When comparing a ruptured aneurysm vs. stroke, both can occur suddenly, without warning. They share some common risk factors but are two distinctly different diagnoses.
An aneurysm refers to the bulging of an artery wall caused by a weak spot. It can occur anywhere in the body and can rupture, causing life-threatening bleeding. On the other hand, a stroke is an event that interrupts blood flow to the brain. This is caused by either a blood vessel blockage or a leaking or ruptured blood vessel. Strokes occur in the brain and can also be life-threatening, interfering with the vital blood supply to brain cells.
It’s very important to be aware of the symptoms of an aneurysm vs. stroke as both are medical emergencies. Here, we’ll review different types of aneurysm and strokes, their risk factors, symptoms, tests to diagnose them, and treatments.
What Are the Different Types of Aneurysms?
An aneurysm is when an artery wall is weakened, causing it to widen or balloon. Imagine a garden hose that has worn out and starts to bulge where it’s thinned. People are either born with an aneurysm, or they can occur due to disease or injury. Sometimes the cause is unknown.
Arteries are pressurized blood vessels that carry oxygenated blood around the body, so if an aneurysm in an artery ruptures, massive bleeding can occur in a very short amount of time, which can prove fatal. However, not all aneurysms rupture.
The most common aneurysms are:
- Aortic aneurysm, which happens in the main artery that takes blood from the heart into the body. This includes abdominal aortic aneurysms.
- Cerebral aneurysm, which is a brain aneurysm.
- Popliteal artery aneurysm, which happens at the back of the knee.
- Mesenteric artery aneurysm, which is the artery delivering blood to the intestines.
- Splenic artery aneurysm, which occurs in an artery supplying blood to the spleen.
An aneurysm is not the same as a stroke. However, a cerebral aneurysm that bursts can lead to a hemorrhagic (bleeding) stroke.
What Are the Two Main Types of Stroke?
There are two main types of stroke (or CVA, “cerebrovascular accidents”). There’s ischaemic, accounting for most strokes, and hemorrhagic. A stroke occurs when blood flow to the brain is disrupted. This leads to a section of the brain becoming damaged or dying, which can cause long-term disability or even death.
Strokes are more common than aneurysms and are the fifth leading cause of death in the U.S. Every year, around 795,000 people in the U.S. have a stroke, and 137,000 of these people will sadly die from their stroke. This equates to around 17%, whereas 50% of people with ruptured brain aneurysms die within three months.
Hemorrhagic Stroke
Hemorrhagic strokes occur when an artery leaks or ruptures, causing bleeding in the brain. This means downstream of this artery, the brain isn’t getting access to the vital oxygen and nutrients it needs to function. Pressure on the walls of blood vessels can cause damage to the blood vessels causing a leak or rupture, and affecting brain function.
Hemorrhagic strokes are caused by conditions such as high blood pressure, a cerebral aneurysm (brain aneurysm), or anatomical abnormalities.
Ischemic Stroke
Ischemic strokes occur when there’s a blockage within an artery supplying blood to the brain. Most often, the cause of the blockage is a blood clot (thrombus) at the site of fatty deposits (plaques) that have built up along the wall of a blood vessel. This process is known as atherosclerosis. These fatty deposits can also build up in the heart, neck or elsewhere in the circulation, and break away, traveling to and causing a blockage in an artery providing blood to the brain.
Transient Ischaemic Attacks (TIAs)
These are sometimes referred to as “mini-strokes.” They are not a full stroke but rather a temporary interruption to the brain’s blood supply, which can resolve in minutes or up to 24 hours. They are still a medical emergency to rule out stroke, as you can’t tell the difference when symptoms start. They can act as a warning that a stroke may occur if nothing is done to prevent one.
Aneurysm vs. Stroke: What Causes Them?
Risk factors for aneurysm and stroke have a lot of overlap, with some being modifiable and others non-modifiable.
Controllable or Treatable Risk Factors
- High blood pressure
- High cholesterol
- Obesity
- Excess alcohol consumption
- Tobacco use
- Drug abuse, particularly cocaine or amphetamines
- Conditions such as diabetes, blood vessel abnormalities (e.g., arteriovenous malformations), and connective tissue disorders
- For stroke — carotid artery disease, heart disease such as atrial fibrillation, and sickle cell disease
- For aneurysms — injury, such as head injury for a brain aneurysm
Uncontrollable Risk Factors
- Gender — men are at greater risk of abdominal aortic aneurysms (for unknown reasons), while women are at greater risk of brain aneurysms and strokes. Women’s increased stroke risk is thought to be multifactorial, including their life expectancy being longer than men’s.
- Age — both are more common with increasing age, although they can occur at any age
- Family history of aneurysms or stroke
- Ethnicity — Black people are more likely to die from a stroke than white people. This is thought to be due to societal barriers and systems that have harmed their health for a long time leading to increased risk of high blood pressure, diabetes, and obesity.
- Conditions that increase the risk of stroke, such as a previous stroke, TIA, or heart attack
How Can You Reduce Your Risk of Stroke and Aneurysm?
To reduce your risk of stroke or an aneurysm, it’s important to engage regularly in physical activity, eat healthily, and get support to give up smoking or address any excess alcohol intake.
It’s also important to get regular check-ups, particularly for known conditions, and to take prescribed medications to keep these under control.
Aneurysm vs. Stroke: What Are the Symptoms?
Aneurysms and strokes don’t always have symptoms – for example, a small aneurysm that has not ruptured. It is estimated that 10 “silent strokes”(where the person doesn’t experience symptoms) are thought to occur for every stroke that does produce symptoms. In both cases, imaging such as MRI (magnetic resonance imaging), may find these incidentally.
However, being aware of the distinct symptoms for each diagnosis can help identify them early so you can seek treatment urgently.
Aneurysm Symptoms
Aneurysms tend not to display symptoms unless they become large (and at risk of rupture) or rupture occurs. Symptoms of an unruptured vs. ruptured aneurysm often differ from each other, and depending on where the aneurysm is located.
Signs and symptoms of unruptured aneurysms include:
- Brain aneurysm symptoms: Headaches, loss of balance, vision problems (e.g., double vision, pain around or above the eye, one enlarged pupil), facial weakness or numbness, speech or thinking difficulties.
- Abdomen: Abdominal or back pain that doesn’t go away or happens repeatedly. A pulsating feeling, or lump, in the abdomen.
- Groin: A lump in the groin that might pulsate, leg or groin pain, swelling in the lower leg, blood clots.
- Behind the knee: A pulsating feeling or swelling behind the knee, knee or lower leg pain. Skin that looks a different color or feels cold, a numb leg or inability to move a foot.
A sentinel (warning) bleed can occur from a leaking brain aneurysm in the weeks before it ruptures, causing headaches.
Symptoms of a ruptured aneurysm develop quickly and include:
- Brain: Sudden, severe headache, often the worst headache of the person’s life. Vomiting, being sensitive to bright lights, neck stiffness.
- General: Feeling lightheaded, confused, having a fast heartbeat, shortness of breath, having pale or gray skin (check palms too), sudden severe pain in the chest, abdomen or back, loss of consciousness, having a seizure, cardiac arrest or falling into a coma.
Always seek urgent medical attention if an aneurysm is suspected by calling 911 or the emergency services where you are, as it is a medical emergency. If an aneurysm ruptures, it can prove fatal. Unfortunately, this occurs in 80% of people who have an abdominal aortic aneurysm rupture.
Stroke Symptoms
If you or someone you’re with is displaying these F.A.S.T. symptoms of a stroke, you should seek urgent medical help:
- Face: Is one side of the person’s face drooping? Check if the person can smile and if their mouth or eye is drooping.
- Arms: Is there arm weakness? Ask them to raise both arms to check they can do this.
- Speech: Is there speech difficulty? Check if the person can speak clearly and understand what you are saying.
- Time: If you feel or see any of these symptoms, it’s time to call 911 immediately (or the emergency services in the country you’re in).
Other symptoms or signs of a stroke can include sudden onset of:
- Numbness or weakness in the face, arms or legs, particularly on one side of the face or one side of the body
- Confusion — this may show itself by difficulty speaking or understanding what is being said
- Vision changes — difficulty seeing from either eyes, or both
- Difficulty walking, loss of balance, or feeling dizzy
- A headache that may be severe and come on suddenly
Not all the symptoms need to be seen to suspect a stroke. There may be only one, or there may be many. Symptoms depend on which part of the brain is affected.
In the same way that you would act immediately to try to put out a fire to stop it from spreading, acting quickly when there are any signs of stroke might just save a person’s life, as they can be fatal or cause permanent brain damage.
It is a medical emergency if a stroke is suspected, with some treatments only working in the first few hours after symptoms start. Therefore, call 9-1-1.
What Tests Are Used to Diagnose an Aneurysm or Stroke?
A full medical history and examination, including a neurological examination, blood pressure and pulse check, and various tests will be carried out.
Depending on whether a potential stroke diagnosis or aneurysm is being investigated, tests can include CT (computed tomography) or MRI scans, an ultrasound scan, a coronary angiogram (a special X-ray test of the heart) and blood tests. Other tests include ECG (electrocardiogram to check heart rate, rhythm, or any abnormalities), carotid doppler ultrasound scan (of the arteries in the neck), and echocardiogram (a type of ultrasound of the heart).
Separate from diagnostic testing, a screening test for abdominal aortic aneurysms is recommended for men aged 65-75 with certain risk factors.
Aneurysm vs. Stroke Treatments
If someone is experiencing a stroke or ruptured aneurysm, these are treated as medical emergencies.
For an ischemic stroke, clot-busting medication can be given to eligible patients to dissolve and remove the clot. Treatment needs to start as soon as possible, within 4.5 hours after symptoms start. In some cases, physicians may use a device to remove the clot from the brain. A blood thinner and other medication will usually be given to reduce the risk of further strokes.
For a hemorrhagic stroke, treatment options include supportive treatments such as fluids and oxygen, and some people will require surgery to remove the blood from the brain and repair any burst blood vessels. If someone is on blood thinners, treatment may be given to reverse these effects and prevent any further bleeding.
Unruptured aneurysm treatment depends on the size, location, symptoms, and overall risk of rupture. Medications can help reduce the risk of rupture in some cases, or surgery may be recommended to repair the aneurysm if the risk of rupture is high. Regular monitoring of a known aneurysm will be required, and if an aneurysm ruptures, it requires emergency surgery.
For both stroke and aneurysms, healthy lifestyle advice will be given, and the person will be assessed and treated for any other risk factors. They will also be given ongoing treatment and support for any physical or cognitive issues that remain after initial treatment, which may improve to some extent over time. However, this may take weeks or months.
The Importance of Prevention and Awareness
When it comes to an aneurysm vs. stroke, many of the prevention strategies are the same. These include eating a healthy diet, exercising regularly, and managing chronic conditions, such as high blood pressure, diabetes, or high cholesterol, in partnership with your healthcare provider.
Screening tests may also be considered to look for any abnormalities, such as an aneurysm, which may not present with symptoms until they become large or rupture.
With this in mind, consider an Ezra Full Body MRI that can give you insight into your health. This one-hour scan screens up to 13 organs (including the brain) so you can be proactive before symptoms appear.
