What You Should Know About Cerebral Aneurysms

About Cerebral Aneurysms

Cerebral Aneurysm is also called as intracranial aneurysm or brain aneurysm. It is the bulging or weak balloon like spot formed on the artery wall of the brain or in the brain’s blood vessels. Such an abnormality caused in the brain’s blood vessel is essentially due to pounding of blood flow against its walls which gradually starts thinning out due to force or pressure of the blood flow. These artery walls or blood vessels so thinned out are succumbed to the continuous flow of blood, which eventually swell outward over a period of time. This eventually forms bulging spot or ballooning of blood vessels in the brain. The dangers of the blood flow escaping into surrounding vicinity of the brain (threat of rupture) cannot be negated. In case of such brain bleeding, immediate surgical attention is required.

Rate of Occurrence of Cerebral Aneurysm

Due to the fact that aneurysm occurs on the walls of arteries or blood vessels of the brain over a period of time, its occurrence in children and youngsters is extremely rare. Thus, Cerebral Aneurysm is mostly found in adults in the age group of 35 to 60. Facts suggest those unruptured brain aneurysms are found 1 in 50 or approximately six million people in the United States. However ruptured brain aneurysms are found in approximately 25000 to 27000 people in the United States. Further, of the ruptured cerebral aneurysms found, nearly 40% of the cases are fatal. Moreover, out of the people surviving ruptured cerebral aneurysms, facts have suggested that nearly 66% suffer from neurological problems and certain disabilities. Cerebral aneurysms are more commonly found in people with genetic diseases, and certain circulatory disorders. It is also suggested that ruptured Cerebral aneurysms account for 3 to 5% of cerebral stroke or bleeding stroke

Types of Aneurysm

On the basis of shape, Aneurysm is of two types:

• Saccular Aneurysm: 80 to 90% of all Cerebral Aneurysm found belong to this type. These berry shaped projections occur at the base of the brain in the shape of either wide neck or a well defined neck. Nontraumatic Subarachnoid Hemorrhage (SAH) is mostly caused by these sac-like projections.
• Fusiform Aneurysm: This is not common type of Aneurysm. These are spindle shaped and does not have a profound neck. In this, the artery walls or blood vessels expand in all directions there by creating a pouch like shaped on both the sides. These forms of Aneurysm very rarely experience a rupture.

On the basis of size Aneurysm is of four types:

• measuring less than 5 mm are Small aneurysms
• measuring around 6–15 mm are Medium aneurysms
• measuring around 16-25 mm are Large aneurysms
• measuring more than 25mm are Giant aneurysms

Symptoms associated with Cerebral Aneurysm

Unruptured cerebral aneurysms are mostly small aneurysms and do not show any signs or symptoms of their presence. Only the uncommon unruptured aneurysms which are the large aneurysms depict signs of their presence. Certain symptoms depicted by these breed of unruptured aneurysms include: Dilating of pupils, localized headache, pain around and behind eyes, experiencing blurred vision, numbness, difficulty in communicating and feeling of weakness.

Ruptured cerebral aneurysms

When blood ruptures into brain’s vicinity or subarachnoid space, certain definite symptoms are experienced by the victim as: experiencing unconsciousness, excruciating pain around and behind eyes, strenuous headache, feeling of vomiting, sudden weakness or numbness, photophobia or sensitivity to light, stiff neck and drooping of eyelids

Can unruptured cerebral aneurysm bleed?

Larger unruptured aneurysms are more likely to bleed than smaller unruptured aneurysms. Apart from shape, the possibility of bleeding is also dictated by location of aneurysm and the symptoms that flow from it. Once an aneurysm has bled, the possibility that it will bleed again cannot be deemed as remote. If one has already had an aneurysm that has ruptured the chance of him getting it again or that the aneurysm would multiply, is a little over 20%. Moreover, if the causes of cerebral aneurysms are hereditary, then in such case the risk of bleeding is much higher. It is therefore pertinent for cerebral aneurysm to be detected at the first instance, in its initial phase of formation and when it is unruptured and small.

Detecting cerebral aneurysms

Cerebral Aneurysm can be detected by varied tests. It is optimal for one has to be more specific in choosing his tests. The types of tests for detecting cerebral aneurysms would depend on health facility conducting the tests. But if one has to undertake test on basis of ruptured aneurysm, then Angiogram is the best test. If normal tests of screening have to be undertaken then M.R.I (M.R.A.) or C.T.A. should suffice. However, the best overall tests for detecting cerebral aneurysms are:

Magnetic Resonance Angiogram

This method is used as a screening tool of detecting medium to large aneurysms. Small aneurysms cannot be detected by this test. In case of detecting medium to large aneurysms, success rate of this test is over 70%. The risk of MRI stroke is minimal.

Computerized (C.T.) Angiogram

This test is very similar to M.R.A., except that it uses iodine injection and is recommended for those who already had aneurysm clipped before.

Cerebral Angiogram

This is deemed to be the best method of detecting cerebral aneurysms. In this detection there is highest risk of permanent brain stroke, howsoever negligible, rate of risk being 0.5 to 1%.

Certain causes which increases the chance of Aneurysm to bleed

It is rather mysterious that the causes of bleeding in an aneurysm are unknown. However the causes which increase chances of aneurysm to bleed are depicted:

• aneurysm could rupture due to High blood pressure
• aneurysm could rupture due to strain and strong emotions
• aneurysm could rupture due to inclusion of Blood “thinners” found in prescription drugs as well as diet pills and also in cocaine

Treatment options of Cerebral Aneurysm

A person can undertake brain injury therapy or just be under observation in case where aneurysm has not ruptured but only detected. But in the scenario where aneurysm has already ruptured, person has to immediately adhere to surgical treatment as open bypass surgery or usage of endovascular approach.  In treating ruptured aneurysm, care has to be taken to see that rebleed of aneurysm is immediately arrested by getting it sealed by either using the coiling option of treatment or by the clipping option.

Coiling option of treating aneurysm

In this mode of treating aneurysm, angiogram approach is used in inserting multiple coils in aneurysm in order to pack the aneurysm in such a manner so as to enable the blood flow within it to completely clot. Although the success rate of this mode of treatment is a little above 50%, the risk of occurrence of clot stroke or of any other complication is only 3%.

Clipping option of treating aneurysm

This option of treating aneurysm depends on various factors such as consideration of patient age, size and location of aneurysm, shape of aneurysm, Neurological condition of patient, hereditary occurrence of aneurysm or SAH history of occurrence. However, the risk of recurrence of aneurysm is a mere 1.5%, where the treatment is by efficiently clipped aneurysm. The use of this method to treat aneurysm has been drastically increased over number of years. The rate of complication of this procedure depends on the aforementioned factors. The facts however suggest the complication rate to be 17% in this mode of treatment.

Source:

http://www.bafound.org

http://www.neurosurgery.com.au

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