- Hereditary predisposition (collagen protein deficiency in the walls of blood vessels)
- Traumatic damage to the cerebral artery
- Congenital vascular changes (coarctation of the aorta, arteriovenous malformation, etc.)
- Hypertension II-III stage, accompanied by periodic sharp increases in blood pressure (crises)
- Age-related changes (atherosclerosis, degenerative processes)
- Benign and malignant neoplasms
- Systemic pathology of connective tissue leading to damage to the vascular wall
- Embolism of the cerebral artery (blockage of the lumen of the vessel by a detached piece of tumor tissue, thrombus, microorganisms, other foreign bodies)
The wall of a blood vessel in a normal state consists of three layers: internal (intima), muscle and external (connective tissue). Due to the influence of one or more of the above factors, the vessel wall is damaged and its gradual thinning occurs with loss of elasticity in a limited area.
- The shape of the aneurysm can be saccular, spindle-shaped, mixed and false.
- In size, the protrusion can be miliary (less than 3 millimeters), medium (from 0,4 to 1,5 cm), large (from 1,6 to 2,5 cm) and gigantic (more than 2,5 cm)
- By the number of cameras – single-chamber and multi-chamber aneurysms
- According to localization, a pathological formation is more often found in the anterior, less often in the middle cerebral and internal carotid arteries, and even less often in the vertebrobasilar system. Aneurysms can be multiple (appear on several cerebral arteries) and combined (arteriovenous malformations, the vascular network of brain tumors).
Symptoms of a brain aneurysm disease depend on its location and the occurrence of complications. The most dangerous complication, which may be incompatible with the patient’s life, is aneurysm rupture and bleeding.
In this regard, the signs are not always pronounced, which complicates the early diagnosis of the disease and timely treatment. Moreover, up to a certain point, aneurysm of the brain can be asymptomatic and not disturb the person.
The most common symptoms of the disease are headaches, which many patients take for the manifestation of migraine. When the condition worsens due to an increase in the size of the aneurysm and compression of the brain, symptoms such as vomiting, nausea, increased intracranial pressure, impaired coordination and movement can occur.
Then symptoms of visual impairment, convulsions, epileptic seizures, impaired sense of smell, photophobia join in. In cases where rupture of the aneurysm occurs, there may be a coma, often leading to the death of the patient.
Therefore, with the appearance of intolerable headaches that do not pass after taking medication, you need to contact a specialist and undergo a medical examination. As a rule, if the aneurysm was asymptomatic, and severe headaches suddenly appear, they are considered the harbingers of rupture of blood vessels, and the type of pain is called cephalgia.
Symptoms may appear suddenly and gradually increase, but in any case it must be remembered that if any unclear symptoms appear, you should consult a doctor as soon as possible and go to hospital, as in most clinical cases, ruptures of the brain artery can be fatal.
Currently, there are several very accurate and reliable diagnostic methods that may be indispensable for early diagnosis. In turn, early diagnosis can sometimes save the patient’s life, as the operation is widely used and gives good results.
What diagnostic methods can determine cerebral aneurysm:
- Angiography is a study of blood vessels using x-rays and contrast agents. This diagnostic method is widely used in modern medicine and can determine the degree of narrowing or expansion of the arteries of the brain and neck. The method is used for cerebrovascular accident, various brain tumors, as well as in case of cerebral hemorrhage.
- CT (computed tomography) of the head is a non-invasive diagnostic method that allows you to determine the rupture of the aneurysm, which is used immediately when the doctor suspects the possibility of rupture of the cerebral artery. If contrast agents are used in CT, then this method is called CT angiography.
- MRI (magnetic resonance imaging) is a harmless diagnostic method, since the diagnosis uses a magnetic field and radio waves of different frequencies. If CT gives a two-dimensional image of the skull and blood vessels, then with MRI you can get layered three-dimensional images that allow you to consider all the details of the aneurysm of the vessels.
- Analysis of cerebrospinal fluid – is performed in case of suspected rupture of the cerebral artery.
If a patient after all studies has an aneurysm of the brain, this does not mean that he is guaranteed a rupture of the vessel. As a rule, the clinic depends on the size of the aneurysm. If it is small in size, it will be enough for such a patient to be monitored by a neurologist or angiologist, and also undergo an outpatient examination periodically.
The probability of a break depends on gender, age, profession and location of the aneurysm. The older a person and his activity is associated with heavy physical exertion, the more the probability of a break increases.
The treatment of cerebral aneurysms is mainly surgical, but recently the method of endovascular embolization, which is a good alternative method for the treatment of unexploded aneurysm, has been used. In this case, the treatment consists in filling the aneurysm with platinum thread to completely destroy the pathology of the vessel.
Among the surgical operations, the clipping method (clipping) is used, in which a titanium clip is applied to the neck of the aneurysm. Such a clip subsequently disrupts blood flow to the aneurysm.
These methods of treatment are quite risky and complex, since during surgery, damage to other cerebral vessels may occur. There is no prevention of aneurysm, and with such a diagnosis, the best prevention is a healthy lifestyle.
Aneurysm of cerebral vessels – an increase in the size of the arteries of this organ. Thinning of the walls of blood vessels and the formation of an aneurysmal sac are noted. This pathology proceeds at the first stages almost asymptomatically.
The causes of the disease:
- Injury to the walls of blood vessels, arteries, which was obtained as a result of surgical intervention or with a gunshot wound.
- Damage to the vessels of this organ of an infectious nature.
Factors that may contribute to the formation of vascular aneurysm:
- High blood pressure.
- Tobacco smoking.
- Blood cholesterol is above normal.
As for the treatment, in order to get rid of the pathology of the brain it is necessary to carry out surgery:
- Clipping bulging walls of blood vessels.
- Intravascular intervention.
In modern medicine, it has still not been precisely established how the development of this brain pathology occurs, but the provocative factors have been carefully studied:
- Birth defects. They are considered the most dangerous cause. Aneurysm occurs in most cases on strong bends of arteries and their joints. It can also provoke a disease and collagen deficiency, which refers to a hereditary factor.
- Hemodynamic disorders. Occur in areas where branching of the arteries is observed. As a result, blood flow is disturbed and pressure is applied to the deformed vascular walls.
- Genetic disorders that cause vascular lesions. They are considered pathological phenomena, as a result of which the entanglement of veins and arteries of the brain occurs, while the blood flow is disturbed.
Very often, aneurysms develop in parallel with malignant neoplasms.
It is also worth noting such reasons for the occurrence of aneurysm:
- Tobacco smoking.
- Drug addict.
- Diseases of the vascular system.
- Infectious diseases.
- Injury and head injury.
All of the above reasons have a negative effect on the circulatory system, blood vessels.
Aortic aneurysm is an expansion that contributes to the formation of a sac in a blood vessel. This type of pathology does not have severe severe symptoms, and in most cases there are no symptoms at all. It occurs due to thinning and overextension of the vascular walls.
Also, certain factors can affect the formation of aortic aneurysms:
- Late stage of syphilis.
- Injury of blood vessels of an infectious nature.
- Congenital defects of the vascular wall.
We also note the reasons that provoke an aortic aneurysm:
- Genetic factors.
- Age category over 49 years.
- Inflammatory process in the aorta.
Treatment depends on its size and rate of development. If the pathology is large and intensively developing, then surgical intervention is performed. Ignoring this fact may lead to rupture of the aneurysm.
The disease, which is small, ruptures in rare cases, and treatment involves taking medications that reduce the load on the aortic wall and lower blood cholesterol, exercise, and diet. Be sure to abandon bad habits.
If the patient has previously had surgery to eliminate this pathological condition, it is recommended to regularly undergo examinations and ultrasound, which helps to control the parameters of the aneurysm.
Symptoms of cerebral aneurysm
At the beginning of its development, aneurysm of the cerebral vessels does not manifest itself in anything (asymptomatic course).
As the protrusion increases, depending on its location, the first signs of the disease begin to appear:
- Bursting headache, aggravated by physical and psychoemotional stress
- Bouts of nausea, repeated vomiting
- Intermittent syncope, seizures
- Acute or gradual deterioration in visual acuity
- The occurrence of sensitivity disorders (numbness, hyperesthesia) in certain parts of the body
- Neurotic and mental disorders (memory loss, distraction, irritability, insomnia, hallucinations)
When the aneurysm ruptures, hemorrhage occurs with brain damage and accumulation of blood inside the ventricles or in the subarachnoid space. Depending on the localization of the pathological process, the following main symptoms may be noted:
- Cerebral – severe headache, fever, increased blood pressure, cramps followed by loss of consciousness, coma
- Rupture of the internal carotid artery leads to pain in the forehead, visual impairment and movement disorders of the eyeball, as well as a decrease in muscle strength in the arm and leg on the side opposite to the lesion, sensitivity disorders in the upper and middle parts of the face
- If the anterior cerebral artery suffers, often mental disorders (amnesia, distraction, schizophrenia-like symptoms), as well as motor disorders (more in the leg on the opposite side, that is, contralaterally)
- Aneurysm of the middle cerebral artery during rupture leads to the development of paresis of the extremities on the side opposite to the lesion, speech, vision, and convulsive seizures
- Violation of the integrity of the main (basilar) artery causes the appearance of paresis of the oculomotor nerve, nystagmus (oscillatory eye movements), blindness, and a decrease in limb strength. Massive hemorrhage significantly aggravates the patient’s condition – loss of consciousness occurs (up to a coma), breathing is disturbed, pupils become wide
- Rupture of an aneurysm of the vertebral artery is accompanied by impaired speech and swallowing, sensitivity disorders, respiratory disorders
As for the symptoms of this pathology, the aneurysm can develop over a long period without the manifestation of any negative signs. If there is a sharp increase in pathology, then in rare cases the patient complains of a sharp headache in the fronto-orbital region.
If a cerebrovascular aneurysm ruptures due to provoking factors, then the blood enters the cranial cavity. In this situation, the symptoms will depend on where the blood gets:
- If blood enters the subarachnoid space:
- A sudden and sharp headache that develops into a migraine.
- Violation of light perception.
- Nausea and vomiting that do not help relieve the condition.
- Loss of consciousness.
- If blood enters the brain:
- Impaired visual function and movement of the eyeballs.
- Paralysis of the arms and legs.
- Impaired speech function.
- Cramps in the limbs and throughout the body.
- Loss of consciousness.
Diagnosis of aneurysm
- If you have complaints, you need to see an appointment with a neurologist, as well as an ophthalmologist (to see the fundus, which is a kind of “mirror” of the vascular system of the brain). A neurological examination allows, in some cases, to reveal indirect signs of compression of the brain structures by a growing aneurysm of the cerebral vessels and to schedule instrumental studies to help establish cerebral pathology.
- A CT scan of the head without contrast, performed in the acute period (after rupture of the aneurysm), can reliably establish the fact of subarachnoid and intraventricular hemorrhage and its severity, evaluate the size of the hematoma, the presence of ischemic lesions, signs of compression of the brain. The informational content of tomography in the first 10-12 hours after rupture of the cerebral vessel is approximately 95%, and after 10-20 days – only 30%.
CT angiography – the study of blood vessels after contrast, significantly improves the information content of the study and allows the detection of brain aneurysms in the absence of complaints.
- Magnetic resonance imaging of the brain with MR angiography (a study of cerebral arteries) is indispensable for the initial detection of aneurysm in an outpatient setting, allowing even without the introduction of a contrast agent to clearly visualize the existing vascular disorders, including the size and shape of the protrusion, the state of the artery wall, involvement in process of neighboring structures.
Brain vascular MRI performed after rupture of the aneurysm is most informative in the subacute and chronic period after hemorrhage (on days 5-20 of the disease). The information content of the method is 80-100%.
- Cerebral angiography is an X-ray examination of the blood vessels of the brain, performed after the introduction of a contrast medium into the bloodstream. Highly informative method, which allows to detect the presence of cerebral aneurysm, determine its size, accurate localization, assess the state of blood flow, the degree of ischemia of brain tissue. High-quality digital computer processing of data obtained during the study can be done using digital subtraction angiography.
- In a hospital, a spinal puncture may be prescribed to detect subarachnoid hemorrhage.
High-quality diagnostics carried out by highly qualified specialists on modern equipment, allows you to quickly establish the correct diagnosis and conduct timely surgical treatment of the revealed aneurysm.
Diagnosis of aneurysms is carried out after a patient visits a specialist with severe symptoms. It is based on clinical data and instrumental examination data.
- Neurological examination. If aneurysm rupture has not occurred, the patient may complain of intense headache. During the examination, neurological pathologies or disorders are not detected. Also, the patient may have paralysis of the limbs, impaired visual and speech function. If the gap has occurred, then there are clear neurological pathologies and disorders.
- Computed tomography and magnetic resonance imaging of the brain with a vascular program.
- Cerebral angiography and magnetic resonance angiography.
- If necessary, a consultation with a therapist is prescribed.
Treatment of cerebral aneurysm
The choice of treatment tactics depends on the location of the cerebral aneurysm, its shape, size, condition of the surrounding tissues and the pathological formation itself (before or after rupture, the presence of signs of stratification), the time elapsed after the hemorrhage, the patient’s age and his state of health.
Surgical treatment is recommended for all patients who have revealed aneurysm of the cerebral vessels.
- If aneurysm is detected without signs of stratification, surgical treatment is recommended in a planned manner in a specialized vascular center or clinic of neurosurgery. It is important not to delay the operation (according to statistics, the risk of rupture of the aneurysm is about 1-2 percent per year) and to ensure the possibility of active dynamic monitoring of the patient. Surgical treatment can eliminate the symptoms of the disease and prevent dangerous complications.
- After rupture of the cerebral aneurysm, it is necessary to turn it off from the blood circulation as soon as possible. The best results are obtained by early surgical intervention in the first hours after a violation of the integrity of the cerebral vessel and up to two weeks after rupture (during this period, repeated hemorrhage occurs in every fifth patient). However, which option (active or expectant) will be used depends on the clinical picture and the general condition of the patient. For example, with subarachnoid hemorrhage and a serious condition of the patient, conservative treatment is carried out, as with a hemorrhagic stroke, and after improving well-being, the question of the need for surgical intervention is considered.
The main surgical methods for treating cerebral aneurysm
- Open microsurgery with clipping aneurysm. The skull and the dura mater are opened, after access to the aneurysm, it is isolated from the bloodstream by applying a miniature clamp (clip) to the base (neck). The surgical wound closes. Clipping efficiency – 98%. If the aneurysm ruptures and subarachnoid hemorrhage, in addition to installing the clip, spilled blood is removed.
- Endovascular (through a catheter inserted into the vascular cavity) treatment of cerebral aneurysms. A catheter is inserted into the peripheral (femoral) artery, which is led to an aneurysm and special microcoils are inserted into its cavity. Gradually, the aneurysm is filled with blood clots and isolated from the cerebral artery. Endovascular access also allows you to install a flow-guiding stent in the neck of the aneurysm and to eliminate the access of blood to its cavity.
- In the formation of intracerebral hematoma and the presence of indications for surgical treatment, aspiration of accumulated blood is performed (transcranially, endoscopically or stereotactically)
- With intraventricular hemorrhage, external ventricular drainage can be performed. In this case, drainage is introduced into the cavity of the ventricle and cerebrospinal fluid is removed along with the spilled blood in a special container.
Timely diagnosis and the right method of surgical treatment of cerebral aneurysm is the key to achieving good treatment results and restoring patients to work.
To recover from cerebral aneurysms, it is necessary to have surgery. If the pathology is small and does not develop, then the patient is prescribed drug therapy.
Surgical intervention is of two types:
- Clipping areas that are stretched. Thus, the entry of blood into the aneurysm is stopped.
- Intravascular intervention. If the patient is prescribed this method, then a catheter is passed through the arteries to the vessels of the brain.
Surgery for aneurysm is considered the best option. This is due to the fact that this pathology is detected at a late stage, when non-surgical treatment is no longer so effective.
The patient may be prescribed operations such as:
- Strengthening the vascular walls.
- Endovascular surgery.
The choice of surgical intervention depends on the condition of the patient and the general condition of the vessels. The minimum cost of surgery is from 35 thousand rubles. The cost will depend on the type of operation and the area where it will be carried out.
Sometimes there are cases when, after surgery, the patient has complications that are associated with brain hypoxia, vasospasm. Also, the patient may experience oxygen starvation. A fatal outcome is likely with significant amounts of pathology and at the last stage of development.
In rare cases, if the aneurysm was detected by chance, conservative treatment is performed. It is recommended that the patient be constantly monitored by specialists. In this situation, an individual approach is required, taking into account the general condition and characteristics of the body. Also, this method of therapy is not the last in surgical intervention.
The patient is prescribed drugs that prevent the rupture of the pathological formation and improve the general condition:
- Painkillers and antiemetics. Help relieve the condition.
- Drugs that stabilize blood pressure. If the pressure will constantly increase, then this can provoke a rupture of the aneurysm and, as a result, hemorrhage.
- Drugs that eliminate cramps.
- Calcium channel blockers.
To achieve a positive result, it is necessary to combine surgical and non-surgical treatment.
If the aneurysm does not burst, then it goes unnoticed and may not harm the body throughout life. If it began to grow intensively, and there was a gap, the patient was not provided with timely treatment and help, then this can lead to death.
The prognosis after a break will depend on the patient’s age group and general well-being, as well as on neurological disorders. As for rehabilitation therapy, it will be required less if the treatment was carried out precisely with an unexploded aneurysm. Recovery after treatment and rupture may take several weeks or months.
Below are reviews of patients who suffered from aneurysm of the brain.
Anatoly, 51 years old: “A year ago, aneurysm of the cerebral vessels was discovered in me. It happened by chance as a result of a routine examination (I try to monitor my health, since the age is no longer young). As it turned out, I had it a long time ago, after a traumatic brain injury.
After CT, MRI, it was found that the aneurysm does not develop and does not increase in size, so he underwent drug treatment. The therapy lasted several months under the supervision of specialists. Then he was examined again, it turned out that the treatment helped. Satisfied and happy. “
Tamara, 56 years old: “My brain aneurysm was discovered by accident. I turned to a specialist because of deterioration of health and severe headaches. After the examination, this diagnosis was made. The doctor has prescribed clipping.
I want to say that the operation is not cheap, but it helped me. Also, after a medication was prescribed, which helped to recover after the operation. A year later, the condition was completely stabilized and the disease, as if there wasn’t. ”
Aneurysm of the brain is a serious pathology that can provoke certain complications, and even death. With the manifestations of the first negative signs of the disease, it is recommended to consult a specialist and undergo an examination. Do not ignore the symptoms and engage in self-treatment, as it will not be effective.
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