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A cerebral aneurysm is an abnormal swelling of a blood vessel wall inside the brain. A cerebral aneurysm occurs at a weak point in the wall of a blood vessel (artery) that supplies blood to the brain. The bulging aneurysm can put pressure on a nerve or surrounding brain tissue. It may also leak or rupture, spilling blood into the surrounding tissue (called a hemorrhage). Some cerebral aneurysms, particularly those that are very small, do not bleed or cause other problems.
Causes of Cerebral Aneurysm
Aneurysms may result from congenital defects, pre existing conditions such as high blood pressure and atherosclerosis (the buildup of fatty deposits in the arteries), or head trauma. Cerebral aneurysms occur more commonly in adults than in children but they may occur at any age. They are more common in women than in men, by a ratio of 2 to 1. A person may inherit the tendency to form aneurysms, or aneurysms may develop because of hardening of the arteries (atherosclerosis) and aging.
Aneurysms are also classified by size. Small aneurysms are less than 11 millimeters in diameter (about the size of a standard pencil eraser), larger aneurysms are 11-25 millimeters (about the width of a dime), and giant aneurysms are greater than 25 millimeters in diameter (more than the width of a quarter).
Symptoms of Cerebral Aneurysm
Aneurysms usually cause no symptoms unless they rupture and cause bleeding into the brain. However, a sudden, extremely severe "thunder-clap" headache is the telltale symptom that an aneurysm has ruptured.
Symptoms of a ruptured brain aneurysm often come on suddenly.
They may include :
- Sudden, severe headache (sometimes described as a "thunderclap" headache that is very different from any normal headache).
- Neck pain.
- Nausea and vomiting.
- Sensitivity to light.
- Fainting or loss of consciousness.
- Seizures.
- Speech impairement
- Eyelid drooping
- Stiff neck
Diagnosis of Cerebral Aneurysm
On the CT scan it may be possible to see an evidence of hemorrhage associated with a brain aneurysm.
CT Angiography: is a noninvasive way of seeing brain blood vessels but often does not give well defined images with which to plan treatment.
MRI examination shows in detail the aneurysm and it relationship to the brain.
Carotid & Vertebral digital substraction angiography: is the definitive method to detect aneurysms. Using a groin artery, a catheter is placed in the blood vessels leading to the brain and a contrast agent or dye is injected to photograph the blood vessels.
Treatment of Cerebral Aneurysm
Unruptured aneurysm would probably be treated with a surgical procedure called the clip ligation, as described below.
Most cerebral aneurysms can be fixed with microsurgery that will involve either :
- Clipping the "neck" of the aneurysm at the artery, to cut off the blood flow
- Repairing the aneurysm through a catheter inserted into the damaged blood vessel
Know more about :
Endovascular Coiling
Surgical Clipping
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