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Aneurysms (Brain & Aortic)

A weak, bulging spot in an artery — most often in the brain or in the aorta, the body’s main artery. Many never cause trouble, but a rupture is an emergency, so screening, follow-up and lowering blood pressure matter.

What is an aneurysm?

An aneurysm is a weak spot in the wall of an artery that bulges out like a small balloon. The two kinds this guide covers are brain (cerebral) aneurysms and aortic aneurysms, which form in the aorta, the large artery that carries blood from the heart to the rest of the body (NINDS, NHLBI). Many aneurysms grow slowly and quietly for years. The danger is that a large or growing one can burst (rupture) or tear, which is life-threatening (NHLBI, NINDS).

Brain aneurysms

A brain aneurysm can press on nearby nerves and brain tissue, or burst and bleed into or around the brain — a type of stroke that can cause brain damage, coma or death. Many, especially very small ones, never bleed, and they are often found by chance on a scan done for another reason (NINDS). About 1 in 50 people in the U.S. is thought to have an unruptured brain aneurysm, while about 30,000 ruptures happen each year (Brain Aneurysm Foundation, MedlinePlus). Most cause no symptoms until they become very large or rupture. A large one may cause pain above and behind one eye, numbness, weakness, a widened pupil, or blurred or double vision (NINDS).

Aortic aneurysms

  • Abdominal aortic aneurysm (AAA) — in the part of the aorta that runs through the belly. It is the most common type (NHLBI). Most cause no symptoms until they are close to bursting; some cause a deep, steady ache in the belly or low back, or a pulsing feeling in the belly (Cleveland Clinic).
  • Thoracic aortic aneurysm (TAA) — in the chest. It is less common (NHLBI). Most people have no symptoms until it leaks or grows; pressure on nearby structures can cause hoarseness, trouble swallowing or chest and upper back pain (MedlinePlus).

Possible rupture — call 911 right away. A burst aneurysm is a medical emergency, and fast treatment can save a life.

Some people have a smaller “warning” headache from a small leak days or weeks before a major rupture, so any sudden, severe headache needs emergency care (NINDS). No chiropractic, herbal or other complementary approach can treat a ruptured aneurysm.

Who is at risk?

Screening

  • Abdominal aortic aneurysm: the U.S. Preventive Services Task Force recommends a one-time ultrasound for men aged 65 to 75 who have ever smoked (generally meaning 100 or more cigarettes in a lifetime). For men that age who never smoked, screening is offered selectively. It recommends against routine screening for women who have never smoked and have no family history, and says the evidence is unclear for women 65 to 75 who have smoked or have a family history (USPSTF, 2019). The test is painless, uses no radiation, and is done with an ordinary abdominal ultrasound (USPSTF).
  • Medicare Part B covers one AAA screening ultrasound per lifetime, with a referral, if you have a family history of AAA or are a man aged 65 to 75 who has smoked at least 100 cigarettes. You pay nothing if the provider accepts assignment (Medicare.gov).
  • Brain aneurysms: there is no general screening program. Families in which several close relatives (parents, children or siblings) have had brain aneurysms are at higher risk, and regular brain-artery imaging, usually MRI or MRA, may be recommended for their first-degree relatives (Brain Aneurysm Foundation).

Talk with your doctor if you are a man aged 65 to 75 who has ever smoked, if a parent, brother or sister has had an aortic or brain aneurysm, or if you have a condition such as Marfan syndrome or polycystic kidney disease. Relatives of someone with an AAA may want screening too (Cleveland Clinic).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Screening, then either watchful waiting with regular scans and risk-factor control (blood pressure, quitting smoking), or repair: surgical clipping, coiling or a flow-diverting stent for brain aneurysms; open surgery or a stent graft (EVAR) for aortic aneurysms. AAA screening ultrasound: $0 under Medicare Part B for those who qualify (once per lifetime). Repair: published U.S. hospital costs of about $24,000–$26,000 for unruptured brain aneurysms (2008 data) and about $37,000–$43,000 for AAA repair (VA trial); what you pay depends on your insurance. Many small aneurysms are simply watched. Repair before rupture often goes well; a rupture is life-threatening. Stent repairs mean shorter hospital stays but lifelong follow-up scans.
Chiropractic Does not treat or prevent aneurysms. If you have a known aneurysm or a connective-tissue disorder and want care for back or neck pain, get medical clearance first. About $50–$200 a visit without insurance ($15–$75 with); first evaluations $100–$250. Neck manipulation has been linked to rare tears in neck arteries that can cause a stroke. Whether it causes them is debated, but you should be told about this risk beforehand.
Acupuncture Being researched — coming soon.
Herbal medicine No herb is proven to shrink, prevent or repair an aneurysm. The main concern is safety: supplements that raise blood pressure or affect bleeding. Cost estimate being researched. Licorice and stimulant-type products can raise blood pressure; ginkgo may raise bleeding risk with blood thinners. Check with your doctor or pharmacist first.
Massage therapy Gentle relaxation massage only, with your doctor’s OK. Not a treatment for aneurysms. About $60–$120 for 45–60 minutes with a private therapist, or $50–$90 at clinics, gyms and spas. We found no research on massage for people with aneurysms. Serious harms from massage are rare, but most reported cases involved vigorous, deep-tissue work.
MBHA Wellness Coach Blood pressure control, quitting smoking, avoiding stimulants, limiting heavy lifting and straining if advised, keeping up with follow-up scans, and emotional support. Cost estimate being researched. Quitlines (1-800-QUIT-NOW) are free. Supports — never replaces — your doctors. Controlling blood pressure and quitting smoking are the main things you can do to lower the risk of growth and rupture.

Approach 1 of 6

Conventional medicine (AMA)

Care depends on where the aneurysm is, how big it is, how fast it is growing and your overall health. Not every aneurysm needs a procedure; the choice is between watching it carefully and repairing it (NINDS, NHLBI).

1. Finding and measuring the aneurysm

Brain aneurysms are found with CT or CT angiography, MRI or MR angiography, or cerebral angiography (a catheter test with contrast dye). After a suspected bleed, a spinal tap may be used to look for blood (NINDS). Aortic aneurysms are usually found and tracked with ultrasound, CT or MRI (NHLBI, Cleveland Clinic).

2. Watchful waiting

  • Brain: a doctor may recommend monitoring very small unruptured aneurysms, as long as nothing else raises the risk of rupture. Treating an aneurysm that causes no symptoms carries risks of its own, so doctors weigh the chance of rupture against your age, health and family history (NINDS). Aneurysms that are growing are the biggest rupture risk, followed by size (NINDS). People being watched often have imaging about once a year (MedlinePlus).
  • Abdominal aorta: small aneurysms that cause no symptoms are rarely operated on; instead their size is checked with ultrasound over months or years (MedlinePlus). The Society for Vascular Surgery recommends a scan every 12 months for an AAA 4.0–4.9 cm across (SVS guideline, 2018). Cleveland Clinic generally watches AAAs under 5.5 cm in men or under 5.0 cm in women that cause no symptoms (Cleveland Clinic).
  • Medicines: doctors may prescribe blood pressure medicines (such as beta blockers, ACE inhibitors or ARBs), statins for cholesterol, and sometimes aspirin, which can raise bleeding risk (NHLBI). We don’t list doses; your care team will tailor any medicine to you.

3. Repairing a brain aneurysm

4. Repairing an aortic aneurysm

What it costs

  • AAA screening: Medicare Part B covers one screening ultrasound per lifetime, with a referral, for men 65–75 who have smoked at least 100 cigarettes and for anyone with a family history of AAA; $0 if the provider accepts assignment (Medicare.gov).
  • Brain aneurysm repair: in a national study of 2008 hospital data, the median cost to the hospital of an uncomplicated stay was about $23,600 for clipping and $25,700 for coiling of an unruptured aneurysm, and much higher when there were complications (study, AJNR, 2012). These are older hospital costs, not bills; today’s prices are likely higher.
  • AAA repair: in the VA’s OVER trial of 881 veterans, the average cost of the hospital admission was about $37,100 for EVAR and $43,000 for open repair. The stent graft itself cost far more, but EVAR patients went home sooner (about 5 vs. 10.5 days) (trial, Journal of Vascular Surgery, 2012).
  • What you personally pay for a repair depends on your insurance: MBHA cost estimate being researched.

What to expect

Outcomes for abdominal aortic aneurysms are often good when they are repaired before they rupture; once ruptured, only about 1 in 5 people survive (MedlinePlus). Ruptured brain aneurysms are fatal in about half of cases, and about two-thirds of survivors have some lasting effects (Brain Aneurysm Foundation), while diagnosing and treating an aneurysm early improves the outlook (NINDS). That is why screening, follow-up scans and controlling blood pressure matter so much.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care does not treat, shrink or prevent aneurysms. Some people with an aneurysm still look for help with back or neck pain, so the important question is safety.

Neck manipulation and artery tears

  • The NIH says manipulation of the neck has been linked to small tears in the walls of the arteries in the neck (cervical artery dissection). These tears are rare but can lead to a stroke. Experts disagree about whether manipulation actually causes them, but patients should be told about this possible risk, and the chance of a serious side effect may be greater in people with underlying health problems (NCCIH).
  • An American Heart Association / American Stroke Association statement found that most population studies show a link between neck manipulation and a type of stroke from a torn vertebral artery in younger patients. It is unclear whether this is because the manipulation caused the tear or because a tear that was already there went unrecognized. Either way, the statement says patients should be told about the link before having their neck manipulated (AHA/ASA statement, Stroke, 2014).
  • A torn neck artery can itself first show up as a one-sided headache or pain at the back of the neck (AHA/ASA statement). A sudden, severe headache is an emergency — call 911, don’t book an adjustment.

If you have a known aneurysm

We found no research on chiropractic care for people with brain or aortic aneurysms. As a precaution, MBHA suggests you get clearance from your neurosurgeon, vascular surgeon or primary doctor before any spinal manipulation — especially of the neck — and particularly if you have a connective-tissue disorder, which weakens artery walls (NINDS). Tell the chiropractor about your aneurysm, your blood pressure and every medicine you take (NCCIH), and ask whether gentler, non-thrust techniques are an option.

What it costs

Find a chiropractor in our directory

Approach 4 of 6

Herbal medicine

No herb or supplement has been shown to shrink, prevent or repair an aneurysm. Because high blood pressure is a leading risk for both growth and rupture (NINDS, NHLBI), and because some people take blood thinners or have procedures ahead of them, the real issue with herbs here is safety.

Supplements that can raise blood pressure

  • Licorice root: contains glycyrrhizin, which can cause serious side effects, especially in large amounts or with long-term use. Even small amounts have been linked to severe problems in people with high blood pressure, heart or kidney conditions, or a salty diet (NCCIH).
  • Bitter orange (synephrine): a stimulant found in some weight-loss and “energy” products. Some studies show it raises blood pressure and heart rate, and heart rhythm problems, heart attacks and strokes have been reported with multi-ingredient products that contain it. It became popular as a substitute for ephedra, which the FDA banned from supplements in 2004 over safety concerns (NCCIH).
  • Green tea extract supplements may raise blood pressure, and large amounts of green tea can weaken the blood pressure medicine nadolol (NCCIH).

Supplements that can affect bleeding

  • Ginkgo: taking it with the blood thinner warfarin is linked to a higher risk of major bleeding (NCCIH, NCCIH).
  • Cat’s claw may slow blood clotting and raise bleeding risk during surgery, and may interact with blood pressure medicines; Asian ginseng may interfere with clotting and has uncertain interactions with blood pressure drugs (NCCIH).

Before you take any supplement, show the bottle to your doctor or pharmacist — especially if you have an aneurysm, take blood pressure medicine, aspirin or a blood thinner, or have a scan or procedure coming up (NCCIH, NCCIH). We don’t list doses here.

Approach 5 of 6

Massage therapy

Massage is not a treatment for aneurysms, and we found no research on massage for people who have one. Some people find gentle massage relaxing, and avoiding stress is part of NIH advice for living with an aortic aneurysm (NHLBI).

Safety

The risk of harm from massage appears to be low, but rare serious problems — such as a blood clot, nerve injury or broken bone — have been reported, often with vigorous or deep-tissue massage or in people at higher risk of injury. If you’re not sure massage is right for you, talk with your health care provider first (NCCIH). As a precaution, MBHA suggests:

  • Ask your doctor before any massage if you have a known aneurysm.
  • Choose gentle, relaxation-style work rather than deep-tissue massage.
  • With an abdominal aortic aneurysm, ask the therapist to avoid pressure on your belly.
  • After a repair, wait until your surgeon says the incision has healed.

What it costs

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach can help you build the daily habits that lower the chance an aneurysm grows or ruptures — alongside, never instead of, your doctors.

Blood pressure

High blood pressure damages and weakens arteries, and people with unruptured brain aneurysms are advised to treat it aggressively (NINDS). With an aortic aneurysm, keep taking your prescribed medicines and avoid situations that push your blood pressure up (NHLBI). Everyday steps that help include:

  • eating less salt and saturated fat and more foods rich in potassium and fiber;
  • about 2½ hours of moderate activity a week, if your doctor agrees;
  • reaching a healthy weight, limiting alcohol, and getting enough sleep (CDC).

A coach can help you track your readings, take medicines on schedule and bring questions to your next appointment.

Quitting smoking

Smoking is linked to both the formation and rupture of brain aneurysms (NINDS), and a current smoker’s abdominal aortic aneurysm may grow faster and be more likely to burst (NHLBI). Free help is available: call 1-800-QUIT-NOW for confidential coaching. Using counseling and medicine together gives you the best chance of quitting for good (CDC). The National Cancer Institute’s quitline is 1-877-448-7848 (NHLBI).

Stimulants to avoid

Lifting and straining

Straining to lift or push heavy things, ongoing stress and sudden strong emotion can all raise blood pressure (Cleveland Clinic). People with aortic aneurysms are advised to avoid lifting heavy weights or objects (NHLBI). Ask your doctor what limits apply to you, and a coach can help you adapt exercise, chores and work around them.

Keeping up with follow-up scans

Watchful waiting only works if the scans happen. How often you need one depends on your risks (NHLBI); after a stent repair (EVAR), imaging about once a year is usual (Cleveland Clinic). A coach can help you keep a calendar, arrange rides and write down questions. Close relatives may want to ask their own doctors about screening (Cleveland Clinic, Brain Aneurysm Foundation).

Emotional support

Living with a “watch and wait” aneurysm, or recovering from a rupture, can be frightening. Long-term stress, anxiety or depression can also contribute to high blood pressure (CDC). The Brain Aneurysm Foundation runs in-person and virtual support groups for patients and families (Brain Aneurysm Foundation). Make sure the people close to you know the emergency warning signs above and to call 911.

Still being researched: Acupuncture. We add each approach once its costs and results are sourced. Are you a practitioner with experience treating Aneurysms (Brain & Aortic)? Tell us.

Member stories

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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