Cerebral aneurysm - features of the disease
An aneurysm is a very dangerous disease associated with impaired cerebral circulation. When it occurs, a section of the artery bulges. This can happen for a variety of reasons and develops at any age, although it is very rare in children. Statistics show that the disease develops more often in women. For unknown reasons, a large percentage of patients with aneurysm are registered in Japan and Finland.
The danger of the disease is that it is difficult to diagnose. It is often asymptomatic and is detected only when the aneurysm ruptures. Without timely treatment, this condition can be fatal because it causes intracranial bleeding or hemorrhage. Currently, there are no effective methods for preventing aneurysm; you can only try to reduce the likelihood of its rupture. The disease is treated primarily through surgery. It is very important to be attentive to your condition and if disturbing symptoms appear, consult a doctor.
Description of the disease
According to the ICD, cerebral aneurysm belongs to the group of diseases of the circulatory system. During its formation, damage to the vessel wall occurs. Part of it protrudes, forming a sac filled with blood. It can put pressure on nearby vessels and nerves, causing various neurological disorders.
But in most cases, the aneurysm does not cause any discomfort to the patient. The danger is that the wall of the vessel at the site of the protrusion becomes thinner, and under certain conditions it may rupture. In more than half of the cases, this condition leads to the death of the patient.
An aneurysm can form on almost any vessel. But most often the protrusion occurs near the base of the skull. Such arterial aneurysms of cerebral vessels occur due to the fact that the blood pressure here is higher than in other vessels. And if there is slight damage to one of the layers of the artery wall, part of it protrudes under the pressure of blood.
Types of cerebral aneurysms
In order to describe the disease in more detail and prescribe the correct treatment, doctors distinguish many types of aneurysms. They are classified by place of origin, form, and even by how long ago they appeared.
Sometimes there is a congenital cerebral aneurysm, but mostly it is an acquired disease. Protrusions of the walls of blood vessels can be small, medium and large. It is also very important to determine where the aneurysm develops.
There are several types of the disease based on its form; a saccular aneurysm most often develops on cerebral vessels. It occurs due to local damage to the vessel wall, in the area of which a sac filled with blood forms. It can grow and break at any time.
When diagnosing and choosing the right treatment, it is important to know how many aneurysms have formed in the patient’s blood vessels. Most often, single defects occur. But there are also multiple aneurysms of cerebral vessels, due to which the blood supply to certain areas may be disrupted.
Cerebral aneurysm: causes
Why does damage to the walls of blood vessels occur? It can be caused by many factors. The main reason for the development of an aneurysm is high blood pressure. With hypertension, a protrusion of the vessel wall in a weak spot can occur at any time. Why does such a defect form?
After a closed head injury, dissection of the vessel wall is often observed. An aneurysm may form at this location. Defects in the walls of blood vessels can form after inflammation of the meninges caused by infection.
The development of an aneurysm is also provoked by various diseases: cancer, polycystic kidney disease, atherosclerosis and others. Vascular damage can be caused by a systemic infection that spreads through the blood. This is, for example, syphilis or endocarditis.
Various congenital genetic or autoimmune diseases cause weakening of connective tissue. This also creates the preconditions for the occurrence of an aneurysm. Drug and alcohol use, as well as smoking, impair blood circulation and weaken the walls of blood vessels, causing their areas to bulge.
Sometimes the disease develops at birth. Although the number of such cases is very small, it can be said that there is a predisposition to its occurrence. But most often, cerebral aneurysm is not inherited by itself, but in the form of genetic abnormalities and connective tissue defects.
Manifestation of the disease
Often, aneurysms in the brain are small and do not cause any negative consequences. The patient can live for a long time without noticing this defect. But in some cases, the symptoms of an aneurysm can be severe. This happens when:
- the size of the aneurysm is large;
- the patient has pathologies in the functioning of the cardiovascular system;
- the aneurysm is localized in an important area of the brain;
- the patient does not comply with preventive measures.
Consequences of cerebral aneurysm
Protrusion of part of the vascular wall leads to various disorders in the patient’s health. And the more aneurysms in the brain, the worse it is. What does the formation of a pouch on the wall of a vessel lead to?
Because of it, blood flow slows down, and the tissues behind the aneurysm are less well supplied with oxygen and nutrients. Due to turbulence in the movement of blood, the risk of blood clots increases. As the aneurysm grows, it puts pressure on surrounding tissues, vessels and nerves. The most dangerous consequences are observed during rupture.
Rupture of a cerebral aneurysm
When the vessel wall ruptures, hemorrhage occurs, which causes severe damage to the nervous system, hemorrhagic stroke and even death. Therefore, if you have this disease, it is very important to follow the measures recommended by your doctor to prevent such an outcome.
If you consult a doctor in time, hemorrhage can be prevented. To do this, you need to follow all the recommendations: take prescribed medications, eat right, do not overexert yourself, and undergo regular examinations.
Surgical removal of an aneurysm
After examination and determination of the type of disease, the doctor decides which operation to use for treatment. To prevent rupture of the aneurysm, it is clipped. Using a metal clip, the pedicle of the bulging section of the vessel is clamped. Cerebral aneurysms are often treated this way. In most cases, the patient is subsequently diagnosed with disability. After such treatment, many restrictions must be observed, but this still does not prevent the appearance of new aneurysms.
In complex cases, when there are many deformities, clipping will not help. Then endovascular occlusion of cerebral aneurysms is performed. A special metal stent is inserted into the resulting cavity and protects the vessel wall from rupture. Recovery after surgery may take several days. But after this the patient must change his lifestyle.
Consequences of surgery for cerebral aneurysm
This treatment almost completely returns the patient to a normal lifestyle. With proper rehabilitation after surgery, performance is fully restored. If treatment is carried out on time, relapse of the disease can be avoided. For control, it is necessary to undergo regular examination by a doctor.
Sometimes surgery can cause complications. This happens more often in elderly and weakened patients with concomitant chronic diseases. It is possible to develop vascular obstruction and frequent spasms. All this leads to oxygen starvation.
Pregnancy with cerebral aneurysm
The most dangerous thing for a patient's life is a rupture of an aneurysm. And during pregnancy, the likelihood of such an outcome increases. After all, all the changes that occur in a woman’s body are reflected in the blood vessels. Moreover, the volume of blood increases at this time, which can lead to an increase in the aneurysm and to its rupture.
The danger is that a woman often finds out about the presence of an aneurysm closer to the middle of pregnancy, and surgical treatment cannot be performed at this time. Therefore, a woman should be constantly under the supervision of a doctor.
In case of this disease, timely consultation with a doctor is of key importance. The symptoms of an aneurysm should not be ignored, as this can lead to fatal consequences.
Symptoms
Symptoms of cerebral aneurysm
Doctors identify the following symptoms of cerebral aneurysm:
-
A sharp deterioration in vision;
Photophobia;
Double vision;
Numbness of body parts, mainly on one side;
Headache;
Hearing problems;
Speech impairment.
Attacks of nausea;
Headache with cerebral aneurysm is most often paroxysmal, similar to migraine. The pain is localized in different places, but most of all it manifests itself in the back of the head. One of the signs is considered to be a pulsating noise in the head area. As the blood flow accelerates, the noise increases.
Signs of a cerebral aneurysm that are not considered major, but which should still be paid attention to:
Strabismus;
Sharp noises in the ears;
Strong dilation of the pupils;
Drooping of the upper eyelid;
Hearing loss on one side;
Vision problems such as distortion of objects, cloudy vision;
Sudden onset of weakness in the legs.
When an aneurysm ruptures, there is unbearable sharp pain.
Very often, aneurysm occurs in children, mainly in boys under two years of age. It is located in the postcranial fossa and is quite large in size. Symptoms are similar to those in adults.
The main reasons why a cerebral aneurysm may occur are:
Traumatic brain injury;
Head wound;
High blood pressure;
Various types of infections;
Atherosclerosis (problems with blood vessels, which are accompanied by the fact that cholesterol begins to be deposited on the walls of blood vessels);
Other diseases that have a detrimental effect on blood vessels;
Drugs and cigarettes.
What to do if you discover one of the symptoms of a cerebral aneurysm
If you discover one of the symptoms of a cerebral aneurysm, you should consult a doctor who will prescribe a list of tests and conduct a series of examinations to diagnose the disease and prescribe effective treatment.
Diagnosing an aneurysm is a rather complicated process, since the formation does not manifest itself in any way before the rupture. Diagnosis is carried out using x-ray studies of blood vessels. Studies reveal destruction or narrowing of blood vessels in the brain and parts of the head. Diagnosis is also carried out using computed tomography of the head and magnetic resonance imaging (MRI). An MRI provides the clearest view of the blood vessels and shows the size and shape of the aneurysm.
Diagnostics
This diagnosis is made by a neurologist during the initial examination. Also, the diagnosis of cerebral aneurysm occurs through an X-ray examination of the skull, examination of the spinal cord fluid, and a tomographic examination. An MRI examination allows identifying signs of a cerebral aneurysm much more quickly.
Symptomatic signs of cerebral aneurysm.
Very often, the signs of a cerebral aneurysm are not expressed in any way until it becomes particularly large or ruptures.
If symptoms of the disease occur, then, as a rule, they are expressed in the following manifestations:
- aching eyes;
- paralysis syndrome;
- weakening of the facial muscles;
- blurred vision;
- enlarged pupils.
Symptoms of a ruptured cerebral aneurysm are expressed in intense and piercing pain in the head, gagging, nausea reflex, nuchal rigidity (increased tone of the neck muscles), and in some episodes, fainting. Sometimes the symptoms of the disease in a patient are expressed in migraines, which can be long-lasting. Less commonly, signs of a cerebral aneurysm may include:
- drooping eyelid;
- increased sensitivity to bright light;
- violation of mental stability;
- increased restlessness;
- convulsions.
All these symptoms are an “alarm bell”; in this case, you should urgently seek medical help. It must be remembered that only a specialist can make a diagnostic conclusion; All of these signs of cerebral aneurysm do not completely determine the presence of this disease. Any conclusions can only be drawn by a neurologist, based on the examination and the results of the examination.
Diagnosis of signs of cerebral aneurysm
Signs of a cerebral aneurysm require a medical examination; only a doctor can confirm or deny the presence of the disease in a patient.
The examination is very important, since the risk of hemorrhage from the detected pathology is very high. The likelihood of this negative prognosis is influenced by many factors: the magnitude of the pathology, its location, the condition of the blood vessels, as well as general anamnesis. Recurrence of hemorrhage occurs in a more complex form and increases the risk of death. That is why signs of a cerebral aneurysm are a serious reason to seek medical help. If the symptoms become more and more pronounced, then when the patient contacts specialists, the following types of examinations are possible:
- When examining a patient, a neurologist makes appropriate conclusions. A doctor's examination helps identify meningeal (symptoms of irritation of the meninges) and focal (deficiencies that begin due to local damage to the brain) symptomatic signs. Using them, a specialist can confirm that the observed problems are signs of a cerebral aneurysm.
- Signs of a cerebral aneurysm are confirmed or refuted by an X-ray of the skull. The procedure “shows” clots in the vessels, as well as a violation of the integrity of the bones at the base of the skull, which helps to identify the disease.
- CT scans make it possible to quickly scan the brain structure and its structure. Diagnosis of signs of cerebral aneurysm using this method allows us to record the slightest abnormal changes in the brain and determine the disease. A CT scan will immediately “see” signs of a cerebral aneurysm; MRI also helps to cope with this task.
- MRI also helps to identify signs of cerebral aneurysm in the early stages. The procedure makes it possible to “examine” the structure of an organ (brain) and “see” abnormal formations. MRI usually detects signs of cerebral aneurysm from the first procedure, except in cases where the pathology is negligible. Then the diagnosis of signs of cerebral aneurysm is carried out using CT. However, with primary signs of a cerebral aneurysm, specialists most often prescribe an MRI.
- Signs of a cerebral aneurysm are grounds for a doctor to prescribe a cerebrospinal fluid examination. Diagnosis of signs of cerebral aneurysm using the presented method is carried out using laboratory tests. Experts check how clear the liquid is.
- If there are signs of a cerebral aneurysm, angiographic examination of the vessels is also prescribed. It determines where the pathology develops, determines its shape and dimensions, and scans the veins of the brain.
- signs of cerebral aneurysm do not appear for a long time;
- The diagnosis can be made by studying the signs of a cerebral aneurysm only when examining the patient with special equipment;
- if signs of a cerebral aneurysm appear, it means that the disease has acquired a serious form;
- the signs of cerebral aneurysm indicated on the website do not determine the presence of the disease; only a specialist can determine the diagnosis. Only a doctor can diagnose a cerebral aneurysm.
In addition to all these methods, the collection of information based on anamnesis is of great importance in diagnosing the disease. Before prescribing any examinations, the neurologist asks the patient or his relatives and the following important factors:
- symptoms that worry you most at the moment;
- first manifestations of the disease;
- concomitant chronic or acquired diseases;
- treatment performed previously, whether it was performed at all;
- injuries;
- allergies;
- hereditary diseases.
Sometimes this disease can be discovered completely by accident when the patient undergoes an examination due to complaints about other circumstances. Similar diagnostic examinations are also carried out if tumor formations in the brain are suspected. Even more often, this disease, unfortunately, is discovered only after the aneurysm ruptures, in which case the patient is urgently hospitalized.
Treatment
Treatment of cerebral aneurysm
There are several types of treatment for cerebral aneurysm:
Operation clipping. The point is that compression clips are applied, which ultimately remove the aneurysm from the bloodstream.
Transcranial removal.
Blocking of blood supply by emboli to one structure of the body. This leads to a reduction in the size of the aneurysm.
Surgical intervention. If the aneurysm has not yet ruptured, then the following operations are performed:
In 14 percent of cases, rupture of the tumor leads to bleeding into the ventricles. In this case, the hematoma is removed.
Hemorrhage into the ventricles is also possible, in which case the doctor performs ventricular drainage.
It is possible to use folk remedies in the treatment of aneurysm. Infusions of hawthorn, dill, elderberry and jaundice will help.
The prognosis for the treatment of this disease depends on many factors. It all depends on the location and size of the aneurysm.
If the tumor ruptures, the prognosis is not encouraging. Chance of disability: 25-37%, and chance of death even higher: 35-52%.
A cerebral aneurysm (in other words, an intracranial aneurysm) is considered a small tumor in the human brain that immediately begins to grow and fill with blood. However, some types of aneurysms, namely the smallest aneurysms, do not cause bleeding, and removal entails few consequences. An aneurysm is often located where all the arteries are, namely along the lower part of the brain and the base of the skull, and treatment without surgery is considered likely.
According to some experts, surgery for a cerebral aneurysm is undesirable, since the consequences can be very unpredictable, and the results are always individual.
Surgeries for cerebral aneurysm
Endovascular surgery for cerebral aneurysm is carried out only under the careful supervision of doctors, who will continue to monitor the process of recovery of the body for a long time. Rehabilitation after surgery for cerebral aneurysm takes place in medical institutions. Clipping of a cerebral aneurysm is performed under general anesthesia.
There are about ten officially reported aneurysm ruptures per hundred thousand people per year, which is about twenty-seven thousand people per year in America. The development of an aneurysm can also be influenced by factors such as hypertension, frequent use of alcohol, drugs (especially cocaine) and cigarettes.
In addition, the development of the disease, the risk of rupture and the effectiveness of treatment of the aneurysm directly depend on its size.
In any case, you should immediately contact a specialist, and he will prescribe the appropriate treatment for you.
Medicines
If a strange and sharp headache occurs, a person must immediately contact the nearest medical institution for qualified help. The disease is not treated with medication, but there is prevention and rehabilitation after surgery.
Surgical intervention is currently the only and most promising method of treating aneurysm. Treatment with special drugs is used only to stabilize the patient or in a situation where surgery is contraindicated or not possible at all.
Chemical drugs cannot eliminate an aneurysm; they only reduce the likelihood of vessel rupture by eliminating critical factors. Some medications are included in a complex of general therapy, which is aimed primarily at alleviating the symptoms of the initial pathology in patients. What vitamins and medications are taken for cerebral aneurysm?
Calcium channel blockers
The main representative of the nimodipine group. The chemical drug reliably blocks calcium channels in the muscle cells of the vascular walls. The vessels dilate. Blood circulation in the cerebral arteries is significantly improved. These drugs are simply irreplaceable in the prevention of dangerous arterial spasms.
Antacids
The principle of action is based on blocking H2 histamine receptors in the stomach. As a result, its acidity decreases and the secretion of gastric juice is significantly reduced. This group includes Ranitidine.
Anticonvulsants
Today, Fosphenytoin is the main representative of this group. The drugs cause reliable stabilization of membranes in nerve cells. Pathological nerve impulses noticeably slow down and do not spread.
Antiemetic drugs
Prochlorperazine is mainly used. The gag reflex is reduced by blocking postsynaptic dopamine receptors in the mesolimbic region of the brain.
Painkillers
Morphine is very effective for pain relief. The level of pain is reduced as a result of the effect on specific opioid receptors.
Antihypertensive drugs
Recently, three main drugs have been used: labetalol, captopril, hydralazine. Due to the effect on enzymes and receptors, the overall tone of the arteries is reduced and rupture is prevented.
Folk remedies
Aneurysm of cerebral vessels. Are folk remedies used?
A brain aneurysm is one of those physiological disorders for which drug treatment alone will not be enough. The same can be said about folk remedies. However, drugs used in folk medicine can affect blood flow inside the cerebral arteries. In many cases, this will be enough to reduce the risks associated with hemorrhagic stroke and aneurysm rupture.
The main condition for the use of traditional methods
Traditional methods are applicable only when they are approved by a doctor. Cerebral aneurysms are treated with folk remedies only after an examination and determination of the degree of development of the dangerous disease.
Before you begin treating an aneurysm with traditional medicine, you need to decide what effect the drugs used have on the body and whether they cause allergic reactions.
Keeping in mind the high risk of complications, experts recommend giving preference to medications. Treatment of cerebral aneurysm with folk remedies is only permissible when the doctor has given the green light to the use of alternative medicine.
5 recipes that can reduce risks
The first thing that treatment with folk remedies should provide is a decrease in blood pressure. The 5 recipes offered are tested not only by time, but also by laboratory testing. It has been proven that they have a positive effect on the cardiovascular system and at the same time strengthen the body, saturating it with necessary substances, which helps curb the disease and make it less dangerous.
The most effective methods include:
- Blackcurrant decoction. Dry berries are used to prepare this product. Take 100 grams and add a liter of hot boiled water. Make a quiet fire on which the berries simmer for 10 minutes. The strained and cooled product is taken in 50 g. three times during the day.
- Beetroot juice mixed with honey in equal proportions. Take 3 tablespoons three times a day.
- Potato peel decoction. The potatoes are boiled unpeeled, and then the drained liquid is drunk. It is also beneficial to eat boiled potatoes unpeeled.
- The jaundice is poured with boiling water and infused. Take 2 tablespoons per glass of water. Take one tablespoon 4 or 5 times a day.
- Corn flour. A tablespoon of flour is mixed with a glass of boiling water and left overnight. In the morning, you need to drink the expressed liquid on an empty stomach.
There are other methods worth considering. The choice must be made by a specialist. Without his approval, you should not resort to folk remedies.
The information is for reference only and is not a guide to action. Do not self-medicate. At the first symptoms of the disease, consult a doctor.
They represent a limited intracranial protrusion of the vascular wall. Among all their varieties, saccular ones account for 95-99%.
The pathology is characterized by a progressive change in intracerebral hemodynamics with a redistribution of blood flow in favor of pathological expansion. The disease causes intracerebral hemorrhage and stroke in 23-30% of patients.
A saccular cerebral aneurysm is a spherical vascular protrusion connected to the involved artery through a neck. Inflammatory and degenerative diseases, atherosclerosis, and congenital vascular anomalies predispose to the disease. Women suffer 2-2.5 times more often than men.
Frequency – 23-30 cases per 100,000 population. ICD-10 code: I67.1.
Distinctive features:
- Formed in the area of vascular forks and branches;
- Develop from abnormally developed and underdeveloped vascular segments;
- Single chamber;
- Singles;
- In 97% of cases, the branches of the anterior cerebral basin are affected;
- Rarely exceed 1 cm.
Dimensions:
- Miliary (less than 3 mm) – 15-20%;
- Small (4-15 mm) – 70-78%;
- Large (16-25 mm) - 2-3%;
- Giant (more than 25 mm) - less than 2%.
Localization and differences depending on location
Saccular aneurysms of the brain develop in the following arteries:
In women, the ICA is more often affected, in men - the ACA, PSA.
If you want to learn about the main types of cerebral aneurysms and their classification, we suggest reading about it.
Clinical picture
For sizes less than 3 mm, the flow is hidden. As the diameter increases, a bright clinic appears:
- Local headache, which quickly becomes diffuse, migraine-like;
- Nausea and repeated vomiting that do not bring relief;
- Episodes of loss of consciousness;
- Convulsive attacks;
- Impaired sensitivity and motor functions;
- Short-term fever for no apparent reason;
- Gradual changes in personality traits.
When a rupture occurs, the following manifestations occur:
- Increased blood pressure;
- Persistent fever;
- Paralysis;
- Psychomotor agitation or loss of consciousness;
- Coma.
Possible risks and complications
The risk of rupture in the first three years from the moment of formation is 45-50%. Aggravating factors: smoking, hypertension, female gender, pregnancy.
Complications:
- Intracerebral or;
- Hydrocephalus;
- Brain swelling;
- Displacement of brain structures (dislocation syndrome);
- Intraventricular hemorrhage;
- Death.
In the first 14 days after rupture, the risk of rebleeding is 87%.
Measures to prevent complications:
- Maintaining blood pressure no higher than 140 per 90 mmHg;
- Salt intake up to 3 g per day;
- Control of blood sugar and lipid levels;
- Taking statins, beta blockers, ACE inhibitors (according to indications);
- Rejection of bad habits.
Diagnostics
The diagnosis is made on the basis of complaints, clinical picture and data from laboratory and instrumental studies. Algorithm:
- Complaints. Headaches, fever, hypertension, fainting, decreased memory and attention, impaired sensory and motor functions. History of arterial hypertension, trauma, diabetes mellitus.
- Inspection. Dilated pupils without reaction to light. Hyperemia of the face and neck, forced sitting position with head thrown back. There may be no external changes.
- Objective research is not effective. When meningitis occurs (5-12% of patients), local pain in the meningeal points and stiffness of the neck muscles are detected.
- Laboratory research. Hemorrhagic component in the cerebrospinal fluid; during spinal cord puncture, the cerebrospinal fluid flows under pressure.
- Cerebral angiography. Limited accumulation (depot) of contrast in the area of protrusion, defects in the contour of the vascular wall.
- CT scan of the brain allows you to determine the type and size of the aneurysm, vascular spasm, and the focus of cerebral ischemia. In case of complications - hemorrhagic impregnation and compression of brain structures, destruction of bone tissue.
- MRI. Foci of intracerebral hemorrhage and ischemia, thrombus formation, spasm of the artery distal to the dilatation, hydrocephalus.
- EEG. Absence of alpha waves, appearance of delta and theta waves.
- Transcranial Dopplerography. The Lindengaard index (the ratio of blood flow velocity in the internal carotid and middle cerebral arteries) is more than 6.
Therapy tactics
The choice of treatment method for saccular cerebral aneurysm is based on complaints, the patient’s well-being and the characteristics of the formation. If the diameter is less than 3 mm and there is no clinical picture, dynamic observation is indicated:
- CT or angiography to monitor progression;
- Treatment of hypertension;
- Consultations with a neurosurgeon 2 times a year.
If the size increases and complaints appear, surgical treatment is indicated, which can be open or endovascular.
Indications for open intervention:
- Risk of bleeding;
- Hydrocephalus;
- Brain swelling;
- Compression of brain tissue by hematoma;
- Ventricular hemorrhage;
- Spasm and decreased blood flow in the affected artery;
- Displacement of brain structures;
- Size more than 1 cm;
- Hypertension;
- Episodes of loss of consciousness.
Indications for endovascular treatment:
- Old age (over 75 years);
- Damage to the vertebral artery;
- No threat of complications.
The operation includes turning off the enlarged area from the bloodstream, if present, removing a blood clot, and in case of hydrocephalus, installing a drainage for the outflow of cerebrospinal fluid.
Prognosis and life expectancy
With miliary aneurysms, the prognosis is favorable - they are characterized by an asymptomatic course and rapid calcification of the formation. In other cases, with timely treatment, the prognosis is relatively favorable.
Without treatment, the prognosis is unfavorable - mortality is 20-30%, disability occurs in 20% of patients.
When the aneurysm is removed from the bloodstream, the symptoms disappear within 6-12 months after the intervention. With the restoration of motor, sensory and cognitive functions, the quality of life is not changed. Life expectancy is determined by blood pressure levels, the risk of relapse and the presence of concomitant diseases. Mortality from re-rupture reaches 50%.
Cerebral aneurysms are a common complication of hypertension and congenital vascular anomalies. A neurologist, a neurosurgeon and instrumental diagnostic doctors are involved in identifying pathology. Treatment is surgical and carried out in specialized microsurgical hospitals. The outcome of the disease depends on the patient’s age, location and size of the formation.
Thank you
The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!
What is a cerebral aneurysm?
Cerebral aneurysm is a most dangerous pathology, and in case of untimely diagnosis and treatment, it is associated with a high mortality rate or disability of the patient. An aneurysm is an abnormal dilation of one or more blood vessels in the brain. That is, it is a kind of protrusion of the walls of blood vessels, located in one of the areas in the brain and having a nature either congenital or acquired. As an aneurysm forms, it damages the walls of blood vessels (in most cases, arteries). Therefore, there is a high probability of rupture, which entails the development of intracranial hemorrhages. These hemorrhages, in turn, can cause neurological damage and, in severe cases, be fatal. The incidence of cerebral aneurysm is very difficult to estimate. The reason for this is the difficulty of diagnosing this disease, as well as the peculiarities of its clinical course and symptoms. However, relying on various clinical and statistical data, it can be argued that cerebral aneurysms occur in 10 - 12 patients out of 100 thousand people. Data from morphopathological examinations (autopsies) show that almost 50% of aneurysms that did not rupture were discovered completely by accident, since they did not cause any symptoms.
The main threat posed by a cerebral aneurysm is the high probability of rupture, leading to intracranial bleeding (hemorrhage in the subarachnoid space or subarachnoid hemorrhage), requiring emergency medical attention. Statistics from foreign hospitals show that 10% of patients with subarachnoid hemorrhage die almost instantly, eliminating the possibility of medical intervention. Approximately 25% of such patients die in the first day, and another 40 - 49% die in the first 3 months. Thus, the probability of death from a ruptured aneurysm is approximately 65%, with a predominance of death during the first few hours/days after rupture.
In modern medicine, the only and most effective treatment for aneurysm of blood vessels in the brain is surgical intervention, however, despite progressive neurosurgery and the accelerated development of medicine these days, it does not exclude death. It is worth noting that the probability of death from sudden rupture of an aneurysm is almost 2 - 2.5 times higher than the risks associated with surgery.
Statistically, the highest frequency of cerebral aneurysms (about 20 cases per 100 thousand population) occurs in Japan and Finland. Cerebral aneurysm is almost 1.5 times more likely to be found in women. Also, giant aneurysms predominate among women compared to men (they occur approximately three times more often). Such formations pose a particular danger to pregnant women.
Causes of cerebral aneurysm
The very formation of an aneurysm in any vessel is almost always a consequence of a violation of the normal structure of the vascular wall. In the case of arteries, the wall consists of three main layers. Damage to at least one of them leads to a local loss of tissue strength. Since the brain is supplied with blood from the carotid artery, the blood pressure here is quite high. The brain substance consumes a lot of energy in the process of life and is constantly in need of nutrients. This may explain the fact that aneurysms in general form more often in the arteries of the aorta (at different levels) or the brain. It is in these vessels that the pressure is quite high. The artery wall consists of the following membranes:
- Intimacy. This shell lines the inner surface of the vessel. It is very thin and sensitive to various damages. These damages are most often not mechanical in nature. They can be caused by toxins, antibodies, or infections that come into contact with intimal cells. The function of this membrane is to ensure normal blood flow (without turbulence and the formation of blood clots).
- Media. The middle layer determines the elasticity of the vessel. It contains muscle cells that can cause the artery to narrow or widen. This significantly regulates blood pressure (as the vessel narrows, it increases). This shell is rarely damaged first. More often, pathological processes from the intima spread to it.
- Adventitia. The outer shell of the vessel is the most durable. There are many fibers and connective tissue cells located here. When this membrane is damaged, the underlying membranes almost always bulge, forming an aneurysmal sac.
Is cerebral aneurysm inherited?
Cerebral aneurysm itself is not a separate disease that can be inherited. However, there is a certain predisposition to its occurrence in blood relatives. However, it is associated with the transmission of structural abnormalities or other genetic diseases that, under certain conditions, will lead to the formation of an aneurysm.The transmission of any defect or disease by inheritance occurs as follows. All structural substances that form body tissues are encoded by a set of genes in DNA molecules. Blood relatives have many of the same genes. Accordingly, the likelihood of having any defective genes is increased. For example, there are genes responsible for the substance of connective tissue (cells, proteins, connective tissue fibers, etc.). Defects in this gene lead to the fact that a person’s connective tissue is not so strong, which means that the vascular wall is more easily stretched under blood pressure. Defects in other genes can cause other disorders.
In general, we can say that a predisposition to the following diseases can be inherited:
- hypertonic disease;
- atherosclerosis;
- genetic diseases associated with connective tissue (Marfan syndrome, etc.);
- some autoimmune diseases (systemic lupus erythematosus).
Types of cerebral aneurysm
In medicine, in principle, there is a fairly broad classification of vascular aneurysms. It is also applicable to cerebral aneurysms, although this case has its own characteristics. Such an aneurysm can be classified according to a number of criteria, including location, shape, age of occurrence, etc. When making a diagnosis, doctors try to cover as wide a range of criteria as possible. This helps to more accurately select treatment and make a more detailed prognosis. Based on their shape, cerebral aneurysms are divided into the following types:
- Saccular (sac-like) aneurysm. It is the most common type, if only cerebral aneurysms are taken into account. Its features will be described below.
- Fusiform aneurysm. It is a common form when located on the aorta, but on the vessels of the brain it is much less common. In shape it resembles a cylinder and represents a relatively uniform expansion of the walls of the vessel with an increase in its diameter.
- Dissecting aneurysm. Also less common in the brain. The shape is a longitudinal cavity in the wall of the vessel. It forms between the layers of the wall if the latter are not tightly connected due to pathological processes. The mechanism of dissection is the formation of a small defect in the intima. Blood flows here under pressure, which causes separation and cavity formation. However, in the vessels of the brain, the blood pressure is not as high as, for example, in the aorta, so this type of aneurysm is rare here.
Cerebral aneurysms are divided by size as follows:
- small aneurysms – up to 11 mm in diameter;
- medium – up to 25 mm;
- large - more than 25 mm.
Aneurysms can be located on the following vessels:
- anterior cerebral artery;
- posterior cerebral artery;
- middle cerebral artery;
- basilar artery;
- superior and inferior cerebellar arteries.
Also, when formulating a diagnosis, it is necessary to note the number of aneurysms in the vessels of the brain. In most cases these are single formations. But after serious traumatic brain injuries or large-scale operations, several aneurysms may appear in the cranial cavity. If the patient suffers from diseases that weaken connective tissue, then there can be many aneurysms. Moreover, in this case, the simultaneous presence of aneurysms of the cerebral and aortic vessels (sometimes of other vessels) is often observed. Of course, multiple aneurysms are much more dangerous, since blood circulates worse through the affected vessels, and the risk of rupture increases many times over.
Saccular aneurysm of cerebral vessels
The saccular form is the most common for cerebral aneurysms. This defect is usually formed due to local (point) damage to one of the layers of the vessel wall. Loss of strength leads to the wall beginning to bulge outward. A kind of blood sac is formed. The diameter of its mouth is equal to the size of the wall defect, and the bottom can be wider. This is an asymmetrical lesion of the vessel.Saccular aneurysms can cause the following local disorders:
- turbulence in the blood flow, as part of the blood enters the sac;
- a slowdown in blood flow, due to which the areas of the artery behind the aneurysm may be less well supplied with blood;
- the threat of developing blood clots, because turbulence inside the sac often activates blood clotting factors;
- overstretching of the walls of the aneurysm with an increased risk of rupture;
- compression of the brain substance with severe bulging of the wall.
False cerebral aneurysm
Most often in medical practice, true vascular aneurysms occur. In this case, we are talking about a loss of tissue strength, due to which all the membranes of the vessel can bulge. A hernial protrusion is also often encountered, in which one or two membranes seem to tear due to a pathological process, and the remaining ones bulge into the lumen, forming an aneurysm. False aneurysms are very rare and have a slightly different structure.In fact, a false aneurysm is not a bulging of the vessel wall, but its rupture. Due to a small through defect in the wall, blood leaves the vascular bed and accumulates nearby in the form of a hematoma. If the vessel defect does not heal and the blood does not spread, a limited cavity is formed in the tissues, which is connected to the lumen of the artery. At the same time, blood can flow into it, and the pressure in it changes. An aneurysm appears, which, however, does not have walls made of stretched vessel membranes. Such false aneurysms are sometimes also called pulsatile hematomas.
The main problem is the high risk of heavy bleeding, since there is already a small defect in the vessel wall. Symptoms of false aneurysms can resemble both the symptoms of true cerebral aneurysms and the symptoms of hemorrhagic stroke. It is very difficult to distinguish such an aneurysm from a normal one at an early stage, even with the help of modern diagnostic methods.
Congenital cerebral aneurysms
By congenital vascular aneurysms we mean those that already exist at the time of birth of the child. They are formed in the prenatal period and, as a rule, do not disappear on their own after birth. Congenital aneurysms have slightly different causes than ordinary aneurysms formed during life. Congenital aneurysms should not be confused with aneurysms formed due to congenital diseases. The second case implies that there is some pathology (often a genetic defect) that increases the risk of aneurysm formation during life. In practice, however, these pathologies can lead to changes in the structure of blood vessels even in the prenatal period.The development of a cerebral aneurysm in a fetus can be caused by the following reasons:
- some infections (usually viral) that the mother suffered from during pregnancy;
- genetic diseases that weaken connective tissue;
- any toxins entering the mother’s body during pregnancy;
- chronic diseases of the mother;
- ionizing radiation that affected the mother’s body during pregnancy.
The prognosis for children born with a cerebral aneurysm varies from case to case. If this is a single pathology and no other developmental defects are observed, then the prognosis is often favorable. Aneurysms are usually true, and their walls are quite strong. Thanks to this, the risk of rupture is not so great. However, children require constant attention and regular monitoring by a neurologist. In some cases, their presence can affect the mental or physical development of the child. In severe cases, congenital aneurysms reach large sizes and may even be incompatible with life.
Symptoms and signs of cerebral aneurysm
In most cases, cerebral aneurysms do not cause any symptoms for a very long time. This is due to the fact that the arteries inside the skull are quite small, and aneurysms themselves rarely reach large sizes. They exert insignificant pressure on neighboring tissues, and it is not enough to seriously interrupt the transmission of nerve impulses and disrupt the functioning of any parts of the brain. But there are also very difficult cases. Cerebral aneurysms can cause severe symptoms in the following cases:
- with a significant size of the aneurysm, it still compresses neighboring tissues quite strongly, disrupting the transmission of nerve impulses;
- when an aneurysm is localized in particularly important parts of the brain, even small formations can lead to tragic consequences;
- non-compliance with preventive measures (heavy physical activity, stress, sharp increase in blood pressure, etc.) leads to an increase in the aneurysm or even its rupture;
- the presence of concomitant chronic pathologies (hypertension, etc.);
- the presence of a concomitant arteriovenous anastomosis (malformation) leads to a mixing of arterial and venous blood, which impairs the supply of oxygen to nerve cells.
Cerebral artery aneurysms can cause the following symptoms:
- Headache. Headaches are one of the common symptoms of cerebral aneurysm. They can have varying durations and most often appear in the form of attacks (sometimes due to increased blood pressure). The localization of pain varies and depends on which part of the brain the aneurysm is located. With deep-lying aneurysms, the pain is less intense, since the brain itself does not have pain receptors. At the same time, superficial aneurysms that compress the meninges can cause very severe pain. Sometimes people with an aneurysm suffer from severe migraine attacks, which go away after surgery.
- Sleep disorders. The location of an aneurysm in the area responsible for sleep control can cause insomnia or, conversely, drowsiness. Problems with sleep cannot be excluded in other localizations. Then this will be associated with deteriorated blood supply to certain parts of the brain.
- Nausea. Nausea and vomiting often occur when the meninges are irritated. In these cases, we are more likely talking about superficially located aneurysms. Also, large formations can increase intracranial pressure, one of the manifestations of which is dizziness and nausea. A distinctive feature of this symptom with an aneurysm of a vessel in the brain is that nausea usually does not go away even after taking medications. Unlike poisoning, when the smooth muscles of the gastrointestinal tract (GIT) are affected, here we are talking about irritation of a specific center in the brain. Vomiting can be very severe and completely unrelated to food intake.
- Meningeal symptoms. Meningeal symptoms are understood as a set of signs indicating irritation of the meninges. They usually appear with superficial aneurysms or large aneurysms. Such symptoms include tension in the neck muscles (even at rest), the inability to bend the head forward so as to touch the chin to the chest. A healthy person also sometimes cannot perform this action, but the patient experiences sharp pain. There are also Kernig and Brudzinski signs, based on flexion of the legs at the hip or knee joint. A patient with irritation of the meninges cannot perform the necessary movements, and pain occurs when trying.
- Cramps. Cramps are uncontrolled contractions of skeletal muscles. In this case, they are caused by compression of the superficial parts of the brain (usually the cerebral cortex). This symptom indicates serious disorders and appears, as a rule, with large aneurysms. Convulsions are dangerous in themselves, as they can cause respiratory arrest. Frequent seizures associated with aneurysms may be similar to those associated with epilepsy. Only a neurologist can distinguish them after a thorough examination.
- Sensory disturbances. Depending on the location of the aneurysm in the brain, various structures responsible for sensitivity may be compressed. In this case, tactile (skin) sensitivity may be lost in certain areas. Visual and hearing disturbances may also occur. Coordination of movements also suffers, since it partly depends on sensory receptors in the joints themselves. In other words, a person may no longer normally determine the position of his body in space. There are other, more rare variants of sensitivity disorders.
- Movement disorders. Such disorders primarily include paralysis, in which a person loses the ability to control one or another muscle group. They can occur when an aneurysm ruptures (stroke) or very large aneurysms.
- Disorders of cranial nerve function. 12 pairs of cranial nerves control some types of sensitivity and, to some extent, the movements of small muscles. If their functions are impaired, eyelid drooping (ptosis), asymmetry of the facial muscles, hoarseness, etc. may occur.
What is the clinical picture of a cerebral aneurysm?
The concept of clinic in this case means the course of the disease over time, the appearance or disappearance of symptoms, as well as changes in the general condition of the patient. This refers to all manifestations of the disease that appear externally, without hardware or laboratory research methods. Thus, the clinical picture as such does not appear in all aneurysms. Small formations located in relatively “safe” areas of the brain may not cause any symptoms at all.The clinical course of aneurysms can be very diverse. This depends on the position of the aneurysm, its size, as well as the reasons that caused its appearance. Some aneurysms appear and grow so quickly that they lead to rupture and hemorrhagic stroke within the first few days. The clinical picture, in principle, can appear already at the rupture.
Other aneurysms appear and grow slowly. Then a person may first experience headaches, fatigue, and problems sleeping. In some cases, the first symptoms are a decrease in hearing acuity, vision, deterioration in sensitivity or coordination of movements. In later stages, the pain intensifies and the primary disorders worsen.
Multiple cerebral aneurysms
With a number of hereditary diseases affecting the connective tissue of the body, a patient may develop several aneurysms during his life. This phenomenon is sometimes called multiple aneurysms. However, it is not at all necessary that all these aneurysms are located only in the vessels of the brain. It is possible, for example, their combination with an aortic aneurysm (or aneurysms).In such cases, cerebral circulation suffers even more. Blood enters the cerebral arteries from the branches of the aortic arch. Wherever aneurysms are located, they will seriously impair the flow of blood to the nerve tissue. This explains the fact that various symptoms and manifestations of the disease appear much more often in people with multiple aneurysms.
heart defects, as well as vision problems due to subluxation of the lens. Patients with various rheumatological diseases often complain of associated joint pain.
Cerebral aneurysm in children
Aneurysms in children are generally not that common. This is due to the fact that it usually takes time for a defect in the vascular wall to form. For example, in atherosclerosis, damage is preceded by a long-term accumulation of cholesterol, which circulates in the blood. Such disorders are rare in childhood, and aneurysms simply cannot form. However, they still occur at any age. In newborns and preschool children, these are usually congenital vascular defects. They appear due to the fact that the mother’s body was affected by some unfavorable factors during pregnancy. It is also possible for aneurysms to form in early childhood with congenital syphilis (acquired in utero from a sick mother).In children, cerebral aneurysms most often manifest as follows:
- constant anxiety of the child;
- sleep disorders;
- seizures;
- retardation in mental (less often physical) development;
- specific neurological symptoms (lack of reflexes that should be present at a given age).
Pregnancy with cerebral aneurysm
As noted above, the greatest danger in the presence of an aneurysm in the brain is its rupture. Pregnancy in this case can be considered as an additional risk factor that increases the likelihood of stroke. This is due to the fact that during pregnancy a variety of changes occur in a woman’s body. Partly they relate to hormonal levels and the functioning of the cardiovascular system. Usually there is fluid retention in the body and an increase in the volume of circulating blood. Accordingly, pressure in the vessels (including in the vessels of the brain) can increase, stretching the walls of the aneurysm.Thus, for some women, symptoms of an aneurysm may first appear during pregnancy. Before this, while the formation was smaller, it did not bother the patient. But stretching the walls sometimes leads to compression of the brain tissue and the appearance of neurological symptoms. In general, the manifestations of the disease will not differ much from the manifestations in other patients listed above.
Due to the increased risk of rupture and other complications, patients with obvious neurological symptoms that appear during pregnancy should urgently undergo a series of diagnostic procedures. If cerebral aneurysms are detected, drug treatment should be started immediately, which will reduce the pressure in the vessels and strengthen the wall. Any surgical procedures are usually not performed due to severe stress and the possibility of harming the unborn child. Radical treatment (removal of an aneurysm, etc.) is postponed until the postpartum period. But in severe cases, when the risk of stroke is obvious, treatment is necessary. Thus, such patients should be managed by an experienced doctor who can correctly assess the risk for the mother and child and choose the optimal treatment tactics. Self-medication by any method is strictly contraindicated for such women.
Before use, you should consult a specialist.Aneurysm of cerebral vessels (intracranial aneurysm, cerebral aneurysm) is a protrusion of the arterial wall caused by a violation of its normal three-layer structure. Aneurysm of cerebral vessels is localized mainly in the areas where arteries branch.
According to experts, this pathology is very common (approximately 5% of the population has it), but since in most cases it is asymptomatic, it remains undiagnosed or is discovered in the patient during an examination carried out for other reasons.
The main danger of a cerebral aneurysm is that it can rupture. This results in non-traumatic subarachnoid hemorrhage. Most often, rupture of an intracranial aneurysm occurs in people aged 40 to 60 years.
Protrusion of the arterial wall of a cerebral vessel
Causes and risk factors
To date, there is no single theory explaining the formation of this vascular pathology. Most researchers believe that cerebral aneurysm is a multifactorial pathology. Changes in the structure of the walls of blood vessels can lead to:
- atherosclerosis;
- hyalinosis;
- exposure to ionizing radiation;
- hereditary predisposition;
- inflammation of the vascular wall of a bacterial or mycotic nature;
- traumatic vascular injuries.
In addition to those listed, there are factors that directly influence the development of an aneurysm, and then provoke the rupture of its sac. These include:
- arterial hypertension;
- uneven blood flow, in which the movement of blood through the vessel becomes turbulent rather than laminar.
Forms of the disease
Depending on the size of the protrusion of the artery wall, cerebral aneurysms are of the following types:
- miliary (less than 3 mm);
- small (from 4 to 10 mm);
- medium (from 11 to 15 mm);
- large (from 16 to 25 mm);
- giant (from 26 mm or more).
According to the location of the aneurysm, they are divided as follows:
- aneurysms of the vertebrobasilar system;
- aneurysms of the internal carotid artery;
- middle cerebral artery aneurysm;
- aneurysm of the anterior cerebral artery.
In approximately 15% of cases, patients have several aneurysms simultaneously located on different arteries.
Depending on the shape, cerebral aneurysms can be fusiform or saccular. The second form is approximately 50 times more common than the first.
Stages of the disease
Depending on the characteristics of the clinical picture, three stages of cerebral aneurysm are distinguished:
- Asymptomatic.
- Unruptured (tumor-like).
- Bursting (apoplectic).
Symptoms
As mentioned above, in most cases, intracranial aneurysms are asymptomatic. But sometimes the bulging arterial wall puts pressure on certain brain structures, leading to brain symptoms. This course of the disease is called tumor-like. Most often, tumor-like aneurysms are localized in the cavernous sinus and the area of the chiasm (optic chiasm).
Cerebral aneurysm is a very common pathology, but since it is often asymptomatic, it remains undiagnosed or is diagnosed accidentally.
If a cerebral aneurysm is located in the chiasm area, the following are noted:
- narrowing of visual fields;
- deterioration of visual acuity;
- optic nerve atrophy.
Symptoms of an aneurysm localized in the cavernous sinus:
- oculomotor disorders (strabismus, convergence disorder);
- trigeminal neuralgia.
With a long-standing cerebral aneurysm, the process of destruction of the skull bones can begin.
When an aneurysm ruptures, bleeding occurs into the subarachnoid space, ventricles, or the brain itself. In this case, the disease takes on an apoplectic character.
When a cerebral aneurysm ruptures, about 15% of patients die in the prehospital stage.
The main signs of a ruptured cerebral aneurysm:
- sharp intense headache;
- nausea;
- repeated vomiting;
- stiff neck;
- hyperesthesia;
- the appearance of meningeal symptoms (Kernig, Brudzinsky);
- disturbances of consciousness;
- mental disorders;
- epileptiform seizures.
Diagnostics
When asymptomatic, cerebral aneurysms usually become incidental diagnostic findings discovered during examination of a patient for another reason. When clinical symptoms appear, a cerebral aneurysm is diagnosed based on the existing neurological symptoms, as well as data from instrumental studies, which include:
- radiography of the skull;
- computer or magnetic resonance imaging of the brain;
- X-ray or magnetic resonance angiography.
The detection of blood in the cerebrospinal fluid obtained during a lumbar puncture confirms the rupture of a cerebral aneurysm.
Tumor-like forms of cerebral aneurysm require differential diagnosis with space-occupying processes in the brain (abscess, cyst, tumor). In the apoplectic form of the disease, differential diagnosis is carried out with meningitis, ischemic stroke, transient cerebrovascular accident, and an attack of epilepsy.
Treatment
Patients with small cerebral aneurysms should be under constant medical supervision to monitor the size of the protrusion of the arterial wall and the course of the disease. Surgical treatment is not indicated at this stage. If necessary, conservative therapy is carried out aimed at preventing the enlargement of the aneurysm. For this purpose, antiarrhythmic, antihypertensive, antibacterial drugs, statins to lower cholesterol levels and other drugs according to indications are prescribed.
Surgical treatment of a cerebral aneurysm can prevent its possible rupture. The main methods of surgical intervention in this case are:
- endovascular occlusion;
- clipping of the neck of the protrusion;
- artificial thrombosis;
- stereotactic electrocoagulation.
Rupture of a cerebral aneurysm is an urgent condition that requires urgent specialized medical care. Conservative therapy is carried out, similar to therapy for hemorrhagic stroke. If indicated, surgery is performed to remove the hematoma. If there is bleeding into the ventricular cavity, it is drained.
Possible complications and consequences
Intracerebral hemorrhage, which occurs when a cerebral aneurysm ruptures, can be fatal. If they survive, patients require lengthy and expensive rehabilitation. At the same time, 25% of patients remain with persistent disabling consequences.
The main danger of a cerebral aneurysm is that it can rupture. This results in non-traumatic subarachnoid hemorrhage.
Forecast
Small-sized cerebral aneurysms in the absence of growth can exist throughout the patient’s life without clinical manifestation.
When a cerebral aneurysm ruptures, about 15% of patients die in the prehospital stage. Every second patient with a ruptured intracranial aneurysm dies within the first month of the disease. 50% of survivors experience neurological disorders of varying severity.
Prevention
Prevention of cerebral aneurysms should be based on eliminating risk factors that contribute to damage to the vascular wall. Here's what it consists of:
- cessation of smoking and alcohol abuse;
- normalization of body weight;
- blood pressure control;
- proper nutrition with the obligatory inclusion in the diet of foods rich in polyunsaturated fatty acids;
- moderate exercise;
- timely detection and treatment of diseases.
Video from YouTube on the topic of the article:
A cerebral aneurysm (also called an intracranial aneurysm) appears as a small abnormal formation in the blood vessels of the brain. This compaction can actively increase due to filling with blood. Until it ruptures, such a bulge is not dangerous or harmful. It only exerts slight pressure on the organ tissue.
When an aneurysm ruptures, blood enters the brain tissue. This process is called hemorrhage. Not all aneurysms can be complicated by hemorrhage, but only some types. In addition, if the pathological bulge is quite small in size, then it usually does not cause any harm.
Aneurysms can occur anywhere in the blood vessels that supply the brain. The age of a person does not matter. But it is still worth noting that middle-aged and older people are most often susceptible to the disease; children are diagnosed very rarely. Doctors note that neoplasms in the brain vessels appear less often in men than in the fair sex. People between thirty and sixty years of age are often at risk.
The rupture of a cerebral aneurysm becomes “fertile ground” for strokes, central nervous system damage, or more dire consequences. It is noteworthy that after one rupture such a pathological formation can appear and burst again.
Etiology
Today, scientists have not fully elucidated the factors responsible for the appearance of aneurysms in the vessels of the brain. But almost all “bright minds” agree that the occurrence factors can be:
- natural - which include genetic abnormalities in the formation of vascular fibers in the brain and other abnormal processes that can weaken the walls of blood vessels. All this can lead to the emergence of neoplasms;
- acquired. There are many such factors. These are mainly traumatic brain injuries. Aneurysms often occur after severe infections or diseases that have adversely affected the condition of the walls of blood vessels supplying the brain.
Many clinicians are confident that the most common cause of cerebral aneurysm is heredity.
Rarely, the causes of formation in the vessels of the brain can be:
- head injury;
- increased blood pressure;
- infections or tumors;
- accumulation of cholesterol on the walls of brain vessels;
- addiction to nicotine;
- disordered drug use;
- human exposure.
Varieties
There are several types of cerebral aneurysms, which can differ due to many factors.
They are in form:
- baggy. As its name suggests, it looks like a small sac filled with blood that is attached to an artery in the brain. The most common type of aneurysm in adults. It can be single-chamber or may consist of several chambers;
- lateral. It is a tumor localized directly on the wall of the vessel;
- fusiform. It occurs due to the expansion of the vessel wall in a certain area.
According to the size of the aneurysm, there are:
- miliary - do not reach three millimeters;
- small - up to ten millimeters;
- medium size - up to fifteen millimeters;
- large - from sixteen to twenty-five millimeters;
- very large - more than twenty-five millimeters.
Aneurysms are classified according to the location of their occurrence:
- anterior cerebral artery;
- middle cerebral artery;
- inside the carotid artery;
- vertebrobasilar system.
Symptoms
Small-volume cerebral aneurysms appear and proceed without symptoms. But this is exactly until the formation begins to increase in size and put pressure on the vessels (until it completely ruptures). Medium-sized aneurysms (those that do not change in size) are not painful or cause significant symptoms. Large formations that are constantly growing put a lot of pressure on the tissues and nerves of the brain, which provokes the manifestation of a vivid clinical picture.
But the most striking symptoms appear with a large aneurysm of cerebral vessels (regardless of the location of the formation). Symptoms:
- painful sensations in the eyes;
- decreased vision;
- numbness of the face;
- hearing loss;
- enlargement of only one pupil;
- immobility of the facial muscles, not all of them, but on one side;
- headache;
- convulsions (with giant aneurysms).
Symptoms that often precede a rupture:
- double vision when looking at objects or people;
- severe dizziness;
- noise in ears;
- speech impairment;
- decreased sensitivity and weakness.
Symptoms indicating that hemorrhage has occurred:
- sharp intense pain in the head that cannot be tolerated;
- increased perception of light and noise;
- the muscles of the limb on one side of the body are paralyzed;
- change in mental state (anxiety, restlessness, etc.);
- decreased or complete loss of coordination of movements;
- disruption of the process of urination;
- coma (only in severe form).
Complications
In many cases, an aneurysm may not manifest itself and a person lives with it for many years, without even knowing about its presence. It is also impossible to know the exact time when the aneurysm will rupture, so complications from its destruction can be serious.
Lethal outcome is observed in almost half of clinical cases if hemorrhage occurs. About a quarter of those who have an aneurysm become disabled for life. And only a fifth of people who have suffered a ruptured aneurysm may remain able to work. Complications of an aneurysm are as follows:
- irreversible brain damage;
- speech and movement disorders;
- may appear ;
- reduction or cessation of blood supply to certain areas of the brain, which will lead to ischemia of its tissues;
- constant aggressive state of the patient.
Diagnostics
Very rarely, more often in the case of a routine examination or diagnosis of other diseases, it is possible to detect such a tumor before it ruptures. Diagnostic measures are often used after aneurysm rupture. Diagnostic methods:
- angiography - X-ray with contrast, allows you to see the entire brain in the image, and thereby see where the formation is localized;
- – determines in which part of the brain the rupture occurred and the number of affected tissues and vessels;
- CT angiography is a combination of the two above methods;
- – shows a more accurate picture of the vessels;
- the collection of fluid located between the spinal cord and the membranes that surround it.
In addition to the hardware examination, a detailed survey of the patient is carried out to clarify the main symptoms, concerns of the person himself, the presence of additional injuries or diseases, etc. After which the doctor will conduct a full examination of the patient and refer him for tests.
Treatment
Nowadays, the most effective method of treating an aneurysm is surgical intervention. Drug therapy is carried out only for prevention and stabilization of the patient, because pharmaceutical drugs will not destroy the aneurysm, but will only reduce the risk of its rupture.
In modern medicine, there are several operations aimed at removing an aneurysm from the brain.
Surgical treatment methods:
- craniotomy and clipping of cerebral aneurysm. The intervention consists of opening the skull and installing a clamp on the neck of the formation, which will keep the formation intact and prevent it from bursting. After applying the clamp, the aneurysm dies and is replaced with repair tissue;
- endovascular intervention. It is carried out in the middle of the vessels, so that you can get to the aneurysm from the inside. The operation is carried out under observation using an X-ray machine. When the doctor reaches the place with the aneurysm with a catheter, he inserts a spiral there, which will lead to its death. This method can also be used after aneurysm rupture.
Before the aneurysm ruptures and when it is small, only the patient decides how to treat, whether to undergo surgery or not. The decision should be based only on consultations with a doctor, who will provide detailed information about the possible outcomes of the operation or refusal of it.
Self-medication for cerebral aneurysm is prohibited.
Prevention
Preventive methods to prevent the development of an aneurysm and its rupture come down to the timely removal of this formation. Prevention is aimed at reducing the risk of developing a blood sac in the vessels of the brain. Preventive measures consist of:
- complete cessation of smoking and alcohol;
- blood pressure control;
- permanent physical exercises and loads;
- avoiding traumatic sports;
- periodically undergoing a full examination by a doctor;
- taking medications prescribed by a doctor.
Prevention can be carried out using traditional methods. The most effective means are:
- fresh beet juice;
- honeysuckle tincture;
- potato peel decoction;
- valerian root;
- cornmeal drink;
- blackcurrant decoction;
- infusions of motherwort and immortelle.
You should not carry out prevention only with traditional methods, much less give preference to them. They will only be useful in combination with medications.
To prevent an aneurysm from forming again, you need to follow simple steps:
- monitor blood pressure;
- stick to a diet;
- Check with your doctor regularly and take your prescribed medications.
Loading...