological symptoms. Fear, anxiety, and depression are common emotional responses for both patients and caretakers.

Hospitalization is essential for monitoring the patient's condition, managing pain, and preventing complications. Patients often require prolonged care in an intensive care unit. Patients may undergo rehabilitation programs to regain strength, coordination, and cognitive abilities.

Supportive and rehabilitative care for a patient with a ruptured aneurysm focuses on various aspects, including physical, cognitive, and emotional well-being. Here are some key components of supportive and rehabilitative care for such patients:

• Physical Therapy: A physical therapist assists in regaining strength, mobility, coordination, and balance through exercises and activities tailored to the patient's abilities.
• Occupational Therapy: Occupational therapists focus on restoring and improving daily living skills, such as self-care, work-related tasks, and leisure activities.
• Speech Therapy: If the ruptured aneurysm resulted in speech and swallowing difficulties, a speech therapist helps the patient regain or develop these skills.
• Cognitive Rehabilitation: Cognitive rehabilitation programs target memory, attention, problem-solving, and other cognitive functions affected by the aneurysm. This may include exercises, compensatory strategies, and assistive technologies.
• Counseling and Therapy: Mental health professionals, such as psychologists or psychiatrists, provide counseling and therapy to address emotional challenges, anxiety, and depression.
• Support Groups: Participating in support groups, either in-person or online, allows patients to connect with others who have experienced similar challenges, share experiences, and offer mutual support.

Patients may require medications to control blood pressure, prevent seizures, manage pain, or reduce the risk of complications such as blood clots or infections. Regular monitoring by the medical team is crucial to adjust medication dosages and ensure optimal management of the patient's condition.

Patients and their caregivers should receive education about the condition, treatment options, and potential complications. Lifestyle modifications, such as adopting a healthy diet, regular exercise, smoking cessation, stress management, and maintaining healthy blood pressure levels, are emphasized to reduce the risk of further complications.

Regular follow-up appointments with neurologists, neurosurgeons, or vascular specialists are essential to monitor the patient's progress, assess any potential complications, and adjust treatment plans as needed.

Diagnostic tests, such as imaging studies or angiograms, may be performed periodically to evaluate the condition of the blood vessels and monitor for any potential aneurysm recurrence or new aneurysm formations.

Caregivers play a vital role in providing physical, emotional, and logistical support.

It is crucial for caregivers to prioritize their own well-being to effectively care for the patient

• Engage family, friends, and healthcare professionals to create a strong support network.
• Communicate openly and honestly with the patient to understand their needs and concerns.
• Prioritize self-care through regular breaks, exercise, and seeking support from others.
• Educate yourself about the condition to better understand and address the challenges faced by the patient.
• Encourage the patient to explore activities they enjoy and find purpose in their life post-ruptured aneurysm.
• Celebrate small victories and milestones during the recovery journey.
• Foster an environment where open communication between the patient and caretaker is encouraged.
• Encourage the patient to express their emotions and concerns without judgment or criticism.
• If necessary, seek professional help for mental health support, counseling, or therapy.
• Recognize that it is normal to feel overwhelmed at times and that professional assistance can be beneficial.

Living with a ruptured aneurysm is a life-altering experience that requires resilience, support, and a strong commitment to self-care. Both patients and caregivers face numerous challenges throughout the journey, but with the right knowledge, understanding, and support, it is possible to navigate this path with hope and determination.

For patients, it is important to remember that recovery takes time and varies from person to person. Embracing a positive mindset, participating in rehabilitation programs, and adopting a healthy lifestyle can contribute to long-term healing and well-being. Seeking cognitive and emotional support, whether through therapy or support groups, can provide valuable resources and connections with others who share similar experiences.

Living with a ruptured aneurysm is undoubtedly challenging, but it is important to remember to take one day at a time. By embracing a team approach, seeking support, and actively engaging in the recovery process, both patients and caregivers can navigate this journey together and find strength and inspiration along the way.

• Living with an unruptured aneurysm may involve dealing with symptoms such as visual disturbances and headaches.
• If observation has been chosen as the course of action for an unruptured aneurysm, you will need to undergo regular health checkups and radiological investigations.
• Following treatment for a ruptured aneurysm, physical rehabilitation, occupational therapy, and cognitive therapy may be required.
• The role of the caretaker is of utmost importance in managing the lifestyle of a patient with a brain aneurysm.

• National Institute of Neurological Disorders and Stroke
• American Association of Neurological Surgeons (AANS): Cerebrovascular Disease
• Brain Aneurysm Foundation
• American Association of Neurological Surgeons (AANS): Cerebral Aneurysm
• American Brain Foundation (ABF)