Despite being potentially fatal, brain aneurysms remain dangerously underdiagnosed. Doctors calls for urgent awareness and early detection.
We tend to think of a brain crisis as dramatic a stroke, a traumatic injury, a loss of speech or movement that demands immediate attention. But some of the most dangerous threats to our brain don’t arrive with fanfare. They sit quietly, sometimes for years, hidden deep within the folds of the brain’s blood vessels, waiting for the smallest moment to change a life forever.
A brain aneurysm is one of these silent threats. And yet, most of us know little to nothing about it. A brain aneurysm is a bulge in the wall of a blood vessel in the brain, often likened to a balloon that has begun to thin and stretch. Many remain unnoticed. But if it ruptures, it causes a sudden, often devastating bleed into the brain what we call a subarachnoid haemorrhage. When that happens, every second counts.
Globally, brain aneurysms cause nearly half a million deaths every year. Half of those individuals are younger than 50. The implications are heartbreaking not only for the patient, but for families who must navigate sudden loss or life-altering disabilities. And yet, awareness remains disturbingly low.
In my practice, I often meet patients who are stunned to learn they had an unruptured aneurysm only after an MRI or CT scan performed for another reason. This is not rare. Worldwide, an estimated 1 in 50 people have an unruptured brain aneurysm. That’s over 6.8 million individuals in the U.S. alone. In the UAE, we lack precise prevalence data but what we do know suggests the issue is present, but under-recognised.
The challenge lies in the silence. Many brain aneurysms show no symptoms until it’s too late. But when symptoms do appear sudden thunderclap headaches, nausea, light sensitivity, neck stiffness they should be treated as neurological emergencies. Unfortunately, they are often mistaken for migraines or viral illnesses. The opportunity to act slips away.
We must shift this paradigm. Awareness isn’t just helpful it’s lifesaving. Who is at risk? While anyone can develop a brain aneurysm, some groups face a higher likelihood. Women are up to twice as likely as men to develop aneurysms. Those with connective tissue disorders like Ehlers-Danlos or polycystic kidney disease are particularly vulnerable. Genetics matter too having a first-degree relative with an aneurysm significantly raises your own risk.
So what can we do?
We start with information. Education campaigns, social media outreach, even simple pamphlets in clinics can plant a seed of awareness. At a systems level, screening strategies particularly for high-risk groups need to be taken seriously. Imaging tools like CTA, MRA or the gold standard DSA (Digital Subtraction Angiography) are already available in most hospitals. What we need is the will to use them preventively and proactively.
Early detection is not a luxury. It is the difference between crisis and control. A multidisciplinary approach combining the expertise of neurologists, neurosurgeons, radiologists, and general practitioners is critical in both diagnosis and long-term management. When patients are caught early, they may benefit from interventions that prevent rupture entirely.
With the right knowledge, a potential catastrophe can be rendered manageable even avoidable. But the conversation cannot stop in hospital corridors. Brain aneurysms need a place in our public health dialogue. Support groups, fundraising efforts, and partnerships with neurological advocacy organisations will amplify the message. And behind all of this, we need to invest in research to understand not just how to treat aneurysms, but how to prevent them.
When something is invisible, we tend to underestimate it. But silence does not mean safety. As we continue to make remarkable progress in heart disease, cancer, and stroke prevention, we must now turn that same attention to the quieter killers the threats we don’t see until it’s too late. Let brain aneurysms be part of that conversation. Let us move from reaction to prevention. Because in medicine, as in life, awareness is power and action is everything.
Dr. Gopalakrishnan contributes this opinion piece, a senior neurologist at Medcare Orthopaedic and Spine Hospital
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