The basilar artery is the most important artery in the back of the brain. The basilar artery can develop a bulge that pushes outward, putting stress on the artery wall and causing it to burst. When basilar artery aneurysms burst, they account for an estimated 27 percent of ischemic strokes, according to neurologists affiliated with St. Louis University.
Most people with basilar artery aneurysm rupture experience mini strokes (transient ischemic attacks) in the days and weeks before the aneurysm. The most common symptoms of basilar artery aneurysm include weakness on one side of the body or face; problems with speech and articulation; dizziness, nausea and vomiting; headaches and visual problems; loss of consciousness.
People who develop basilar artery aneurysms often have the following risk factors: high blood pressure (hypertension), diabetes, heart disease, vascular disease, cigarette smoking and high cholesterol levels.
A person may be diagnosed with basilar artery aneurysm after undergoing blood tests to check for blood clotting problems and heart disease. Doctors also use imaging tests, including computed tomography (CT) scanning and magnetic resonance imaging and angiography to check a patient's brain for bleeding, tumors and aneurysm and rule out other conditions that may be causing the patient's symptoms. In addition, doctors may use transcranial Doppler, echocardiography, and electrocardiography to make the diagnosis of basilar artery aneurysm.
If a basilar artery aneurysm is found before it ruptures, doctors may prescribe medications to lower blood pressure and relax blood vessels and prevent the aneurysm from breaking through the artery wall. Basilar artery aneurysm is usually treated with intravenous (in the vein) or intra-arterial (in the artery) thrombolysis, which uses drugs to break down clots in the body. In the United States, doctors administer medications called tissue plasminogen activators (tPA) to people with basilar artery aneurysm rupture. The success of these medications is dependent on how quickly a person sought treatment. TPA medicines may not be useful if given more than 12 hours after symptoms appear.
The National Heart, Lung and Blood Institute also notes that people with basilar artery aneurysm may need surgery to strengthen the artery wall and reduce the risk of basilar artery aneurysm rupture. People who have basilar artery aneurysm rupture are admitted to a stroke unit for immediate and long-term care. Doctors' first priority in treating patients with basilar artery aneurysm involves maintaining blood flow to the brain and other areas of the body. Patients may undergo a surgical procedure known as clipping, which involves placing a small clip near the aneurysm. This takes the aneurysm out of the brain's circulation and prevents excessive bleeding.
Survival and Complications
Basilar artery aneurysm rupture causes death in more than 70 percent of the people who experience it and occurs twice as often in men as in women, eMedicine.com reports. People who survive basilar artery aneurysm rupture have a 20 percent chance of having another stroke later. They often need to make changes to their diet, exercise habits and lifestyle once they are released from the hospital and post-stroke rehabilitation program. They may need neurological and psychological therapy to cope with physical and emotional changes they experience after aneurysm.