When people hear the word "stroke," many think of an often-fatal condition that only strikes the elderly.
But about 20 percent of the time the stroke is a cerebral -- or brain -- aneurysm, which usually hits people in the prime of their life.
An aneurysm is the ballooning or the abnormal stretching in the wall of a vein or artery. Brain aneurysms may be present from birth, or may develop as a result of high blood pressure or smoking. They most often occur in people ages 35 to 60.
Aneurysms can occur in other parts of the body, such as in the leg or abdomen, but a brain aneurysm is especially grave because of the danger of rupturing and bleeding in the brain.
Being able to treat someone with a ruptured brain aneurysm in the first few hours is crucial, said Dr. Warren Selman, director of the Neurological Institute at University Hospitals Case Medical Center, where he serves at the chairman of neurosurgery."A patient who survives the first bleeding could go on to bleed again, which is why it is critical to get the aneurysm 'secured' within the first 24 hours," he said. If detected before it ruptures, doctors often can successfully treat a brain aneurysm, Selman said.
Brain aneurysms are not always fatal. Music mogul Quincy Jones suffered two near-fatal ones in 1974, and musician Neil Young was treated for one in 2005 after an MRI discovered it. Both made full recoveries.
But in most cases, a burst brain aneurysm causes a stroke or excessive bleeding and, if it doesn't cause immediately death, leaves the patient incapacitated.
"It is very common for an aneurysm to present as a sudden rupture with no warning signs," Selman said. "But sometimes one of the warning signs is a sudden, severe and unusual headache."
In other rare instances, people mistake the pain of a brain aneurysm for an extreme toothache, said Dr. Matthew Kirlough, director of the division of general dentistry at MetroHealth Medical Center.
If a patient has elevated blood pressure and exhibits signs of stroke, such as a crooked smile or garbled speech, dentists know to direct that patient for a fuller medical evaluation, he said.
Modern imaging, such as CT scans and MRIs are the key to finding them before they burst. Once a doctor can pinpoint the location, he or she can do a procedure that "clips" or "coils" the aneurysm by essentially sealing it off and keeping other nearby vessels open.