Cerebral Aneurysm- Symptoms, Causes, Diagnosis, and Treatment

What Is a Cerebral Aneurysm?

An aberrant focal dilatation of an artery in the brain caused by a weakening of the inner muscle layer or the intima of the blood vessel wall is known as a cerebral or intracranial aneurysm.

The vessel dilates in a "blister-like" manner, becoming thin and prone to rupture without warning. Some brain aneurysms, especially minor ones, do not bleed or produce significant complications.

Aneurysms of this type are generally discovered during imaging examinations for other medical issues. Aneurysms can form anywhere in the brain, but the majority form in the major arteries that run along the base of the skull. Aneurysms in the brain can happen at any age. They are most common in individuals between the age of 30 and 60, with women having a higher prevalence than men. People who have specific hereditary illnesses are also more vulnerable. All cerebral aneurysms have the potential to burst, causing bleeding in the brain or the surrounding area.

What Are the Symptoms of Cerebral Aneurysm?

It is possible that a brain aneurysm would not be discovered until it bursts. The majority of brain aneurysms are asymptomatic and tiny in size. However, symptoms may appear prior to a rupture as a result of a bit of blood flow. This type of brain hemorrhage is known as "sentinel hemorrhage."

Symptoms of an Unruptured Aneurysm

The majority of brain aneurysms do not cause symptoms until they have grown to a significant size or ruptured. An aneurysm that is constantly expanding in size may push on tissues and nerves, resulting in:

• Numbness.

• Discomfort behind and above the eyes.

• Vision alterations or double vision.

• Dilated pupil.

• Unilateral paralysis of the face.

Symptoms of a Ruptured Aneurysm

A ruptured aneurysm is characterized by the presence of a sudden, intense headache. This headache is frequently referred to as the "worst headache" ever. A ruptured aneurysm shows the following symptoms:

• Vomiting and nausea.

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• Neck stiffness.

• Consciousness loss.

• Seizure.

• Drooping eyelids.

• Confusion.

• Double eyesight or hazy vision.

• Light sensitivity.

• Weakness.

• Cardiac arrest.

Symptoms of a Leaking Aneurysm

An aneurysm can occasionally leak a small amount of blood into the brain, also known as a sentinel bleed. Prior to rupture, however, only a small percentage of people experience a sentinel headache. If one has a sudden, severe headache, especially if it is accompanied by other symptoms, they should seek medical help right away.

What Are the Causes and Risk Factors Associated With Cerebral Aneurysms?

A variety of events can cause artery wall weakening and increase the risk of a brain aneurysm or aneurysm rupture. Some of these risk factors emerge over time, while others are present from the moment one is born.

Risk factors for developing an aneurysm:

Some congenital defects are linked to an increased chance of having a brain aneurysm. These are some of them:

• Ehlers-Danlos syndrome is a genetic disorder of connective tissue which causes the blood vessels to weaken.

• The large blood channel that transports oxygen-rich blood from the heart to the body, the aorta, is narrowed (coarctation of the aorta).

• A polycystic kidney disorder is a hereditary condition that causes fluid-filled sacs in the kidneys and typically raises blood pressure.

• Arteriovenous malformation is a condition in which the arteries and veins in the brain become twisted, obstructing blood flow.

• A relative of first-degree, such as a parent, brother, or sister, has a history of a brain aneurysm.

Factors that increase the risk over time are :

• Aging.

• Smoking.

• High blood pressure.

• Drug abuse such as cocaine.

• Alcoholism.

Risk factors that are not as well-known include infection in the artery wall, head injury, or brain tumor. Risk factors that cause an aneurysm to rupture. All the aneurysms do not burst. Aneurysm rupture can also be influenced by medical disorders. The following are some of the risk factors:

• High blood pressure damages the blood vessels making them more susceptible to rupture.

• Multiple aneurysms in the brain may occur as a result of smoking.

• The aneurysms which are bigger in size are most likely to burst.

• Aneurysms on the posterior communicating arteries and the anterior communicating artery are more likely to rupture.

• A family history of aneurysm rupture.

How Is a Cerebral Aneurysm Diagnosed?

The majority of brain aneurysms go undetected until they rupture or are discovered via medical imaging examinations for another reason. To diagnose brain aneurysms, diagnostic tools used are:

• Computed Tomography (CT) Scan: This quick and painless scan is frequently the first test a doctor conducts to see if blood has leaked into the brain.

• Computed Tomography Angiography (CTA): This technique gives more detailed images of blood flow in the brain arteries. An unruptured or ruptured aneurysm can be measured, located, and shaped using this technique.

• Magnetic Resonance Imaging (MRI): It creates comprehensive images of the brain arteries and can reveal an aneurysm's size, location, and shape.

• Cerebral Angiogram: This imaging approach can detect blockages in the brain or neck arteries. It can also see weak regions in an artery, such as an aneurysm.

What Is the Treatment and Management for a Cerebral Aneurysm?

Small aneurysms that have not ruptured or caused symptoms may not require treatment. However, this is dependent on the health and the severity of the aneurysm.

If you have a brain aneurysm that has not ruptured yet, some lifestyle modifications can help reduce your risk of it leaking or popping.

• Surgery

  • For the treatment of cerebral aneurysms, there are a few surgical treatments. These procedures come with some risks, such as injury to other blood vessels, the possibility of aneurysm recurrence and rebleeding, and stroke risk.

  • Clipping of the microvascular system to halt the aneurysm's blood supply.

  • Coil embolization with platinum, in which a catheter is inserted into an artery and threaded through the aneurysm.

  • Flow diverters are an endovascular therapy option in which a tiny stent is used.

• Medications

  • Anti-seizure medications can help avoid seizures caused by a ruptured aneurysm.

  • Calcium channel blockers can minimize the risk of stroke caused by vasospasm.

• Rehabilitative Therapy

  • Physical, speech and occupational therapy are generally required for those with a subarachnoid hemorrhage to restore lost function.

Conclusion:

A sudden, intense headache that includes or excludes stroke symptoms could indicate a brain aneurysm. A ruptured brain aneurysm is a dangerous, sometimes fatal ailment that necessitates immediate medical attention and treatment. If one has an unruptured brain aneurysm, discuss the risks and advantages of various treatment and management options with the healthcare professional. People can live their lives without realizing they have a brain aneurysm that has not ruptured. The chances are good as long as it is in decent condition.

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