Can you fly with a brain aneurysm?

The Central Nervous System, in which the brain is included, is an indispensable component of our anatomy.

Without it we could not survive, but neither could we think, feel, make decisions or be aware of what is happening to us; all the characteristics that make us human exist because we have a brain that works as it should.

However, there are many diseases that can jeopardize its functioning and, therefore, our survival, a brain aneurysm is one of them.

Can you fly with a brain aneurysm?

Yes, you can fly with a brain aneurysm. The rate of aneurysm rupture in an airplane is almost non-existent. However, it all depends on the type of aneurysm and its size.

A cerebral aneurysm is a cerebrovascular disease in which a part of a blood vessel in the brain becomes dilated, which becomes swollen over time.

This bulging of that segment of the blood vessel is due to a weakening of its wall, which causes the pressure of the blood to tighten it even more, thus increasing the risk that the vessel will rupture and part of the brain will be flooded.

A brain aneurysm is a dilation of the wall of an artery in the brain. The most complex thing about these vascular conditions is that they usually have no symptoms. Thus, little by little, and without the person noticing, that area is bulging with the consequent risk that it will end up breaking. The consequences, if you don’t act quickly, can be fatal.

Most of us know someone who has suffered this delicate reality. There are those who, thanks to early detection, have been able to benefit from a rapid intervention (such as the classic embolization), to be able to lead a normal life without major sequelae. Other patients, on the other hand, carry the effects of a ruptured aneurysm.

Be that as it may, there is one fact that we must not neglect. Although it is a condition that usually appears more frequently between 40 and 65 years of age, it can also manifest in young people and even children. Sometimes, certain genetic problems or arteriovenous malformations lead to the appearance of these dangerous changes in the cerebral arteries.

Prognosis: what happens when the aneurysm ruptures?

The rupture of a cerebral aneurysm is almost always a very serious event for the health of the person, since on the one hand the leakage of blood affects the functioning of the parts of the brain, causing them to not work well and killing nerve cells, and on the other, it produces a deficit of blood supply in others, causing them to die.

Beyond these generalities, the prognosis of a ruptured cerebral aneurysm is highly variable, depending basically on its size, the affected brain area, the general state of health of the person and the time that has passed between the rupture of the vessel and the onset of medical care.

In general, an average of 40% of people do not survive 24 hours after the rupture of the cerebral aneurysm, and it is frequent that in the cases of recovery some type of sequelae remain.

That is why urgent medical attention is necessary before the appearance of the first symptoms.

Types of brain aneurysms

Aneurysms that affect the brain can be classified according to several criteria. Here are some of them.

Types of aneurysms by size

• Very small: 3 mm. or less
• Small: more than 3 mm. and less than 11 mm.
• Large: from 11 to 25 mm.
• Giants: more than 25 mm.

Types of aneurysms according to their shape

• Saccular aneurysms: bulging in the shape of the vessel wall.
• Dissecting aneurysms: the inner layer of the vessel wall is broken creating a bifurcation that separates the normal path of the vessel and another that runs parallel to it on the other side of the inner wall.
• Spindle aneurysms: in this type of aneurysm there is no specific and very well defined area in which the vessel wall inflates, but rather the vessel wall expands in all directions along a relatively long segment of the vessel.

Causes and risk factors

Brain aneurysms can be the product of genetically rooted alterations or acquired diseases. Risk factors related to unhealthy lifestyle habits are alcoholism, excessive intake of foods with high levels of fats and sugars, tobacco abuse, cocaine use, and the use of certain contraceptives and anticoagulants.

Hypertension, obesity and, especially, atherosclerosis, are also risk factors for the possible appearance of brain aneurysms, which are associated with the weakening of the walls of the blood vessels.

Symptoms of a brain aneurysm

When small, brain aneurysms tend not to produce symptoms until they rupture, although larger ones can disrupt certain mental and behavioral functions before they do, by putting pressure on adjacent areas as they expand.

1. Symptoms before the break

Among the most common symptoms of aneurysms that have not ruptured are dizziness, alterations in perception, loss of vision and balance and, in general, a weakening of some psychological functions.

However, these symptoms can be confused with the effects of lack of sleep or fatigue and stress produced by a too intense workday, so that in many cases they go unnoticed until the blood vessel ruptures and the hemorrhage.

2. Symptoms immediately after the break

The person who has ruptured a cerebral aneurysm will experience symptoms immediately, feeling suddenly much weaker and, in some cases, suffering severe alterations in consciousness that may be accompanied by entering a coma or sudden death.

Typically, if you do not lose consciousness, the most common signs that an aneurysm has occurred are tiredness, severe dizziness, blurred vision, and trouble focusing on something.

It is also common to experience speech problems (aphasia), alterations in perception and entering a confused state. However, as we have seen, these symptoms depend on many factors, as does the prognosis.

Diagnosis of aneurysms

Doctors generally have different scales to assess the severity of a brain aneurysm. The most common are the Glasgow scales (in case the person has lost consciousness) and the Hunt and Hess scale. In the latter case, the following dimensions are assessed:

• Degree of headache and neck stiffness.
• Drowsiness and degree of mental confusion.
• Appearance or not of hemiparesis (paralysis on one side of the body or face)
• Appearance of coma, state of maximum severity and worse prognosis.

Likewise, and in case we have a family history, it is advisable to undergo checkups and diagnostic tests. The most common way to identify the presence of a brain aneurysm before it ruptures is by: 

• Computerized tomography.
• Cerebral angiography.

On the other hand, one aspect should be noted. Many people die without knowing that they have a brain aneurysm. That is, not all these cerebrovascular alterations end with a tear; the probability is not very high but as such, it can happen with the consequent risk.

Treatment

When treating a brain aneurysm, multiple factors are taken into account. The first is whether a breakage has already appeared or not.

The second is the size, location, age of the patient, and other associated neurological conditions. 

However, the good news is that if there is early detection, the treatments are effective and a very complex surgery is not required, an endovascular approach is enough. These are the most common.

Endovascular Embolization

The technique consists of introducing a small catheter through the patient’s groin, following the cerebral artery to the brain. Once there, the aneurysm is blocked.

Stents are used, devices that control and channel these pathologies.

Brain Bypass

The application of a cerebral bypass requires that the patient be admitted between three and five days. In this case, the intervention is a bit more complex than embolization, because it requires carrying out a small craniotomy to apply this bypass, which is intended to regulate and reduce abnormal blood flow to that artery or vein.

Surgical locking procedure

Lastly, and in more serious cases, doctors may opt for an intervention that requires making an incision in the skull. However, the admission is short and the intervention simple. Titanium devices are inserted to channel and treat the aneurysm.

Be that as it may, all these treatments are highly effective if the aneurysm is not ruptured. It is clear that we are not always so lucky, that we are not always aware of their existence because these conditions are asymptomatic. However, it is necessary to keep this information in mind in all cases to be forewarned and know how to act.

Can you fly with a brain aneurysm?

It is estimated that between 3 and 5% of the adult population have a brain aneurysm, the vast majority undiagnosed, and that commercial flights carried out throughout the world over a period of year are about 2.5 billion. 

The risk of an aneurysm rupture as a result of the flight is very small and thus, in a 2009 narrative review no case of aneurysm rupture related to an airplane flight had been published, and the three found they are in publications of 2014 and 2015.

Before a person diagnosed by imaging studies of one or more cerebral aneurysms, who has to travel by plane, it will be necessary to establish individually the risk of bleeding, which will be conditioned by the size of the aneurysm, its location, the presence of multiple aneurysms, family history of aneurysm rupture, and personal history of bleeding from brain aneurysms.

FAQS: Can you fly with a brain aneurysm?

What should you avoid if you have a brain aneurysm?

To prevent brain aneurysms, you must control your cardiovascular risk factors and control diseases that can weaken blood vessels, such as diabetes, cholesterol, and arteriosclerosis; In addition, you must maintain a healthy lifestyle, avoid stress and the consumption of tobacco and alcohol.

How long can a person live with a brain aneurysm?

Around 75 percent of individuals with a ruptured aneurysm of the brain live more than 24 hours. However, within six months, a fifth of the survivors could have life-ending complications.

Can you cause a brain aneurysm?

High blood pressure is the leading cause of subarachnoid hemorrhage. Strong emotions, such as being upset or angry, can raise blood pressure and can subsequently cause aneurysms to rupture.

Can you work with a brain aneurysm?

It may not be necessary for individuals who suffer from an aneurysm to perform work operations, let alone everyday tasks. It can be life-threatening to develop an aneurysm, and medication may not always hold it under control.

Can aneurysm heal itself?

Yes, an aneurysm can heal itself. 

References

Cui V, Kouliev T, Wood J. A case of cerebral aneurysm rupture and subarachnoid hemorrhage associated with air travel. Open Access Emerg Med. 2014 Apr 5;6:23-6.

Guglielmi G (September 2007). “History of endovascular endosaccular occlusion of brain aneurysms: 1965-1990”. Interventional Neuroradiology.

Lv X, Yang H, Liu P, Li Y (February 2016). “Flow-diverter devices in the treatment of intracranial aneurysms: A meta-analysis and systematic review”. The Neuroradiology Journal.