Emilia Clarke from Game of Thrones made national headlines last week after revealing that she'd nearly died after suffering from not one, but two ruptured brain aneurysms. In a powerful essay for the New Yorker, the actress shared how she was rushed to the hospital in 2011 after experiencing an excruciating headache mid-workout. After some preliminary scans, Clarke was told that an aneurysm had ruptured in her brain and that she would need immediate surgery. She was just 24 years old.
Miraculously, Clarke survived after spending a month in the hospital. But then, in 2013, doctors found another aggressive growth, this time on the other side of her brain. The actress ended up needing two separate surgeries to deal with the second aneurysm and barely made it out alive. "If I am truly being honest, every minute of every day I thought I was going to die," she wrote in the essay. (Related: I Was a Healthy 26-Year-Old When I Suffered a Brain Stem Stroke with No Warning)
She is in the clear for now, but will likely have to go in for routine brain scans and MRIs to keep an eye out for other potential growths. Her very revealing essay on such a shocking health scare brings up a lot of questions about how someone as healthy, active, and young as Clarke could suffer from such a serious—and potentially fatal—condition, and twice.
Turns out, what Clarke experienced isn't exactly uncommon. In fact, approximately 6 million, or 1 in 50 people, are currently living with an unruptured brain aneurysm in the U.S., according to the Brain Aneurysm Foundation—and women, in particular, are at a greater risk for developing this silent and potentially fatal disformity.
What exactly is a brain aneurysm?
"Sometimes, a weak or thin spot on an artery in the brain balloons or bulges out and fills with blood. That bubble on the wall of an artery is known as a brain aneurysm," says Rahul Jandial M.D., Ph.D., author of City of Hope in Los Angeles.
These seemingly harmless bubbles often remain dormant until something causes them to explode. "Most people aren't even aware that they have an aneurysm," explains Dr. Jandial. "You could live with one for years and never present with any symptoms. It's when an aneurysm ruptures that [it] causes serious complications."
Of the 6 million people living with aneurysms, approximately 30,000 experience a rupture each year. "When an aneurysm ruptures, it spills blood into the surrounding tissue, otherwise known as a hemorrhage," says Dr. Jandial. "These hemorrhages are fast-acting and can lead to severe health problems such as a stroke, brain damage, comas, and even death." (Related: Science Confirms It: Exercise Benefits Your Brain)
Since aneurysms are basically ticking timebombs, and are often undetectable pre-rupture, they are terribly difficult to diagnose, which is why their mortality rate is seriously high: Around 40 percent of ruptured brain aneurysm cases are fatal, and about 15 percent of people die before reaching the hospital, reports the foundation. It's no wonder that doctors said Clarke's survival was nothing short of a miracle.
Women are at greater risk.
In the grand scheme of things, doctors don't exactly know what causes aneurysms or why they can happen in people as young as Clarke. That said, lifestyle factors like genetics, high blood pressure, high cholesterol, smoking, and drug use definitely put people at a higher risk. "Anything that causes your heart to work twice as hard to pump blood will increase your risk for developing aneurysms," says Dr. Jandial.
Certain groups of people are also more likely to develop aneurysms than others. Women, for instance, are one and a half times (!) more likely to develop aneurysms compared to men. "We don't exactly know why this happens," says Dr. Jandial. "Some believe it's tied to the decline or deficiency of estrogen, but there isn't enough research to lock down an exact cause."
More specifically, doctors find that two distinct groups of women seem to be particularly inclined to develop aneurysms. "The first is women in their early 20's, like Clarke, who have more than one aneurysm," says Dr. Jandial. "This group is usually genetically predisposed, and the women are likely born with arteries that have thinner walls." (Related: Female Doctors Are Better Than Male Docs, New Research Shows)
The second group includes post-menopausal women over the age of 55 who, on top of being at a greater risk for developing aneurysms in general, are also more likely to have ruptures compared to men. "These women who are in their 50s and 60s, have usually lived a life of high cholesterol, high blood pressure, and other debilitating health problems that end up being the root cause of their aneurysms," explains Dr. Jandial.
How to know if you need help.
"If you come into the hospital and say you're experiencing the worst headache of your life, we know to immediately check for a ruptured aneurysm," says Dr. Jandial.
These severe headaches, also known as "thunderclap headaches," are one of several symptoms associated with ruptured aneurysms. Nausea, vomiting, confusion, sensitivity to light, and blurred or double vision are all additional signs to watch out for—not to mention symptoms that Clarke experienced during her own health scare. (Related: What Your Headache Is Trying to Tell You)
If you're lucky enough to survive the initial rupture, Dr. Jandial says that 66 percent of people experience permanent neurological damage as a result of the rupture. "It's hard to go back to your original self after experiencing something so catastrophic," he says. "Clarke definitely beat the odds because not many people are as lucky."
So what's important for women to know? "If you have a headache that's something like you've never experienced before, it's crucial to seek medical care immediately," says Dr. Jandial. "Don't try to work through the pain. Listen to your body and get to the ER before it's too late. Getting a diagnosis and immediate treatment maximizes your chances of making a full recovery."