Neurology and Neurosurgery

April 23, 2022

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Dangers of rupture

Dangers of rupture

Illustration depicts a ruptured brain aneurysm causing vasospasm.

Although the precise etiology of brain aneurysm is unknown, the cause might include a genetic component. Mayo Clinic recommends regular MRI of individuals with a family history of aneurysm, to help prevent a ruptured aneurysm and hemorrhagic stroke.

"Screening can be a wise approach to members of families that are prone to aneurysms," says Bernard R. Bendok, M.D., chair of Neurologic Surgery at Mayo Clinic in Phoenix/Scottsdale, Arizona. "About 1% of the general population has an aneurysm. But in some families, the risk is as high as 30%. Treating an aneurysm before it ruptures is much more beneficial than treating it afterward."

Up to 50% of ruptured brain aneurysms are fatal. "Only about half of the individuals who survive make a reasonable recovery," Dr. Bendok says. "Neurosurgery isn't considered a preventive specialty. But preventing ruptured brain aneurysm is a significant issue."

Familial brain aneurysm tends to pose additional risks compared with brain aneurysm in individuals with no family history of the condition. "Familial brain aneurysms are more likely to have thinner walls than sporadic aneurysms have," Dr. Bendok says. "People with familial brain aneurysms also tend to be about a decade younger when ruptures occur."

Common risk factors for aneurysm include smoking and polycystic kidney disease. "A family history of aortic aneurysm, brain aneurysm rupture or various connective tissue diseases also can be risk factors for aneurysm," Dr. Bendok says. "Among individuals with familial brain aneurysms, smoking increases the risk of rupture by a factor of eight."

Mayo Clinic's approach to familial brain aneurysm exemplifies an enterprisewide commitment to preventative care. "Historically, neurosurgeons have dealt with individuals' issues as they became symptomatic," Dr. Bendok says. "But as a specialty, neurosurgery is becoming more focused on prevention. We prioritize counseling patients and their families and, when appropriate, treating them."

For more information

Refer a patient to Mayo Clinic.