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Aneurysm vs Stroke: Which Is Worse?

Reviewed on 1/11/2021

Aneurysm vs. stroke: which is worse?

Strokes and aneurysms are serious brain conditions that may result in death or permanent damage.
Strokes and aneurysms are serious brain conditions that may result in death or permanent damage.

Aneurysms and strokes are brain conditions that require immediate medical attention. When your brain has become damaged and isn't receiving blood and oxygen in the right proportions, it begins to affect your thoughts, speech, and ability to stay conscious. Both of these related conditions could cause permanent damage or even death.

What is aneurysm vs. stroke?

It's important to understand the differences between the symptoms and warning signs of these two serious conditions, along with what steps you can take to prevent further damage and regain your health.

What is an aneurysm?

An aneurysm is an abnormality in your arteries in which the artery wall becomes too thin and a bulge forms. While aneurysms can happen in other parts of the body, they are most common and most deadly in the brain. A burst brain aneurysm is a medical emergency because it causes immediate harm, with 50% of all ruptures being fatal.

What is a stroke?

A Stroke is an abnormal event that happens in the arteries of your brain. In most cases, a blood clot or blockage stops the flow of blood in your brain. This is known as an ischemic stroke and is the most common type of stroke — about 87% of all strokes are ischemic. 

The other type — hemorrhagic stroke — happens when a blood vessel bursts, which damages the brain and blocks blood flow to other areas. Strokes are also the fifth-leading cause of death in the United States, with about 10% to 20% considered fatal. 

What are symptoms and signs of aneurysm vs. stroke?

While aneurysms and strokes are related, they can have different symptoms. Not all of these symptoms happen every time, and they can show up at different times. Some symptoms might come on suddenly, and some might present early warnings. 

Symptoms of an aneurysm

You rarely have symptoms for an aneurysm that hasn't burst. But if you do, you might experience:

  • Dilated pupil in one eye
  • Numbness on one side of your face
  • Changes in your vision
  • Pain behind and above one eye

For a burst aneurysm, you might experience:

Symptoms of a stroke

Symptoms for the two types of strike are quite similar. If you’re experiencing either, it can be difficult to tell the difference, but either case is equally serious. 

For an ischemic stroke, you might experience: 

For a hemorrhagic stroke, you might experience:

  • Sudden, intense headache
  • Seizures
  • Numbness in one arm or leg
  • Weakness and loss of balance or coordination
  • Vision changes
  • Loss of speech
  • Vomiting and nausea
  • Confusion
  • Neck stiffness
  • Hand tremors
  • Irregular heartbeat
  • Shortness of breath
  • Light sensitivity

Any of these symptoms can indicate a life-threatening emergency. You should call 9-1-1 immediately.

What are causes of aneurysm vs. stroke?

There are several causes and risk factors for aneurysm or stroke. While some risk factors are outside of your control, some are within your control. Reducing your risks can help you prevent an aneurysm or a stroke from happening. 

Causes of an aneurysm

Generally, the cause of an aneurysm is any condition or situation that can weaken your blood vessels and let a bulge form. The leading risk factors include:

Causes of a stroke

Blood clots are the leading cause of ischemic stroke, and the leading risk factors include:

Burst brain aneurysms are the leading cause of hemorrhagic stroke. Risk factors for stroke include:

How to diagnose aneurysm vs. stroke

Since burst aneurysms and strokes are medical emergencies, you will likely see a doctor in the emergency department of a hospital. Your doctor will begin with a physical and neurological exam to assess your symptoms. They will order one or more imaging scans to identify and locate a burst blood vessel or blockage.

For a burst aneurysm, you may undergo a computed tomography (CT) scan, computed tomography angiogram (CTA), magnetic resonance imaging (MRI), magnetic resonance angiogram (MRA), or a diagnostic cerebral angiogram. 

For a stroke, your attending doctor may order an electroencephalogram, CTA scan, MRA, diagnostic cerebral angiogram, carotid ultrasound, trans-cranial Doppler ultrasound, or an echocardiogram

You may also have several blood tests to check for infection, cholesterol and blood sugar levels, or blood clotting abilities. Your blood may be tested for thyroid or electrolyte irregularities as well.

Treatments of aneurysm vs. stroke

Your health depends on quick treatment of these conditions. Once your doctor sees the test results, they will determine the best treatment for you. Treatment for aneurysms is different from treatment for strokes.

For aneurysms, your doctor may recommend surgical clipping, also known as microvascular clipping. This is where neurosurgeons place a small clip on the neck of the aneurysm to stop the bleeding. Two less-invasive procedures are coil embolization, in which doctors place tiny metal coils inside the aneurysm to block blood flow, or flow diversion, in which doctors place a mesh-like stent in the artery to divert blood away from the aneurysm.

Stroke treatment depends on the type. For ischemic strokes, your doctor will give you clot-busting medication such as tissue plasminogen activator, known as tPA, or a blood-thinning medication. They may also use a stent retriever inserted into your artery to remove the clot. To prevent further strokes, your doctor may perform a carotid endarterectomy to remove plaque buildup or an angioplasty to insert a stent into your artery.

For hemorrhagic strokes, your treatment is similar to that of a burst aneurysm. You may receive surgical clipping, coil embolization, or flow diversion to block blood flow to the burst artery. Your doctor might perform stereotactic radiosurgery to repair an artery malformation or surgery to remove the blood vessel itself. In addition, you may receive medications to lower your blood pressure and prevent seizures.


 

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References
SOURCES:

American Association of Neurological Surgeons: "Arteriovenous Malformations."

American Stroke Association: "Ischemic Stroke Treatment."

Brain Aneurysm Foundation: "Diagnosis."

Brain Aneurysm Foundation: "Statistics and Facts."

Brain Aneurysm Foundation: "Warning Signs/Symptoms."

Cedars-Sinai: "Aneurysm."

Cedars-Sinai: "Hemorrhagic Stroke."

Cedars-Sinai: "Ischemic Stroke."

Centers for Disease Control and Prevention: "Conditions that Increase Risk for Stroke."

Centers for Disease Control and Prevention: "Stroke Facts."

Harvard Health Publishing, Harvard Medical School: "Understanding aneurysms."

Johns Hopkins Medicine: "Risk Factors for Stroke."

MedlinePlus: "Angioplasty and stent replacement - carotid artery."

National Institute of Neurological Disorders and Stroke: "Cerebral Aneurysms Fact Sheet."

National Institute of Neurological Disorders and Stroke: "Stroke: Challenges, Progress, and Promise."

Office on Women's Health: "How is stroke diagnosed?"

University of Maryland Medical Center: "Hemorrhagic Stroke."

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