Brain aneurysms can be silent for years—this guide explains likely causes and risk factors, symptoms that deserve attention, and today’s treatment options.
Hearing the words “brain aneurysm” can instantly change how you think about headaches, vision changes, or that sudden wave of dizziness. Many people first learn they have an aneurysm after imaging that was ordered for something else—and the uncertainty that follows can be exhausting. The most common questions are also the most human: What causes a brain aneurysm? Would I feel it? And how do I know when it’s an emergency?
This article explains brain aneurysm causes and risk factors, the difference between symptoms of an unruptured versus ruptured aneurysm, and the treatments that may be recommended based on what your imaging shows. It is educational, not a diagnosis—if you have concerning symptoms or you have already been told you have an aneurysm, a specialist can help you understand your specific situation.
A brain aneurysm—also called a cerebral or intracranial aneurysm—forms when a weak spot in the wall of an artery bulges outward and fills with blood. Aneurysms can occur in different places, but they are often found in arteries near the base of the brain.
Not every aneurysm is immediately dangerous. Many stay small and never rupture, and some are found incidentally. The concern is that certain aneurysms can enlarge, press on nearby nerves or brain tissue, leak, or rupture. When an aneurysm ruptures, it can cause bleeding in or around the brain and may lead to stroke, brain injury, or death without urgent treatment.
If you are looking for a broader overview of diagnosis and options, our page on brain aneurysm treatment explains how aneurysms are evaluated and why recommendations can differ from person to person.
There is not one single cause of brain aneurysms. Most specialists view aneurysm formation as the result of a combination of factors: an underlying susceptibility of the vessel wall (sometimes genetic) plus stressors that act on arteries over time (often related to blood pressure, inflammation, or damage to the vessel lining).
Some people have medical conditions or inherited risk that make aneurysms more likely. The source material highlights several examples, including:
If you have a strong family history or one of these conditions, it may be reasonable to ask whether screening or follow-up imaging is appropriate.
Other risk factors are tied to changes in blood vessels over time or increased pressure on the artery wall. Factors listed in the source material include:
The source also notes that women over age 40 are at higher risk. For many patients, the most actionable takeaway is that controlling blood pressure and avoiding tobacco can lower stress on blood vessels, whether or not an aneurysm is present.
It is common to worry that one wrong workout, one stressful argument, or one cup of coffee could cause a rupture. In reality, rupture risk depends primarily on the aneurysm itself (such as its size, shape, and location) plus your overall risk factors. That said, the source material references potential triggers described in research, including intense anger, excessive exercise, coffee or soda consumption, straining during bowel movements, and sexual intercourse.
Rather than trying to eliminate normal activities, a more helpful approach is this: if you have a known aneurysm, ask your specialist what your imaging suggests about rupture risk, what level of activity is reasonable for you, and how to manage modifiable factors like blood pressure.
One of the most challenging aspects of brain aneurysms is that many have no symptoms at all until they grow, leak, or rupture. When symptoms do occur, they tend to fall into two categories: symptoms from pressure on nearby structures (often unruptured aneurysms) and symptoms from bleeding (rupture).
Unruptured aneurysms may cause symptoms if they grow large enough to irritate or compress nearby nerves or brain tissue. Symptoms listed in the source material include:
These symptoms can also come from many other conditions, including migraine or eye problems. What matters is the pattern: new symptoms, worsening symptoms, symptoms that are out of character for you, or symptoms paired with neurological changes should be evaluated.
A rupture usually causes sudden, severe symptoms and is a medical emergency. The source material lists symptoms that can be associated with rupture, including:
If you or someone near you develops a sudden, severe headache—especially with confusion, fainting, seizure, or speech changes—call 911 right away.
If imaging suggests an aneurysm, the next step is not automatically surgery. A careful review focuses on features that help estimate the chance of growth or rupture and guide treatment decisions, including the aneurysm’s:
This is also where many patients benefit from having their scans reviewed by a specialist who treats aneurysms routinely and can translate the radiology language into clear next steps.
Treatment depends on whether the aneurysm has ruptured, is leaking, is causing symptoms, or has imaging features that suggest a higher risk of bleeding. Options can range from monitoring to procedures designed to secure the aneurysm and reduce the chance of rupture.
For some unruptured aneurysms, a physician may recommend observation with periodic imaging, along with lifestyle and medical management. The source material highlights changes such as quitting smoking, eating healthfully, exercising regularly, and managing high blood pressure or high cholesterol. When symptoms like headache or eye pain are present, medications may be used for symptom relief, depending on the clinical scenario.
Microsurgical clipping is an open surgical procedure where a small metal clip is placed at the base of the aneurysm to stop blood flow into the bulge. Clipping may be recommended based on aneurysm anatomy, location, and patient-specific considerations.
Endovascular procedures treat the aneurysm from inside the blood vessel using a catheter, typically introduced through an artery and guided to the aneurysm. Common options include:
For more complex shapes or wide-neck aneurysms, additional techniques may be used, such as stent-assisted coiling or balloon-assisted coiling. A specialist can explain why one approach may be safer or more effective than another for your specific anatomy.
Call 911 for rupture-like symptoms such as a sudden severe headache, loss of consciousness, seizure, new trouble speaking, or severe neck stiffness.
Schedule a specialist evaluation if you have been told you have an aneurysm, if you have a strong family history, or if you have risk factors such as high blood pressure and a smoking history—especially if you are unsure whether monitoring or treatment makes the most sense.
If you have imaging already (MRI/MRA, CT/CTA, or angiography), bringing those images—not just the report—to your consultation can help clarify options.
Aneurysm decisions are rarely one-size-fits-all. The goal is to understand your rupture risk, what symptoms mean in context, and whether observation, microsurgery, or an endovascular procedure best fits your anatomy and health.
At Yashar Neurosurgery, Parham Yashar, MD provides patient-centered aneurysm evaluations and offers both microsurgical and endovascular treatment options when appropriate. If you are looking for a neuroendovascular surgeon in Los Angeles to review your imaging and walk you through options like coiling, flow diversion, or microsurgical clipping, call (424) 209-2669 to schedule a consultation at our office at 8436 W. 3rd Street, Suite 800, Los Angeles, CA 90048.
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