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An unruptured cerebral aneurysm is a weak spot in a brain blood vessel that bulges out and fills with blood. It typically occurs on the underside of the brain and at the base of the skull.
Your doctor may ask these questions to check for this disease:
An unruptured aneurysm can be treated with medication to lower blood pressure and procedures to prevent future rupture. If it ruptures, emergency medical care is needed.
Reviewed By:
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on Jan 29, 2025
Following the Medical Content Editorial Policy
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Q.
Is It a Brain Aneurysm? The Reality and Medically Approved Next Steps
A.
Most headaches are not caused by a brain aneurysm; unruptured aneurysms are often silent, while a ruptured aneurysm typically causes a sudden, worst-ever headache with possible neck stiffness, vomiting, confusion, seizures, or loss of consciousness. There are several factors to consider, and important details below could change which next steps are right for you. Medically approved next steps: call emergency services right away for sudden explosive headache or new neurological symptoms; otherwise schedule a medical evaluation to discuss imaging when appropriate, control blood pressure, stop smoking, and review family history, with fuller guidance below.
References:
* Sawayama Y, Ohnishi Y, Ikezaki K, Yamashita T. Current Status of Diagnosis and Treatment of Intracranial Aneurysms. J Neuroendovasc Ther. 2022;16(11):755-763. doi: 10.5797/jnet.dm22-00044. Epub 2022 Sep 27. PMID: 36171542.
* Mocco J, Hanley DF, Gupta R, et al. Management of Aneurysmal Subarachnoid Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2023 Jul;54(7):e314-e349. doi: 10.1161/STR.0000000000000438. Epub 2023 Jun 13. PMID: 37311317.
* Thompson RE, Lumsden BC, Lawton MT. Current Management of Unruptured Intracranial Aneurysms. Curr Treat Options Neurol. 2019 Jun 25;21(8):37. doi: 10.1007/s11940-019-0578-8. PMID: 31236712.
* Brinjikji W, Rabinstein AA, Cloft HJ, Kallmes DF. Current Status of Endovascular Treatment of Intracranial Aneurysms. Neurosurg Clin N Am. 2019 Jul;30(3):363-376. doi: 10.1016/j.nec.2019.03.003. Epub 2019 Apr 19. PMID: 31084898.
* Hoh BL. Unruptured Intracranial Aneurysms: Natural History, Decision Analysis, and Management. Stroke. 2017 Apr;48(4):1122-1130. doi: 10.1161/STROKEAHA.116.014299. Epub 2017 Mar 21. PMID: 28325712.
Q.
Brain Aneurysm? Why Your Brain Is Warning You and Medically Approved Next Steps
A.
A brain aneurysm is a weak bulge in a brain artery that often causes no symptoms, but a sudden worst-ever headache with neck stiffness, vomiting, vision changes, seizure, confusion, or fainting can signal a dangerous rupture that needs emergency care. There are several factors to consider, from personal risks and red flags to imaging choices and whether monitoring, blood pressure control, or procedures like coiling or clipping are right for you; for medically approved next steps and many more details that could change what you do next, see below.
References:
* Gholamrezaie A, Ebrahimi P, Mirjalili E, Arefian M, Gholamrezaie M. Diagnosis and Treatment of Unruptured Intracranial Aneurysms: A Systematic Review. Cureus. 2023 Mar 19;15(3):e36353. doi: 10.7759/cureus.36353. PMID: 37077463; PMCID: PMC10111663.
* Kumar N, Shah S, Sharma D, Goyal V, Arora K, Narang P, Gadekar R, Kumari S, Saini K. Intracranial Aneurysm: Clinical Aspects, Pathophysiology, and Treatment Options. Brain Sci. 2023 Aug 18;13(8):1209. doi: 10.3390/brainsci13081209. PMID: 37622956; PMCID: PMC10452331.
* Wang J, Yan P, Cao F, Lv X. Unruptured Intracranial Aneurysm Presenting with Symptoms Other Than Cranial Nerve Palsy: A Systematic Review. World Neurosurg. 2021 Jan;145:e189-e200. doi: 10.1016/j.wneu.2020.09.115. Epub 2020 Sep 28. PMID: 32998188.
* Zhou Y, Xie C, Chen C, Liang B, Wei J, Li J. Intracranial Aneurysms: Classification, Pathophysiology, Diagnosis, Treatment and Prognosis. Cell Transplant. 2022 Jan-Dec;31:9636897221102604. doi: 10.1177/09636897221102604. PMID: 35702170; PMCID: PMC9218320.
* Abdulbaqi H, Abdulhafed M, Ahmed I, Najeeb J, Alsheikh J, Alsamir A, Alsheikh N, Albahrani I, Alsaleh A. Diagnosis, Treatment, and Management of Intracranial Aneurysms: An Overview. Cureus. 2022 Nov 22;14(11):e31766. doi: 10.7759/cureus.31766. PMID: 36569145; PMCID: PMC9768641.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Silva MA, Chen S, Starke RM. Unruptured cerebral aneurysm risk stratification: Background, current research, and future directions in aneurysm assessment. Surg Neurol Int. 2022 Apr 29;13:182. doi: 10.25259/SNI_1112_2021. PMID: 35509527; PMCID: PMC9062958.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9062958/Ajiboye N, Chalouhi N, Starke RM, Zanaty M, Bell R. Unruptured Cerebral Aneurysms: Evaluation and Management. ScientificWorldJournal. 2015;2015:954954. doi: 10.1155/2015/954954. Epub 2015 Jun 4. PMID: 26146657; PMCID: PMC4471401.
https://pmc.ncbi.nlm.nih.gov/articles/PMC4471401/Caffes, N., Wenger, N., Cannarsa, G., Oliver, J., Onwukwe, C., Gandhi, D., & Simard, J. M. (2021). Unruptured cerebral aneurysms in elderly patients: key challenges and management. Annals of Medicine, 53(1), 1839–1849.
https://www.tandfonline.com/doi/full/10.1080/07853890.2021.1990393