Can Stress Cause a Brain Aneurysm? Facts and Risk Factors

Stress does not directly cause a brain aneurysm to form, but ongoing stress or a sudden burst of strong emotion can raise blood pressure and trigger a rupture in an existing aneurysm. A brain aneurysm is a bulge in a weakened area of a blood vessel in or around the brain. Most aneurysms are small and never rupture, but a rupture is a life-threatening emergency requiring immediate medical care.

Understanding the relationship between stress and brain aneurysms is important for anyone concerned about their risk. While stress is not a direct cause of aneurysm formation, it can contribute to conditions like high blood pressure that weaken blood vessel walls over time. This article explains what brain aneurysms are, how stress affects them, and what you can do to lower your risk. You can also explore Can You Get Sick from Stress? What the Evidence Shows for a closer comparison.

What Is a Brain Aneurysm?

A brain aneurysm, also called a cerebral aneurysm, is a bulge in a weak area of an artery in or around the brain. The constant pressure of blood flow pushes the weakened section outward, creating a blister-like bump. When blood rushes into this bulge, the aneurysm stretches even farther, similar to how a balloon gets thinner and is more likely to pop as it fills with air.

Brain aneurysms can occur anywhere in the brain, but most form in the major arteries along the base of the skull. Approximately 10% to 30% of people who have a brain aneurysm have multiple aneurysms. The majority of brain aneurysms are small and do not cause symptoms. An aneurysm can cause symptoms if it puts pressure on nearby nerves or brain tissue. If the aneurysm leaks or ruptures, it causes bleeding in the brain, which can be life-threatening. For related context, see our guide to How to Tell If My Dog Is Depressed: Signs, Causes, Help.

According to the Cleveland Clinic, up to 6% of people in the U.S. have an unruptured brain aneurysm. Ruptured brain aneurysms are less common, occurring in approximately 30,000 people in the U.S. per year. Brain aneurysms can affect anyone at any age, but they are most likely to affect people between the ages of 30 and 60 and are more common in women.

How Stress Affects Brain Aneurysms

Stress does not cause a brain aneurysm to develop, but it can play a role in rupture. Researchers think high blood pressure is the most common cause of a rupture. Higher blood pressure makes blood push harder against blood vessel walls. Situations that can increase blood pressure and lead to a brain aneurysm rupture include ongoing stress or a sudden burst of anger or other strong emotion, according to the Cleveland Clinic.

This means that while stress alone won't create an aneurysm, if you already have a weakened blood vessel, a stressful event could trigger a dangerous rise in blood pressure that causes the aneurysm to burst. It's important to note that many people have unruptured aneurysms without knowing it, so managing stress and blood pressure is a wise preventive measure for everyone.

The Barrow Neurological Institute states that stress probably does not cause brain aneurysm formation, but stress can lead to a bleed. There are case reports of aneurysms that ruptured during sexual activity or other stressful events, highlighting the potential trigger effect.

Risk Factors for Brain Aneurysms

Several factors can increase your risk of developing a brain aneurysm or having one rupture. These include:

• Family history: Having a first-degree relative (biological sibling or parent) with a history of brain aneurysms increases your risk.
• Genetic conditions: Certain inherited disorders, such as autosomal dominant polycystic kidney disease (ADPKD) or Ehlers-Danlos syndrome, are associated with a higher risk.
• High blood pressure: Chronic high blood pressure can damage artery walls and increase the risk of aneurysm formation and rupture.
• Smoking: Smoking is a significant risk factor for brain aneurysms.
• Age and sex: Aneurysms are more common in people aged 30 to 60 and in women.
• Drug use: Cocaine or other stimulant use can raise blood pressure and increase rupture risk.

According to the NHS, it's not always clear what causes brain aneurysms, but things that increase your chances include having a close relative who has had a brain aneurysm and having certain genetic conditions. The Mayo Clinic notes that in many cases, brain aneurysms can't be prevented, but you can lower your risk by quitting smoking and managing blood pressure.

Symptoms of a Brain Aneurysm

Most unruptured brain aneurysms do not cause symptoms. If an aneurysm becomes large enough, it may press on nearby nerves or brain tissue, causing symptoms such as:

• Changes in vision, such as double vision
• Pain above and behind one eye
• Numbness or weakness on one side of the face
• Dilated pupil

A ruptured brain aneurysm is a medical emergency. The first sign is usually a sudden, severe headache often described as the "worst headache of your life" or a thunderclap headache. Other symptoms may include:

• Nausea and vomiting
• Stiff neck
• Blurred or double vision
• Sensitivity to light
• Seizure
• Loss of consciousness

If you or someone else experiences these symptoms, call 911 or go to the nearest emergency room immediately. A ruptured brain aneurysm can cause permanent brain damage or death, and prompt treatment is critical.

Diagnosis and Treatment

Brain aneurysms are often found incidentally during imaging tests for other conditions. If an aneurysm is suspected, your doctor may order a CT scan, MRI, or cerebral angiogram to confirm the diagnosis and assess its size and location.

Treatment depends on the size, location, and risk of rupture. Small, unruptured aneurysms may not require immediate treatment; instead, your doctor may recommend regular monitoring with imaging scans. According to the NHS, treatment is not usually needed for small brain aneurysms that are not causing symptoms because they often do not get bigger and have a low risk of bursting.

If there is a risk of rupture or the aneurysm has already ruptured, surgery may be necessary. Two main surgical options are:

• Surgical clipping: A small metal clip is placed at the base of the aneurysm to stop blood flow into it.
• Endovascular coiling: A catheter is threaded through the blood vessels to the aneurysm, and tiny coils are inserted to promote clotting and seal off the aneurysm.

Both procedures are performed under general anesthesia. Your surgeon will discuss the most suitable option based on your individual case.

Prevention and Stress Management

While you cannot change some risk factors like family history or age, you can take steps to lower your risk of aneurysm formation and rupture. The St. Vincent's Health suggests six ways to lower your risk:

1. Manage blood pressure: Keep your blood pressure in a healthy range through diet, exercise, and medication if prescribed.
2. Quit smoking: Smoking damages blood vessels and significantly increases aneurysm risk.
3. Limit alcohol: Excessive alcohol consumption can raise blood pressure.
4. Avoid stimulant drugs: Cocaine and other stimulants can cause sudden blood pressure spikes.
5. Eat a healthy diet: A diet rich in fruits, vegetables, and whole grains supports vascular health.
6. Manage stress: While stress alone doesn't cause aneurysms, reducing stress can help control blood pressure and lower rupture risk.

Stress management techniques such as regular exercise, meditation, deep breathing, and adequate sleep can help keep your blood pressure stable. If you have been diagnosed with an unruptured aneurysm, it's normal to feel anxious. A study published in Stroke found that people diagnosed with unruptured cerebral aneurysms have a higher risk of developing mental health conditions like anxiety and depression, especially those under age 40. Seeking support from a mental health professional or support group can be beneficial. The American Heart Association highlights the importance of providing psychological support to patients with aneurysm diagnoses.

When to Seek Emergency Care

A ruptured brain aneurysm is a life-threatening emergency. Seek immediate medical attention if you experience:

• A sudden, severe headache unlike any you've had before
• Loss of consciousness
• Seizure
• Sudden blurred or double vision
• Weakness or numbness on one side of the body
• Difficulty speaking or understanding speech

Do not wait to see if symptoms improve. Call 911 or have someone drive you to the nearest emergency room. Early treatment can save your life and reduce the risk of permanent brain damage.

Remember, stress is not a direct cause of brain aneurysms, but managing stress and blood pressure is an important part of reducing your overall risk. If you have concerns about your risk factors, talk to your healthcare provider for personalized advice.