A berry aneurysm develops in an artery carrying blood in the brain. Most people do not know they have an aneurysm until it ruptures, which can be life threatening. Lifestyle measures can help prevent the risk of developing an aneurysm.
An aneurysm is a bulging area in an artery wall that causes the artery wall to become thin and weakened. They can develop in blood vessels throughout the body.
According to the Brain Aneurysm Foundation (BAF), a berry aneurysm or saccular aneurysm is the most common type of brain aneurysm. The other type is a fusiform aneurysm.
Brain aneurysms often do not cause symptoms unless they grow very large or rupture, which causes bleeding on the brain that can be life threatening.
A berry aneurysm occurs in certain arteries carrying blood in and to the brain. It causes the artery to bulge on one side, so it resembles a berry shape. A berry aneurysm has a “neck” that connects to the main artery and a rounded “dome.”
Berry aneurysms usually occur at the junctions between two sets of arteries that supply blood to the brain—the internal carotid and vertebral arteries. They are most common in the circle of Willis, a ring-shaped network of arteries at the base of the brain. The BAF states that berry aneurysms usually measure around 1/8 of an inch (in) to 1 in.
The other type of aneurysm, a fusiform aneurysm, causes the artery to bulge on both sides and does not have a defined neck.
When the artery wall becomes too weak, it can rupture and cause blood to leak into the space between the skull and the brain. This is a subarachnoid hemorrhage, and it is fatal in 50% of people.
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They are most common between the ages of 30 and 60 years. In this age group, females and males experience them equally. After the age of 50, females are twice as likely to experience a berry aneurysm than males.
Around 20% to 30% of people with brain aneurysms have more than one.
Several risk factors can increase the chance of experiencing a berry aneurysm. Some
Modifiable risk factors
- smoking
- high blood pressure or hypertension
- drug misuse, particularly cocaine and amphetamines
- high alcohol intake
- high caffeine intake
Nonmodifiable risk factors
- a family history of brain aneurysms, or “familial” aneurysms
- having a connective tissue disorder that weakens artery walls
- having arteriovenous malformations—tangles of blood vessels that
disruptTrusted Source the blood supply - being assigned female at birth
- being 40 years or over
- polycystic kidney disease
- infection
- severe head trauma
Unruptured berry aneurysms do not usually cause symptoms. A person may find out they have one when doctors are screening for another condition. In rare instances, aneurysms grow large and press on nerves in the brain, causing symptoms such as pain around the eye, a drooping eyelid, a dilated pupil, and blurred or double vision.
What happens if a berry aneurysm ruptures?
If an aneurysm ruptures, a person may experience a sudden onset of these symptoms:
- sudden, severe headache
- nausea and vomiting
- stiff neck
- blurry or double vision
- sensitivity to light
- seizure
- drooping eyelid
- dilated pupil
- pain around the eye
- loss of consciousness
- confusion
- weakness and numbness
A ruptured aneurysm is a medical emergency, and someone nearby must call 911 immediately if a person experiences a sudden onset of these symptoms. The BAF advises against driving to the hospital in a private vehicle, as the person may require lifesaving care from first responders on the way to the hospital.
Diagnosing a ruptured aneurysm early is essential, as bleeding into the brain can cause severe damage or death.
Doctors can diagnose a ruptured or unruptured berry aneurysm using imaging scans.
If doctors suspect a ruptured aneurysm, they may recommend a computed tomography (CT) scan to detect brain bleeding. To pinpoint the source of the bleeding, they may use computerized tomography angiography (CTA), which involves injecting a dye that highlights blood vessels and makes the location of the rupture easier to find.
Another imaging technique is an angiogram, which involves inserting a catheter into the groin artery, injecting contrast dye, and capturing X-ray images.
Can a brain aneurysm be misdiagnosed?
The BAF reports that up to 1/4 of people with a brain aneurysm will be given a misdiagnosis when seeking medical attention for symptoms such as a headache. Doctors may consider their symptoms too mild and send them home without having a scan.
Some people develop aneurysms because they have inherited genes that put them at higher risk. People with multiple first-degree relatives (parents, sibling, or child) who have experienced an aneurysm may need regular brain artery imaging to check for aneurysms.
For screening, doctors use magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA), which do not expose people to X-rays.
Doctors recommend various treatments depending on the risk of an aneurysm rupturing and other factors. Treatments include:
Observation
Someone with a small, unruptured berry aneurysm that is not causing symptoms may not need treatment right away. Doctors may recommend monitoring the aneurysm with regular imaging scans.
Medication
Medications for lowering blood pressure may be necessary to reduce the risk of the aneurysm rupturing.
Endovascular treatment
Endovascular treatment is the most common way to prevent rupture. Doctors access the aneurysm by inserting a catheter into an artery in the groin or near the wrist. They can then insert devices such as coils, stents, balloons, and flow diversion devices to prevent blood from flowing into the aneurysm. This seals off the aneurysm from its main artery.
Read about nonsurgical treatments for aneurysms.
Surgery
If other treatments are unsuccessful or unfeasible, surgery under general anesthesia may be necessary. Surgeons access the aneurysm by removing a small piece of the skull bone. They place a clip on the neck of the artery to stop blood from flowing into the aneurysm before reattaching the bone and closing the incision.
Read more about brain aneurysm surgery.
Lifestyle measures can help reduce the risk of a brain aneurysm. These include:
- stopping smoking if necessary
- eating a nutritious diet and avoiding high fat, high sugar foods
- managing blood pressure
- being physically active
- maintaining a moderate weight
- limiting alcohol and caffeine
- avoiding recreational drugs
People with unruptured berry aneurysms can enjoy a good quality of life without experiencing symptoms. Healthy lifestyle choices can help prevent rupture. Doctors recommend regular monitoring of unruptured aneurysms, and if they detect concerning changes, they may recommend treatment.
When an aneurysm ruptures, the outlook is less favorable. Around
Around 50% of people with a ruptured brain aneurysm die, and around 66% of survivors have permanent brain damage.
If someone experiences a sudden, severe headache or other symptoms of a ruptured aneurysm, they need immediate medical attention.
People who experience changes in vision, pain around the eyes, and changes in the frequency or intensity of headaches should visit a doctor as soon as possible.
A berry aneurysm occurs in an artery that carries blood to the brain. It is a thinning area in an artery’s wall that bulges on one side, resembling a berry.
Berry aneurysms typically do not cause symptoms but may rupture, causing hemorrhage and becoming life threatening.
People at high risk of aneurysms may require regular monitoring with imaging scans. Treatment can involve observation, medication to reduce blood pressure, endovascular procedures, and surgery.
