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Aneurysms Common, Sometimes Deadly

Brain Aneurysm Triggers Fatal Hemorrhage for Rep. Tubbs Jones, 58
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WebMD Health News

Aug. 21, 2008 -- The type of brain aneurysm that triggered a hemorrhage and killed Rep. Stephanie Tubbs Jones (D-Ohio), 58, late Wednesday is not uncommon, says a neurology expert from Vanderbilt University.

Often, a brain aneurysm will go undetected and not cause problems, says Howard Kirshner, MD, professor and chairman of neurology at Vanderbilt University School of Medicine in Nashville. But if it ruptures, it can quickly prove fatal, Kirshner says.

Tubbs Jones died Wednesday evening after being admitted to Huron Hospital at the Cleveland Clinic late Tuesday evening, according to Kevin Ziegler, a clinic spokesman. "Throughout the course of the day and into this evening, Congresswoman Tubbs Jones' medical condition declined," according to the statement announcing her death.

Kirshner, who did not treat Tubbs Jones and is not familiar with her medical history, agreed to answer some questions about brain aneurysms for WebMD.

What is a brain aneurysm?

"An [unruptured] aneurysm looks kind of like a balloon, an out-pouching of an artery," Kirshner says. "It almost always occurs at a point where the artery branches off."

While Tubbs Jones had a cerebral, or brain aneurysm; aneurysms can also occur in the aorta (the major artery from the heart), the leg, and other areas. Aneurysms are related to weaknesses in the blood vessel wall.

How common is a brain aneurysm?

''We think that many people have them -- up to 4% have it at autopsy," Kirshner says, citing research, but many show no symptoms. According to Kirshner, about 5% of people will develop a brain aneurysm during their lifetime, but only about 10% of them will experience a rupture.

As a crude estimate, he says, perhaps 25,000 to 50,000 people a year in the U.S. have a brain hemorrhage caused by a ruptured aneurysm. Family history plays a role, experts believe. Family members of a patient with a brain aneurysm have an increased risk of having one. Yet only a small percentage of these are related to hereditary syndromes associated with aneurysms.

Women are more likely than men to have an aneurysm, and African-Americans have more risk of hemorrhage from an aneurysm than do whites.

What are the symptoms that an aneurysm has ruptured?

Aneurysms often go undetected because they can have no symptoms until they rupture and bleed. When that happens, it can cause a sudden severe headache and sometimes nothing more than that, Kirshner says. "But it is usually not like any other headache you've had. It is very sudden or severe, the worst headache of your life." Other symptoms include severe neck pain, dizziness, nausea, and sensitivity to light.

One-third to nearly half of patients have minor hemorrhages or "warning leaks" that later lead to a severe devastating brain hemorrhage days later.

Sometimes, when an aneurysm ruptures, it can go unnoticed, with the person passing off the headache. But once it ruptures, Kirshner says, it is more likely to re-bleed.

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