Brain Aneurysms: Types, Risks, Treatment and Rehabilitation
Generically, an aneurysm is an abnormal, balloon-like bulge in an artery. An artery is a blood vessel that carries oxygenated blood from the heart to outlying parts of the body, in this case, the brain. Although arteries have comparatively thick walls and can, therefore, withstand normal blood pressure, various types of problems can damage or injure the artery walls and make them thinner. Brain aneurysms are sometimes called “berry aneurysms” due to their small size, and they are often asymptomatic until they become large, start to leak blood or burst.
A brain aneurysm and a stroke are similar in that they each involve problems with blood vessels in and around the brain. However, there are differences between the two conditions. An aneurysm involves the weakening of a blood vessel, usually an artery. The weakening can result in a bulge in the artery or in the creation of a blood-filled sac. If the latter, the blood in the sac can clot, break free and create an obstruction elsewhere. In turn, this results in the obstruction of blood flow. Aneurysms often occur in the aorta, but can also occur in the brain. In contrast, a stroke occurs from the death of brain cells due to a lack of oxygenated blood. Stroke symptoms include, sudden weakness, paralysis or numbness in the face, arms, or legs, and trouble speaking or seeing[1].
Left undetected or untreated, some aneurysms can grow large and rupture; they can also “dissect.” A rupture (burst) can cause brain bleeding, is serious and, when it specifically involves the brain, constitutes a catastrophic brain injury. When a brain aneurysm exerts pressure on the brain or surrounding nerves, it can become symptomatic, as evidenced by one or more of the following:
- One or both eyelids droop
- Double vision or other changes in vision
- Pain above or behind the eye
- One or both pupils are dilated
- Numbness or weakness on one side of the face or body
Risk factors that can contribute to the development of brain aneurysms over time include:
- Older age
- Smoking
- Hypertension
- Arteriosclerosis
- Drug abuse, especially cocaine
- Head injury
- Heavy alcohol use
- Certain blood infections
- Lower estrogen levels after menopause[2]
Treatment depends upon the size of the aneurysm, whether or not it is infected and whether or not it has burst. If a brain aneurysm bursts, symptoms can include a sudden, severe headache, nausea and vomiting, a stiff neck, loss of consciousness and signs of a stroke[3]. This is a potentially catastrophic brain injury that requires immediate acute care. Thereafter, neurorehabilitative services and a course of clinically relevant services must be delivered to help the individual achieve the best possible and successful sustained outcome. NeuLife’s highly skilled and experienced staff of medical professionals, including neurologists, RNs and physical therapists, design, implement and monitor the client in achieving these.
If the aneurysm has not burst, there are several surgical options, including surgical clipping and endovascular coiling. These result in sealing off the unruptured aneurysm and help to prevent a future rupture. However, as in any brain surgery, there are many factors to consider, including,
- Size and location of the aneurysm
- Age and general health
- Family history of ruptured aneurysms
- Congenital conditions that increase the risk of rupture
After the individual has surgery and is stabilized, rehabilitation may begin in the acute care facility or, depending on each medical history, to a residential post-acute facility specializing in rehabilitation services and care of individuals with catastrophic injuries such as NeuLife. Following a comprehensive assessment at NeuLife, a customized Client Goal Plan is developed by the team, client and family members, and clinically relevant services are provided to ensure the best possible outcome for the client. The specialized rehabilitative services and care at this stage will include a monitored exercise program and nutritional education among other therapeutic activities and services.
NeuLife’s philosophy is that healing, wellness and personal fulfillment are best accomplished in a positive and uplifting therapeutic environment where caring staff encourage, assist and support each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to increase function and independence. NeuLife seeks to achieve, for all of its clients, maximized, sustained outcomes that exceed the expectations of all persons served.
NeuLife, in Mount Dora, Florida, is an accessible residential post-acute program providing specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries.
2725 Robie Avenue
Mount Dora, Florida 32757
[1] A. Jack Slem, MD, Baptist Health South Florida, Share Care, 2014
[2] Mayo Clinic, Diseases and Conditions, Brain Aneurysm
[3] MedlinePlus, U.S. National Library of Medicine, NW National Institutes of Health
