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Late last year, Samara Maloney, one of the Caribbean’s most beloved social media influencers, passed away unexpectedly from a ruptured brain aneurysm, plummeting the region into mourning. She was only 26 years old. This tragedy highlights an uncomfortable truth about brain aneurysms: They can happen at any time, to anyone.

Given that cerebral aneurysms are relatively rare, most people don’t know how to go about preventing them. That needs to change. Here, five top neurological experts in the Caribbean share the basics of brain aneurysms, dissect their risk factors, and provide actionable ways to keep them at bay. 

A brain aneurysm is a bulging, weakened area in the wall of an artery1 supplying blood to the brain. This weak point places pressure on the artery, forming a sack that fills with blood. This sack has the potential to swell to the point that it ruptures, causing a life-threatening bleed in the brain. A ruptured brain aneurysm is medically known as an Aneurysmal Subarachnoid Hemorrhage.

To be clear, the chance of a brain aneurysm rupturing is low. Peter Kowlessar, M.D., a neurosurgeon at Southern Medical Clinic, notes that between 2-5 percent of the general population is considered at risk of a rupture; conditions like heart attack and stroke are much more likely. In the United States, the annual rate of rupture is approximately 8 to 10 per 100,000 people. Globally, about 500,000 people die of ruptured brain aneurysms each year.

If ruptured aneurysms are relatively rare, why are they important to talk about? Quite simply, because they are sleeping giants. In the case of a rupture, approximately 10% of patients die2 before reaching to hospital; 25% die within 24 hours1; and 50% die within 3 months1. The remaining percentage of survivors are often left with physical and/or cognitive neurological complications.

Internal medicine and neurology specialist, Nicholas Maraj, M.D., notes that ruptures usually happen suddenly, and they can occur in people who are otherwise in good health3. For this reason, brain aneurysms “can feel like a ticking time bomb waiting to rupture,” says neurosurgeon, Robert Ramcharan, M.D.

So, who’s most at risk?

There are a few types of risk to consider when it comes to brain aneurysms: 1) the risk of aneurysm formation in the first place, 2) the risk of growth or changes in the size of the aneurysm, and 3) the risk of a rupture. 

Your overall risk is affected by a mix of modifiable factors (which are within our control) and non-modifiable factors (which are out of our control).

Let’s get the non-modifiable factors out of the way first: For starters, your biological sex seems to play a role. Statistically, women are up to 2.2 times more susceptible4 to brain aneurysms than men, depending on their age. Neurologist and Deputy Dean of Clinical Sciences at The University of the West Indies Medical Campus, Sherry Sandy, M.D. explains that before age 40, there is a roughly equal prevalence of brain aneurysms in both genders. However, after the age of 50, they become more common in women. We don’t have enough data to understand why this is, though medical professionals suspect it could have to do with factors ranging from oral contraception side effects and pregnancy to menopause and decreased estrogen levels.

While brain aneurysms can occur at any age, according to the Brain Aneurysm Foundation, they are most prevalent in people aged 35 to 60.

Kowlessar notes that people who have first-degree relatives (parents, siblings, or children) who have had an aneurysm or subarachnoid hemorrhage (brain bleed) also run an increased risk.

Modifiable risk factors for brain aneurysms include cigarette smoking and hypertension5 (high blood pressure). These represent just a few of the ways that we can prevent brain aneurysms through factors that are within our control. 

How to prevent the formation & growth of a brain aneurysm

Being aware of the risk factors of brain aneurysms is only the first step. From there, prevention becomes a collective responsibility. Here are five neurologist-backed practices we can all do to safeguard our brain health.

Sandy notes that from a public health perspective, it’s not cost-effective for the general public to get screened for brain aneurysms. However, those who have a family history of brain aneurysms, have a connective tissue disorder, or have other non-modifiable risk factors should consider immediate screening.

Managing hypertension is another linchpin of prevention. To improve blood pressure, Ramcharan, recommends getting moderate physical activity for at least 45-60 minutes a day, at least four times per week.

While not all headaches are indicative of an aneurysm, Ramcharan advises that if you have unpredictable, severe headaches that you would call “the worst headaches of my life,” don’t ignore them or take painkillers and move on. Instead, consult a doctor.

These warning headaches, also known as thunderclap headaches, sentinel headaches, or sudden agonizing headaches can be a sign that an aneurysm, if present, may have ruptured. This can’t be overstated: severe or persistent headaches should never be ignored or dismissed.

Smoking cigarettes not only weakens arterial walls9, increasing the risk of rupture, but also contributes to the overall deterioration of cardiovascular health. If you smoke, consider this yet another reason to commit to quitting.

Annual checkups offer an opportunity for early intervention and the chance to modify risk factors before they escalate. Ramcharan strongly advised that visiting your primary physician every year, even if you are well. This will help you stay on top of factors that can influence aneurysm formation, such as blood pressure, cholesterol, etc.

The takeaway

A small percentage of the population will fall victim to a ruptured aneurysm—however, the reality is no one is immune. Studies show that ruptured brain aneurysms disproportionately impact women over 50, cigarette smokers, and people with a family history.

However, you can reduce your risk by staying on top of annual screenings and checkups, telling your doctor about severe headaches, and managing hypertension with holistic lifestyle choices. 

Through continued research, public awareness, and individual responsibility, we can work towards a future where brain aneurysms are not just understood but effectively prevented, ensuring that tragedies like Samara’s become increasingly rare.