Explainer | Headaches, stiff neck? Maybe you have a brain aneurysm. A neurologist explains what to look out for

American Shailja Ambrose woke up on a gloomy November morning in 2017 anticipating a mundane day of work, meetings and parental responsibilities for her two children. Little did she know she would collapse in the bathroom at work because of a ruptured brain aneurysm. As she was slowly losing consciousness, Ambrose asked Siri to contact a colleague for help. Ambrose, then 40, had no symptoms that indicated she had any neurological issues. However, after six years caring for her husband, who died of brain cancer, she gained much knowledge of brain-related issues and signs to look out for. Also known as a cerebral aneurysm, a brain aneurysm occurs when there is a bulge in a weak area of an artery in the brain. When blood flows to the brain, the pressure pushes the weakened section outward and causes it to stretch, similar to inflating a balloon. Dr Omar Syed, a New York neurosurgeon, says the vast majority of aneurysms are asymptomatic, or do not cause symptoms, if they have not ruptured, or burst open. How anxiety and depression raise the risk of 29 physical health conditions But if a brain aneurysm ruptures, it can cause bleeding into the brain and be life-threatening if not immediately treated. A ruptured aneurysm can also cause people to experience extremely painful headaches, nausea, vomiting, stiff neck, blurry vision or a serious loss of consciousness, Syed says. Ambrose remained in hospital for two weeks and had visits from friends and family, including her younger sister, Neerja Patel. “I didn’t know anything about brain aneurysms, but from the internet, I saw that the chances of survival were slim,” Patel says. “The doctor informed me that brain aneurysms run in the family and that I should get screened. I thought to myself, ‘What are the chances I have it, too?’” After some deliberation and encouragement from her husband, Patel was screened and learned she had not one but three brain aneurysms. One aneurysm was especially large and had it been left unclipped, it would have ruptured. That April, Patel had to have a procedure called an open-brain craniotomy to deal with it. “Thankfully, the surgery went well, though I temporarily lost my ability to chew due to weakened jaw muscles and had to go on a liquid diet for six weeks,” Patel says. “I will never forget the surgeon’s words post-surgery. He said it was a close call and had that the aneurysm gone unattended or unclipped, he wasn’t sure how much time I had left.” Through physiotherapy and after a slow recovery, Patel regained her pre-surgery life. As for the other two aneurysms, she has annual MRI screenings. Her mother was also screened, which led to an aneurysm being found. In her case, doctors advised that the risks of clipping it – bleeding, infection and stroke-like complications – did not outweigh the benefits. Research by the US-based Stanford South Asian Translational Heart Initiative found that people of South Asian ancestry have a higher risk of heart disease compared with other ethnic groups, primarily attributed to the lifestyle and diet prevalent within the population. It’s important to know that these are modifiable risk factors and positive changes in diet and lifestyle behaviours can reduce your risk for aneurysm rupture Dr Omar Syed, neurosurgeon Since brain aneurysms are caused by a weakness in the walls of blood vessels in the brain, heart disease is a common contributing risk factor, as is smoking, high blood pressure and family history, studies have found. More than half of unruptured aneurysms are purely incidental findings, though anyone experiencing symptoms such as unprecedented severe headaches, weakness or numbness, confusion, seizures, blurred or double vision, or a stiff neck should seek medical attention immediately. Syed also recommends an annual MRI screening if two or more first-degree relatives – a parent, child or sibling – have had aneurysms. If no aneurysm is detected, then follow-up imaging is recommended every five years. Can lack of sleep raise dementia risk? Yes, studies say, with one exception Anyone with a family history of aneurysms should also pay attention to risk factors such as smoking, high blood pressure, high cholesterol and excessive alcohol intake. “It’s important to know that these are modifiable risk factors and positive changes in diet and lifestyle behaviours can reduce your risk for aneurysm rupture,” Syed says. Like what you read? Follow SCMP Lifestyle on Facebook, Twitter and Instagram. You can also sign up for our eNewsletter here.

Explainer | Headaches, stiff neck? Maybe you have a brain aneurysm. A neurologist explains what to look out for

While most brain aneurysms are asymptomatic if they have not ruptured, people with symptoms like severe headaches should seek medical attention immediately After suffering a shock ruptured brain aneurysm, one woman encouraged her family to get screened. Her mother and sister also had them

While most brain aneurysms are asymptomatic if they have not ruptured, people with symptoms like severe headaches should seek medical attention immediately

After suffering a shock ruptured brain aneurysm, one woman encouraged her family to get screened. Her mother and sister also had them