‘Like a thunderclap’: What to know about brain aneurysms and their symptoms
Radio host Kyle Sandilands has told listeners of the KIIS FM breakfast show, which he co-hosts with Jackie O Henderson, that he has a brain aneurysm. During the update on Monday, he shared he would be undergoing emergency surgery.
“I was told by my medical team, which sounds like I’m already very sick – to have a medical team – that I have a brain aneurysm, and it requires immediate attention, brain surgery,” he said on air.
The news inspired a wave of concern from fans, but also questions about brain aneurysms. We asked health experts to answer some of the most common ones.
Kyle Sandilands announces on the Kyle & Jackie O show that he has a brain aneurysm. Credit: KIIS FM
What is a brain aneurysm?
“A brain aneurysm is a weakness in the wall of an artery that supplies blood to your brain,” says Professor Peter Mitchell, director of the neurointervention service at Royal Melbourne Hospital.
“From that weakness, there’s initially a small outpouching – almost like a little balloon on the side of a tube – and with time and with pressure and with other risk factors, that balloon can get bigger.”
Mitchell says the main risk of an aneurysm is if it bursts and causes a bleed into the brain – a type of stroke which can cause disability or death.
Professor of Medicine at the University of Melbourne and clinical neurologist Professor Bernard Yan says when an aneurysm bursts, it is likened to a thunderclap in the brain. “Some of our patients complain that it’s almost like being hit over the head by a cricket bat. It’s that kind of intensity – a very, very severe headache,” he says.
What causes it?
There are many genetic and lifestyle factors that can cause, or worsen, brain aneurysms.
Yan says genetic diseases such as Marfan syndrome or Ehlers-Danlos syndrome are big predictors of brain aneurysms, as is family history.
Sandilands attributed his own condition to drug-taking and partying: “The facts are, a life of cocaine abuse and partying are not the way to go.”
Charity and research organisation the Brain Foundation’s Anniek Grundy stresses anyone can develop the condition, but says brain aneurysms are linked to cardiovascular health, meaning stimulants, smoking and heavy drinking don’t help.
In addition, Mitchell says high blood pressure, along with smoking, is the main factor he recommends people avoid, monitor and manage.
He says the risk of brain aneurysms increase as people get older as humans are rarely born with the condition, and women are more likely to get aneurysms and to have a brain bleed than men.
How do you know if you have one?
Though Sandilands said his diagnosis came after a period of significant headaches, most aneurysms don’t cause any symptoms. On rare occasions, headaches and dizziness are experienced, according to Grundy.
Asymptomatic aneurysms are often picked up because family members of someone with an aneurysm are advised to get checked, says Yan. They can also be identified during an MRI or CAT scan during treatment for another condition.
While symptoms for brain aneurysms are rare, they can include headaches and dizziness. Credit: iStock
How is surgery performed?
Treatment options are tailored to each individual, and some never need surgery. If surgery is required, it is usually done within 30 to 90 days, though symptomatic aneurysms were usually handled faster – within a week or two.
Mitchell says endovascular treatment is the most common, which involves putting a small needle into an artery at the leg or arm up into the brain, and packing the aneurysm bubble with small coils or walling off the opening with a stent.
About 20 per cent of the time, an aneurysm requires open surgery.
“The surgeon goes in through the skull, bends the brain out of the way, finds the aneurysm that’s ruptured, and very skilfully, puts a metal clip on,” Mitchell says.
How common are they?
About 3 to 5 per cent of the Australian population would have an aneurysm, says Mitchell.
Of those, aneurysms generally have a 1 to 2 per cent chance of rupturing in the next year, while smaller ones have a lesser chance of bursting.
What’s the prognosis for a brain aneurysm?
It depends on the severity of the aneurysm, with a rupture being the worst outcome. Around 10 per cent of people who have a burst aneurysm don’t make it to hospital and die with the bleed. Of those who get to hospital, at least 50 per cent end up with some kind of disability or death, says Mitchell.
If an aneurysm is treated with an endovascular treatment before a rupture, most people will go home the next day and be back doing their usual activities by the end of the week. However, open surgery involves longer recovery time.
Patients will also be monitored for years after treatment as it is possible for an aneurysm to redevelop or for new ones to form.
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