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Cerebral Aneurysm

Cerebral Aneurysms, or brain aneurysms, happen when there is a weak spot in the wall of a blood vessel inside the brain. This weak spot can break open or burst and cause a subarachnoid haemorrhage. This condition is usually caused by the weakened spot in the blood vessel ballooning out until the pressure of the blood inside the blood vessel causes it to break.

There are two kinds of brain aneurysms that can happen. The most common is the Saccular aneurysm, which happens when the bulge in the blood vessel is shaped like a dome. The bulge is connected to the artery by a narrow neck. The other kind of brain aneurysm is a Fusiform aneurysm. This kind of aneurysm does not pouch out in a dome shape and instead makes a widened spot in the blood vessel.

Symptoms

Many brain aneurysms do not cause health problems or symptoms. You might not even know that you have had one. In rare cases, however, these bulges in the blood vessel can break open and cause bleeding in the brain. This is known as a haemorrhagic stroke and requires immediate medical attention. The symptoms of a brain aneurysm are:

  • Intense headache that comes in abruptly
  • Loss of consciousness
  • Nausea and vomiting
  • Drowsiness
  • Loss of balance
  • Loss of coordination
  • Stiff neck
  • Sensitivity to light
  • Dilated pupils
  • Sudden blurry or double vision
  • Drooping eyelid
  • Confusion
  • Reduced mental awareness
  • Seizure

When the brain aneurysm has not ruptured, the most common symptoms are:

  • Drooping eyelid
  • Weakness and numbness in one side of your face
  • Having a hard time speaking
  • Dilated pupils
  • Blurry or double vision

When a sudden onset headache is included in these symptoms, it can be a sign of a sentinel bleed. This can be the early warning sign that a full rupture is imminent.

Causes & Risk Factors

Brain aneurysms usually develop over time as people age. They are most common after the age of 40. You can also have a defect in a blood vessel at birth that grows worse over time. Women have more aneurysms than men. These bulges in the blood vessels tend to happen at the fork of the blood vessels or at places where they branch off since these sections of blood vessels are the weakest. They are also most common at the base of the brain.

Risk factors related to brain aneurysms are:

  • Having high blood pressure
  • Heavy lifting or straining
  • Strong emotions
  • Medications like blood thinners or amphetamines
  • Having atherosclerosis
  • Having a head trauma or injury
  • Having an infection
  • Having cancer or tumours in the head or neck
  • Having a birth defect that causes tangled blood vessels in the brain
  • Having abnormal narrowing of the aorta or having a cerebral arteriovenous malformation
  • Having a family history of brain aneurysms
  • Having polycystic kidney disease
  • Having Ehlers-Danlos syndrome
  • Smoking
  • Alcohol use, particularly if you are a binge drinker
  • Drug use
  • Abuse of stimulants like cocaine or amphetamines

Diagnosis

Diagnosis of a brain aneurysm requires a variety of tests. Usually, a head CT or MRI will be done to get a visualisation of the brain and to identify the flow of blood throughout various parts of the brain’s structures. An angiogram can also be ordered, which allows the doctor to see the weak spots in blood vessels in the brain.

A cerebrospinal fluid test might also be done to see if there is blood in the spinal fluid. This indicates that an aneurysm has burst.

Treatment & Prevention

Prevention of brain aneurysms is not always possible. However, you should avoid the abuse of drugs or alcohol. You should also attempt to get help for strong bursts of emotion. For those with a health condition that predisposes them to brain aneurysms, talking to a doctor about how to prevent this secondary health concern is a good idea.

Treatment of brain aneurysms needs to be done as soon as possible to prevent widespread brain damage. Once a blood vessel in the brain is leaking or has burst, it will be likely to continue to bleed. Treatment can vary based on the location of the brain bleed and the size of the aneurysm.

Surgical clipping is a surgical intervention that is done by placing a metal clip on the opening of the aneurysm and thereby closing the blood vessel. Endovascular coiling does not require surgery and is done through the insertion of a catheter into the groyne to reach the affected area of the brain. The doctor will then place platinum coils inside the vessel and stop the blood flow. Flow diverter surgery is used for larger aneurysms and involves the insertion of a stent that diverts blood away from the burst blood vessel.

Unruptured aneurysms might not need treatment. These will often be monitored closely, and the patient will be given pain medications to help with associated discomfort. You might also be given calcium channel blockers to help prevent blood vessels from narrowing or be given an anti-seizure medication to help with seizure symptoms related to the aneurysm.

 
 
 

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