An aneurysm — a ballooning or bulging out of an artery where the wall is weak — can wreak havoc if it bursts. When aneurysms rupture in the brain, the resulting hemorrhage can cause stroke, coma, death, brain damage and other problems. 

Forty percent of ruptured brain aneurysms are fatal, and 66 percent of survivors suffer permanent brain damage. 

 A better understanding of brain aneurysms, how they are treated, and whether or not you are at risk can help you safeguard your health. Start by testing your knowledge with this quiz, created with the help of Peter Rasmussen, MD, Professor of Neurological Surgery, Cleveland Clinic. 

 Guess which statements are true and which are false:

1. Brain aneurysms produce symptoms similar to stroke 

True and false. Most aneurysms are silent. However, aneurysms that become very large may press on brain structures, causing stroke-like symptoms: loss of balance, speech problems and double vision. When an aneurysm ruptures, the hallmark is a sudden, debilitating headache — often described as the worst of one’s life — along with nausea, vomiting, a stiff neck, loss of consciousness or double vision. This is a medical emergency and requires an urgent call to 9-1-1.

2. All brain aneurysms need to be treated  

False. Every decision to treat a brain aneurysm involves weighing the risks versus benefits for each patient. The location, size and shape of the aneurysm matter. So do the patient’s personal and family health history. Some small brain aneurysms can simply be monitored.

3. Treatment for brain aneurysms means major surgery 

False. Depending on the patient’s health and other factors, minimally invasive techniques may prevent rupture. Specially trained neurovascular surgeons can guide a catheter containing coils or stents into the intracranial (brain) artery. Coils can be placed within the aneurysm to stimulate scarring that prevents blood from entering. Stents (expandable scaffolds) can also be placed at the base of the aneurysm. As they scar over, they seal off the aneurysm from the circulation.  Most brain aneurysms can be treated this way.

4. If brain aneurysms recur, you just have to live with them  

False. Even the most challenging aneurysms can be treated using new technology. Giant aneurysms and aneurysms with a broad base often recur after initial treatment with coils and stents. Flow diversion is a technology showing promise for these aneurysms. An extra-long, flexible, stent-like device is guided through a catheter and placed along the base of the aneurysm and on either side. As healing occurs, the device scars over and forms a new channel through which blood can flow, bypassing the aneurysm.

5. Men and women are equally at risk for brain aneurysms 

False. The risk of developing an aneurysm is slightly greater in women than in men, and roughly 60 to 65 percent of ruptured aneurysms occur in women. Ruptured aneurysms usually occur between the ages of 30 and 60. Brain aneurysms are rare in children but can occur.

6. Aneurysms are too rare to strike more than once in a family 

False. Some aneurysms are related to genetics. Up to 20 percent of those experiencing ruptured aneurysms have a strong family history — in other words, two or more blood relatives who also suffered ruptured aneurysms. If you have a strong family history, it’s important to consult a stroke or brain aneurysm specialist to see if you are at increased risk of aneurysm development and rupture.

Tips for preventing aneurysms 

You can lower your risk of aneurysm formation and rupture and stroke with these lifestyle changes: 

• Stop smoking. Smoking is the greatest risk factor of all in aneurysm rupture and is a key risk factor for stroke. 
• Control high blood pressure. Persistently high blood pressure (hypertension) stresses the artery walls. 
• Avoid drug abuse. Cocaine is the worst offender, narrowing blood vessels and increasing blood pressure and heart rate. 
• Avoid alcohol abuse. Moderate to high alcohol consumption — binge drinking in particular — is associated with brain hemorrhage. 

About Cleveland Clinic

Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. Among Cleveland Clinic’s 72,500 employees worldwide are more than 5,050 salaried physicians and researchers, and 17,800 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,500-bed health system that includes a 173-acre main campus near downtown Cleveland, 21 hospitals, more than 220 outpatient facilities, including locations in northeast Ohio; southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2021, there were 10.2 million total outpatient visits, 304,000 hospital admissions and observations, and 259,000 surgical cases throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 185 countries. Visit us at clevelandclinic.org. Follow us at twitter.com/ClevelandClinic. News and resources available at newsroom.clevelandclinic.org.