[Hinews] Although often attributed to fatigue or stress, headaches can sometimes signal a hidden danger inside the brain. A brain aneurysm—a balloon-like bulge in a cerebral blood vessel—may remain undetected until it ruptures, triggering life-threatening consequences. A ruptured aneurysm results in a severe cerebral hemorrhage, with a mortality rate between 50 and 60 percent. Even those who survive often face significant long-term disabilities.

The primary challenge lies in the absence of symptoms. Most brain aneurysms remain asymptomatic unless they compress nearby cranial nerves, which can lead to neurological symptoms like ptosis (drooping eyelid) or diplopia (double vision). If these symptoms appear, immediate medical evaluation and diagnostic imaging are critical.

A brain aneurysm can grow silently but become deadly upon rupture, underscoring the need for early screening and management. (Image: ClipArtKorea)
A brain aneurysm can grow silently but become deadly upon rupture, underscoring the need for early screening and management. (Image: ClipArtKorea)


A Silent Threat Turns Sudden

When a brain aneurysm ruptures, the situation deteriorates rapidly. Bleeding into the subarachnoid space—the area surrounding the brain—causes blood to accumulate, raising intracranial pressure and triggering intense headaches. Patients often describe the pain as a "thunderclap"—sudden and explosive, like a lightning striking inside the skull. Accompanying symptoms include nausea, vertigo, and altered consciousness, all of which can jeopardize survival.
Post-rupture complications, such as cerebral vasospasm (narrowing of blood vessels) or hydrocephalus (impaired cerebrospinal fluid circulation), are common and can exacerbate neurological damage. Because brain tissue recovery is limited, early detection and timely intervention are crucial for improving outcomes.

Dr. Dong-Sung Shin, Neurosurgeon, Soonchunhyang University Bucheon Hospital
Dr. Dong-Sung Shin, Neurosurgeon, Soonchunhyang University Bucheon Hospital


Diagnosis and Treatment

Brain aneurysms can be identified through imaging techniques like magnetic resonance angiography or computed tomography angiography. Many are discovered incidentally during routine medical examinations. Aneurysms larger than 4 mm in diameter usually require treatment, which may involve surgical clipping (mechanically occluding the aneurysm neck to block blood flow) or endovascular coiling (inserting platinum coils into the aneurysm via catheter to prevent rupture).

Dr. Dong-Sung Shin, a neurosurgeon at Soonchunhyang University Bucheon Hospital, emphasizes the importance of proactive care. "If detected before rupture, an aneurysm can be managed safely," he said. "But a rupture can devastate patients and their families. Postmenopausal women and individuals with a family history are encouraged to undergo regular screenings and manage risk factors such as smoking and high blood pressure."

Prevention Through Vigilance

While the precise cause of brain aneurysms remains unclear, tobacco use and elevated blood pressure significantly increase the risk. Adopting healthy lifestyle habits and undergoing regular screenings are the most effective preventive measures. Early screening and treatment remain the most effective ways to prevent the devastating `consequences of a rupture.

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