Female Smokers Had Highest Risk for Brain Aneurysm Rupture

Brain aneurysms ruptured nearly one third of the time regardless of size

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Departing from previous research findings, a new study suggests that the size of a brain aneurysm is not the most important factor used to predict a rupture.

A brain aneurysm is a bulge or ballooning of an artery wall in the brain. Most aneurysms don’t produce symptoms until they press on a nerve, leak blood or burst, which requires immediate medical attention.

Researchers in Finland recently found that the risk of brain aneurysm rupture can be determined by a number of factors, including the size of the aneurysm, gender and lifestyle habits.

"Quit smoking if you have a brain aneurysm."

Seppo Juvela, MD, PhD, of the Department of Clinical Neurosciences at the University of Helsinki in Finland, led this research.

Dr. Juvela and team focused on unruptured aneurysms in an effort to identify patients with low risk and high risk for rupture over their lifetime.

This research team started with 118 patients (61 women and 57 men) diagnosed with brain aneurysms between 1956 and 1978. The study group had a median age of 43.5 years at the time of diagnosis and were followed until death or until a rupture occurred.

Risk factors for rupture that were analyzed included sex, age, cigarette smoking, systolic blood pressure (top number in a blood pressure reading), diagnosed hypertension (high blood pressure), the size of an aneurysm and the number of aneurysms.

Of the 118 study participants, 34 (29 percent) had an aneurysm hemorrhage at a median age of 51. A hemorrhage occurs when the aneurysm bursts and is marked by symptoms including severe headache, vomiting and loss of consciousness.

The group with the highest risk of a rupture were female smokers with an aneurysm larger than 7 millimeters in diameter. Non-smoking men had the lowest risk factor.

Of the 96 patients diagnosed with aneurysms considered small at less than 7 millimeters, 24 (25 percent) had an aneurysm during the study.

Dr. Juvela and colleagues concluded that almost 30 percent of all aneurysms ruptured during an individual’s lifetime, although risk varied widely based on other factors.

Size had little impact on risk for rupture, the study found, which bucks previously observed relationships.

"This is not to say that aneurysms in non-smoking men never rupture, but that the risk is much lower than we previously thought,” Dr. Juvela said in a press statement. “This means treating every unruptured aneurysm may be unnecessary if one is discovered in a non-smoking man with low blood pressure.”

These findings were published May 22 in the American Heart Association journal Stroke.

The authors did not identify any relevant conflicts of interest.

Review Date: 
May 27, 2014
Last Updated:
May 28, 2014