Sponsored by Nuvance Health
NORWALK – In the wake of news that Kim Kardashian discovered she had a brain aneurysm, Google searches for the word “aneurysm” has skyrocketed.
But a local expert in neurosurgery, Norwalk Hospital’s Dr. Joshua Marcus, told Westport Journal that most people shouldn’t worry about brain aneurysms. He also shared how stress doesn’t directly cause a brain aneurysm.
“Non-problematic brain aneurysms are relatively common. As many as 2% to 3% of the population has them,” Marcus said.
But brain aneurysms can be dangerous if you have uncontrolled high blood pressure or a strong family history.
“If you have high blood pressure, that pressure inside your arteries can make a benign situation dangerous,” Marcus explained.
“If you have a strong family history of ruptured brain aneurysms, meaning a first- or second-degree relative, or if your blood pressure is poorly controlled,” you should talk to your primary care provider about your risk.
Marcus is the Chief of Neurosurgery at Norwalk Hospital, part of Northwell Health. He told Westport Journal that:
“As a neurosurgeon, I’ve seen how frightening and life-altering a brain aneurysm can be. Knowledge, early action and expert care can make all the difference.”
A brain aneurysm is a bulge in an artery caused by weakness in the artery’s wall. Over time, blood can put pressure on the artery, causing the bulge to grow. If it ruptures, it can lead to a brain bleed, also called a hemorrhagic stroke.
Brain aneurysms are often found during imaging tests done for other reasons, like a head CT scan for a headache or migraine, or after someone experiences the symptoms of a rupture.
While there isn’t a single cause for brain aneurysms, several factors can raise your risk:
- High blood pressure (hypertension): Persistent high pressure inside arteries can weaken their walls over time.
- Smoking: Tobacco use harms blood vessels and makes aneurysm rupture more likely.
- Family history: The risk is higher if close relatives have had large or ruptured brain aneurysms.
- Age and sex: People over 40 and women are more frequently affected.
- Certain medical conditions: Disorders like polycystic kidney disease, connective tissue diseases (such as Ehlers-Danlos syndrome) and arteriovenous malformations (AVMs) can increase risk.
- Head trauma: Although rare, injuries to the head may play a role.
- Drug use: Stimulants like cocaine can sharply raise blood pressure, putting extra stress on vessel walls.
Knowing your personal risk factors can help you and your doctor decide if preventive care or brain imaging is appropriate.
Kim Kardashian said that stress may have played a role in developing a brain aneurysm. Stress alone doesn’t directly cause brain aneurysms. However, ongoing stress can lead to high blood pressure, which is a known risk factor.
So, if you’re dealing with chronic stress, talk to your healthcare provider about ways to manage it. Cognitive behavioral therapy (CBT), counseling, medication, healthy eating, regular exercise, good sleep and meditation can all help lower stress levels.
Most brain aneurysms remain symptom-free until they rupture. In some cases, especially if the aneurysm is large or pressing on nerves or brain tissue, you might notice:
- Persistent, localized headaches
- Vision changes, such as double vision or vision loss
- Pain above or behind one eye
- Enlarged pupils or drooping eyelids
- Weakness or numbness on one side of the face
A ruptured aneurysm is a life-threatening medical emergency and can cause:
- A sudden, severe headache (often described as the worst headache ever)
- Nausea and vomiting
- Stiff neck
- Loss of consciousness or confusion
- Seizures
- Sensitivity to light
If these symptoms appear, call 911 immediately.
Many small, unruptured aneurysms don’t need treatment and are simply monitored. Others can be treated with surgery or minimally invasive procedures to prevent rupture. The main goal is to reduce the risk of bleeding while protecting healthy brain tissue. With the right care, many people live full, healthy lives after treatment.
Treatment depends on the brain aneurysm’s size, shape, location and the individual’s overall health. Options include:
- Observation: Small, low-risk brain aneurysms may just need regular monitoring.
- Endovascular coiling: A minimally invasive procedure where coils are placed inside the aneurysm to block blood flow.
- Surgical clipping: A metal clip is placed at the base of the aneurysm to stop blood flow.
- Flow diverters or stents: These devices redirect blood away from the aneurysm, helping it to heal.
Westporters can feel reassured that specialized endovascular neurosurgeons are available around the clock to treat both ruptured and unruptured aneurysms at Norwalk Hospital, using advanced imaging and minimally invasive techniques for the best outcomes.
While a brain aneurysm can sound scary, understanding the risks and symptoms can help you take control. Many brain aneurysms never rupture and can be managed safely. If you or someone you know experiences symptoms — especially those of a rupture — don’t wait. Get emergency help right away. Nuvance Health offers expert, compassionate care to help you move forward with confidence.
Sources:
- American Association of Neurological Surgeons – Cerebral Aneurysm
- Brain Aneurysm Foundation – Warning Signs and Symptoms
- National Institute of Neurological Disorders and Stroke – Cerebral Aneurysms
- WebMD – Brain Aneurysm
Nuvance Health, now part of Northwell Health, has sponsored this content for Westport Journal. Nuvance Health is a system of nonprofit hospitals, medical practices and outpatient healthcare services throughout the Hudson Valley and western Connecticut, including nearby Norwalk Hospital. Visit nuvancehealth.org for more information.
Dr. Marcus presents an excellent review of brain aneurysms; something everyone should be aware of due its devastating potential.
If I may, there is only one additional important thing that I would add:
The article correctly describes the variety of consequences when an aneurysm “Ruptures”. For good reason, most people usually think of a rupture as being a “sudden burst” – and they would be right. That sudden rupture (i.e. burst) can be catastrophic/life threatening as Dr. Marcus describes and requires immediate attention.
However, many such aneurysms might just “leak” prior to “rupturing” causing “warning symptoms”. This is known as a “Sentinel Leak” – and it’s a medical emergency because it’s important to recognize before it subsequently ruptures. A sentinel leak can occur days to weeks prior to the subsequent catastrophic rupture, and obviously it is far better to recognize and repair these leaks more “urgently” rather than as a “critical emergency” once it has ruptured.
So how does one recognize a “Sentinel Leak”? That’s when it might become difficult, and it’s important to not ignore symptoms or self-medicate with analgesics hoping it will go away.
As Dr. Marcus states, the rupture is often described as being “The worst headache of my life”. It’s often described as being “severe and sudden onset”. Even if the patient does not have a history of hypertension, acts that abruptly raise blood pressure (such as heavy lifting, strenuous exertion, sexual intercourse) are often activities that often precipitate the headache.
Patients WITHOUT any past history of headache should be very cautious when a headache(s) suddenly occurs – particularly when they are severe and persistent. From time to time anyone might get a “tension” headache, so this can be difficult to discern. However tension headaches are generally over the forehead area, and sentinel leaks are generally much more generalized, severe, and lasting. When in doubt, seek an evaluation.
In addition: People with a history of chronic “migraine” headaches must be particularly vigilant if their headache is different than the headaches they usually have – different in severity, in longevity, in symptoms, and in resistance to their usually medications. Sentinel leaks can have similar symptom characteristics as a migraine (nausea, vomiting, visual changes, light sensitivity, etc.) so having a history of migraine can confuse the issue, making it very important to pay attention when those symptoms become “different than usual”. Because it can be confusing, too often patients who suffer from chronic migraines just assume it’s the same, even though it is not, and may delay seeking evaluation.
Of course, having any of the severe symptoms that Dr. Marcus describes (stiff neck, seizures, loss of consciousness, etc.) makes it easier to know to seek immediate medical attention.
Emergency physicians and departments are well trained and equipped to differentiate tension headaches, migraine headaches, etc. from aneurysmal headaches – including those caused by warning sentinel leaks.
Jay M. Walshon MD FACEP
Retired Emergency Department Chairman & Director