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Cerebral aneurysm

Intracranial aneurysms are disorders of cerebral blood vessels in which weakness in the wall causes localized dilation or balooning of the blood vessel. A brain aneurysm can leak or rupture, causing bleeding in the brain, also referred to as hemorrhagic stroke. Because of the localization of most aneurysms the bleeding occurs in the space below the arachnoidea, a thin tissue covering the brain. This type of bleeding is called subarachnoid hemorrhage or SAH. Intracranial aneurysms may result from diseases acquired during life, or from genetic conditions. Hypertension, Hardening of the arteries (arteriosclerosis), smoking, excess alcohol consumption, and obesity are all associated with the development of aneurysms. Cocaine use has also been associated with the development of intracranial aneurysms. Genetic conditions associated with connective tissue disease may also be associated with the development of aneurysms. Common signs and symptoms of a ruptured aneurysm include: Sudden, extremely severe headache, Nausea and vomiting, Having a stiff neck, Having blurred or double vision, Sensitivity to light, Seizure, A drooping eyelid, Loss of consciousness and Confusion. In some cases, an aneurysm may leak a slight amount of blood. This leaking may also cause sudden, extremely severe headache. This can be seen in radiologic imaging or in cerebro-spinal fluid, using a lumbar puncture. A more severe rupture often follows leaking. While most intracranial aneurysms don’t show symptoms until they rupture, some unruptured aneurysms can become symptomatic. Because of their mass unruptured cerebral aneurysms may cause symptoms on adjacent neurologic structures. Patients may experience headaches, visual loss, cranial neuropathies, pyramidal tract dysfunction and facial pain. Aneurysms can lead to blood clots, resulting in emboli, which can cause Ischemia and stroke.Patients have a high risk of rebleeding after the first hours and days after aneurysmatic sub arachnoid hermorrhagy, which is associated with increased mortality. Therefore ruptured brain aneurysms can become life threatening fast and require immediate medical attention. Surgical clipping and endovascular coiling are the most commonly used techniques for treating aneurysms. Anatomic considerations such as size, location, other morphological features determine which treatment is most appropriate in the patient. The timing and choice of therapy for a ruptured intracranial aneurysms are dependent on the clinical status of the patient as well as the anatomic charasteristics of the aneurysm. In some cases the physician may choose to observe small unruptured aneurysms and recommend treatment taking into account the patient’s age, existing neurological and medical conditions and the treatment risk. Intracranial aneurysms can be diagnosed using conventional angiography, magnetic resonance imaging including MR Angiography, as well as initially CT scans and CT Angiography. Ruptured aneurysms require immediate medical attention and therapy. In case of unruptured aneurysms we recommend visiting a specialized medical center with adequate vascular neurosurgical and neuroradiological expertise.