Stroke vs. aneurysm

Education

Aneurysm or Stroke? Know These Key Differences

Baptist Health Miami Neuroscience Institute

Strokes and brain aneurysms are serious conditions which are often considered to be the same or similar. But the one thing they have in common is that they both involve blood vessels. Oscar-winning actor Jamie Foxx, 56, just revealed in a new Netflix special that he suffered "a brain bleed that led to a stroke" last year. He was hospitalized and unable to remember a 20-day period from April to May 2023.

Ischemic strokes are most common, accounting for about 87 percent of all strokes. Hemorrhagic strokes represent the remaining 13 percent of stroke cases. They occur when a weakened vessel ruptures and bleeds into the surrounding brain.  However, a severe headache of abrupt onset, sometimes described as a “thunderclap headache,” may be a sign of hemorrhagic stroke. All of these are major red flags that necessitate a call to 911.

A stroke will show telltale symptoms and requires emergency intervention. An aneurysm may not produce any symptoms, unless it bursts or ruptures, which is a life-threatening occurrence that also requires immediate intervention. 

Stroke is the No. 5 killer and a leading cause of disability in the U.S. And getting treated quickly – within a tight window of time from onset of symptoms -- with the latest advanced care is vital. A stroke is when blood flow in and around the brain is blocked, depriving the brain of oxygen-rich blood and nutrients. This can lead to brain cell and tissue damage. Getting treatment quickly can prevent additional damage and preserve brain function.

Knowing the signs and symptoms of stroke is important so you can get help quickly. Stroke symptoms vary and can include severe headaches and fainting or loss of consciousness. F.A.S.T is an easy way to remember the most common signs of stroke:

  • F: Face drooping. One side of the face is drooping or numb, or the smile is uneven.
  • A: Arm weakness. One arm is weak or numb. One arm may drift downward when both are lifted at the same time.
  • S: Speech difficulty. Slurred speech, difficulty speaking, inability to repeat a simple sentence correctly when asked.
  • T: Time to call 911. Call 911 immediately if you or a loved one experiences the above symptoms. If possible, write down when the symptoms first appeared so you can share this information with doctors.

Felipe De Los Rios La Rosa, M.D., stroke program director at Baptist Health Miami Neuroscience Institute.

 

The standard of care for treating stroke patients at Baptist Health is providing individualized care for each patient, whether it involves thrombolytic therapy (clot dissolving medication) or mechanical thrombectomy (minimally invasive surgery) to actually retrieve a clot.

“We have all the tools to be able to treat a stroke so that we can try to prevent brain damage happening in the first place,” said  Felipe De Los Rios La Rosa, M.D., stroke program director at Baptist Health Miami Neuroscience Institute. “And we have all the resources as far as rehabilitation goes, so that the chances for recovery are maximized and they can happen as soon as possible.”

Unruptured Aneurysms: Symptoms and Treatments

When it comes to aneurysms, there is good news: ruptured aneurysms are uncommon, affecting about 30,000 people in the U.S. annually. They account for 3 to 5 percent of all new strokes. In comparison, an estimated 6 million people in the United States have an unruptured brain aneurysm, or 1 in 50 people.

Guilherme Dabus, M.D., co-director of interventional neuroradiology 
at Baptist Health Miami Neuroscience Institute.

 

The most important symptom related to a ruptured aneurysm to remember: A sudden and severe headache, the worst headache of your life, says Guilherme Dabus, M.D., co-director of interventional neuroradiology at Baptist Health Miami Neuroscience Institute. A ruptured aneurysm can also produce symptoms such as nausea and vomiting, sudden blurred or double vision or trouble walking.

When a patient is diagnosed with an aneurysm, it can either be ruptured, when they’ve already bled, or unruptured, which is when they haven’t bled but there’s a risk of bleeding, says Dr. Dabus. “So that’s when we treat them — either before they rupture, or when they become an emergency after they rupture,” he adds.

Many aneurysms don't cause any symptoms, and some people live for years without knowing they have one. Symptoms of an unruptured brain aneurysm can include:

  • Visual disturbances, such as loss of vision or double vision.
  • Pain above or around your eye.
  • Numbness or weakness on one side of the face.
  • Difficulty speaking.
  • Headaches.
  • Loss of balance.
  • Difficulty concentrating or problems with short-term memory.

If an aneurysm is detected, but has not ruptured, there are more options: either treatment or observation. Treatment often means a minimally invasive procedure with a very high success rate. Most aneurysms develop after the age of 40, but are most prevalent in people ages 35 to 60. Most patients are lucky to have the aneurysms incidentally found through a CT scan or MRI after complaining of other possible symptoms, primarily bad headaches.

“Basically, a patient is having a workup done for headaches, migraines and sometimes sinus problems or memory issues, and in those tests, such as CT scans or MRIs, sometimes you’re able to identify those aneurysms and those cases are referred to us,” explains Dr. Dabus. “Not all unruptured aneurysms will need to be treated. But usually there’s a combination of risk factors that are taken into consideration, including patient’s age and family medical history of aneurysms. “

The non-treatment option is following up with the patient to make sure the aneurysm is not growing.

There have been significant advances in endovascular techniques for treating non-bleeding aneurysms over the last few years and the field continues to evolve. Most notable is the use of new “flow diverting” embolization devices.

These devices are similar to a stent in that they are placed into the main vessel adjacent to an aneurysm. The devices divert flow away from the aneurysm and provide a “scaffolding” for healing of the vessel wall over time. A microcatheter can be navigated past the aneurysm without having to enter the aneurysm itself.

“Even if there is not a very high risk in the short-term, this risk accumulates with time,” says Dr. Dabus. “So if you have a patient who is young, like in their 40s or 50s or 60s, they still may have many years ahead of them. So depending on the size or location of the aneurysm, it makes sense to treat those aneurysms instead of just following up.”

Explore stroke and aneurysm services at Baptist Health Brain & Spine Care.

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