Some of the most frightening and serious diseases that can happen to anyone are those that involve the brain. The brain is one of the main organs of the body that controls so much of what we do and who we are, and this can be terrifying if endangered in any way. Will the person be able to make a full recovery? Be “normal” afterwards? Regain full use of all their limbs? Go to the bathroom normally? Remember who people are?
While many people seem to use the terms “stroke” and “aneurysm” interchangeably (aneurysms often happen in the brain, just like a stroke), the truth is, a stroke and an aneurysm are not the same thing at all. In fact, the only thing that is the same about them is that they can both have the same symptoms. With a stroke, one can have sudden headaches, numbness on one side of the body, vision issues, and/or trouble maintaining balance and coordination. An aneurysm can also cause sudden headaches, weakness or numbness in the body, vision issues, and memory issues.
While the symptoms may be the same, and while they may both occur in the brain, what causes an aneurysm versus what causes a stroke is completely different. For example, an aneurysm specifically happens when an artery wall weakens, which causes it to expand out like a balloon. Risk factors can include prior family history of aneurysms, high blood pressure, high cholesterol, and smoking. A stroke, on the other hand, can happen either because of an artery that was blocked, or a blood vessel that was either leaking or bursts. There can also be a less serious form of stroke called a TIA (transient ischemic attack) where a disruption happens, but it only happens temporarily and does not leave lasting symptoms. Risk factors for a stroke are mainly lifestyle based versus family-history based. You are at risk for a stroke if you are obese, have diabetes, are physically inactive, have obstructive sleep apnea, drink heavily, smoke, have high cholesterol or high blood pressure, and have any kind of cardiovascular disease. And finally, having a family history of stroke does indeed put you at a greater risk for getting one.
Procedures and treatments
Both stroke and aneurysm require immediate medical attention. In the case of a stroke, there can be certain procedures done that are effective only within a certain time span after symptoms first appear. If you arrive at the hospital within three to four hours after symptoms first appear–the earlier, the better!–the treating physician may be able to give medicine called tissue plasminogen activator, or tPA. This drug breaks up the blood clots that form to cause a stroke and can allow for a much better recovery. But even if you’ve arrived after the initial four-hour time slot, there are still things the doctor can do. An endovascular procedure may be done by inserting a long tube through a major artery in your arm or leg that then will be used to install a special device in the weak spot that can either remove the clot or place a stent in the artery to restore blood flow.
With an aneurysm, the main form of treatment is surgery. You can either go through surgical clipping, by which the neurosurgeon removes part of the skull to get to where the aneurysm happened. Then the surgeon finds the particular blood vessel that leads to it and puts a clip at the connecting point to stop the blood flowing to the aneurysm. Or the surgeon can choose to go with endovascular coiling, depending on the situation. Slightly less invasive, the surgeon will insert a catheter via an artery (generally in your groin) that leads to where the aneurysm is. The tube will then be used to feed a soft wire to that area which will then interrupt the blood flow from the artery to the aneurysm by coiling up inside the aneurysm and sealing it off.
Since both diseases are quite different from each other, so are their survival rates. According to the National Institute of Neurological Disorders and Stroke, 25 percent of people who suffer from an aneurysm die within 24 hours, and another 25 percent die within 6 months from related complications. Some may experience permanent neurological damage, while others may have no side effects at all and make a complete recovery. For others, recovery can take anywhere from a few weeks to a few months.
With a stroke however, 20 percent of patients will die within the year of having a stroke. Unlike with an aneurysm, a stroke patient can be potentially rehabilitated using thrombolytic therapy which can reverse the symptoms of a stroke. Also, the severity of the stroke can affect the outcome. The less severe, the better the chance of a return to functionality. It also depends on what part of the brain the stroke affected. If the patient was unable to swallow, they may subsequently get aspiration pneumonia whenever anything gets into the lungs which can cause infection. If they had become paralyzed or experienced muscle weakness, they may get pressure sores as well as infection due to the skin breaking down. The more severe the stroke, the greater possibility that seizures can develop.
It is of utmost importance, whether it be a stroke or aneurysm, to get immediate medical care as quickly as possible. This can have a greater positive effect on your survival rate and general quality of life afterwards.
Steve Schadendorf, MD
Founding Medical Partner
Dr. Schadendorf is a board certified neurologist who specializes in vascular neurology at Bass Medical Group. Dr. Schadendorf is a Founding Medical Partner and Medical Director of the Neuromedicine Channel at Doctorpedia.