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Health Inset > Diseases and Conditions > Cerebral Aneurysm

Cerebral Aneurysm

Cerebral Aneurysm Definition

It is one of the commonest cerebrovascular disorders characterized by a localized expansion or ballooning of a blood capillary in the brain. It results from a weakness or defect in the wall of a cerebral vein or artery.

The disorder is also known as “Brain Aneurysm” or “Aneurysm in the brain”.

Cerebral Aneurysm Incidence

The condition can arise in individuals of any age group. However, it is found to affect adults more than children. It is believed to have a sexual predilection as slightly more number of women is seen to suffer from the syndrome than men. Approximately 5-10% of the US population suffers from some form of brain aneurysm, though only a small number of these rupture or cause difficulties. Cerebral aneurysms are believed to affect one in every fifteen individuals.

It is difficult to determine the frequency of brain aneurysms due to variations in their size and diagnostic methods. Unruptured aneurysms are thought to account for half of all cases of aneurysms.

Cerebral Aneurysm Types

There are three primary types of cerebral aneurysms. These are:

Saccular aneurysms

These are tiny, pouch-shaped lumps usually found in the basal region of the brain known as the “Circle of Willis”. These are the most common form of brain aneurysms and tend to rupture if pulse pressure leads to the formation of a hole in the sac.

Fusiform aneurysms

These are long tube-like or spindle-shaped protrusion of vessels on the entire perimeter of the artery. These are localized dilations that rarely suffer a rupture.

Mycotic aneurysms

These are very rare type of brain aneurysms and arise due to an infection of the arterial wall, mainly by a gram-positive Cocci.

A berry aneurysm is another common type of aneurysms of the brain. It is a small saccular aneurysm of an artery of the cerebrum. Its appearance is similar to a berry hence the name. The dilated lumps can vary from a few millimeters to more than a centimeter in size. Giant berry aneurysms can be larger than 2 centimeters in size and more common in adults. Multiple berry aneurysms are acquired more often than other forms of aneurysms.

Cerebral Aneurysm Symptoms

In most cases, the presence of a cerebral aneurysm is not known until it suffers a rupture. When this happens, hemorrhages occur in various parts of the brain. An affected person may pass out or experience other difficulties like:

  • Severe headache
  • Nausea
  • Stiff neck
  • Vomiting
  • Loss of vision
  • Double vision
  • Eye pain
  • Neck pain

Rupture may be minimal or severe. The acuteness of symptoms coincides with the amount of blood lost and the extent of brain damage in suffering individuals. Some patients may not experience any symptoms at all and suffer from death or a permanent vegetative state only when the condition turns most severe. Such types of aneurysm are generally detected when a CT scan or MRI of the brain is conducted for diagnosis of some other problem.

An aneurysm of the brain may begin to “leak” a little blood into the cerebrum. This occurs if the aneurysm exerts pressure on adjoining structures in the brain or causes a rupture (breaking open) of the blood vessels, thereby causing bleeding into the brain.

The symptoms experienced by an individual depend on factors like:

  • Location of the aneurysm
  • Whether or not the aneurysm ruptures
  • Which part of the brain is being pressed upon by the aneurysm

Cerebral Aneurysm Rupture

The rupture of a brain aneurysm is primarily characterized by a severe headache that arises suddenly. Other symptoms of a brain aneurysm rupture may include:

  • Drooping of eyelids
  • Mental confusion
  • Fatigue
  • Sleepiness or stupor
  • Muscular weakness or problems in moving any section of the body
  • Reduced sensation or numbness in any region of the body
  • Speech impairment
  • Seizures
  • Stiff neck (occasionally)
  • Changes in vision

The “sentinel headache” is one of the worst symptoms of a cerebrum rupture. Often described as “the worst possible headache in life”, this painful symptom can be indicative of an impending rupture. In many cases, the rupture occurs a few days or weeks after the first instance of this headache. It is often accompanied by other discomforting symptoms, such as nausea and vomiting.

A cerebral rupture is a medical emergency. Family members of patients suffering from a rupture in the brain aneurysm should seek immediate medical attention. Delay in getting medical assistance may lead to death or permanent vegetative state of a sufferer.

Cerebral Aneurysm Causes

This type of aneurysm can arise from the weakening of an arterial wall due to a congenital defect or medical conditions like head trauma, infection or high blood pressure. An injury to a blood vessel due to a head trauma is one of the primary causes of Cerebral Aneurysm in later life.

Brain aneurysms typically develop due to degenerating or thinning of the artery walls. Aneurysms often form at branches or forks in arteries as these sections of blood vessels are found to be weaker. Aneurysms can develop on any region in the brain. However, they are most frequently found in arteries located at the base of the brain.

Cerebral Aneurysm Risk Factors

The risk factors for this condition are many in number. This is due to the fact that a number of factors can lead to weakness in an arterial wall and enhance the possibilities of getting a brain aneurysm. Some of these risk factors are present at birth (congenital), while others develop over time. These include:

Age

Older individuals are found to be more at risk from this condition. The condition is seen to affect adults more than children.

Gender

The gender, or sex, of a person is also considered to be a determining factor for this problem. Females are more at risk from this disorder than males.

Smoking

People who have a habit of smoking are also found to be more susceptible to a rupture of the Brain Aneurysm. The risk of a rupture is 10 times higher in smokers than in non-smokers.

High blood pressure (hypertension)

A number of studies have indicated hypertension patients to be at a higher risk of suffering from the development and rupture of a Cerebral Aneurysm.

Arteriosclerosis

This condition leads to a hardening of the arteries and increases the possibilities of getting an aneurysm of the brain.

Medicinal abuse

Drug abuse, especially the use of cocaine, can give rise to abnormal changes in the body and increase susceptibility to this problem.

Head injury

A trauma to the head often injures a blood vessel located in the brain. A cosiderable impact can cause brain hemorrhage and lead to blood release from the injured vessel, thereby resulting in a rupture.

Heavy alcohol consumption

It is not clear how exactly alcohol is responsible for aneurysm formation. However, excessive consumption of alcohol is also thought to increase the possibilities of a brain aneurysm.

Inherited conditions

Disorders acquired through gene, such as Ehlers-Danlos syndrome and Polycystic kidney disease, can impact blood vessels and increase blood pressure. This can directly lead to the formation of brain aneurysm. People with a family history of this condition, especially a direct relative such as a parent, sister or brother, are especially at risk from this disease.

Cerebral Arteriovenous Malformation

Also known as Brain AVM, it refers to an unusual connection between veins and arteries in the brain that breaks up the normalcy of blood flow between them.

Coarctation of the aorta

It is a complicated condition that leads to an abnormal constriction of the aorta, or the large blood capillary that supplies oxygenated blood to the body from the heart.

Cerebral Aneurysm Diagnosis

The diagnosis of this condition can be difficult. This is due to the fact that its symptoms generally do not get apparent until after the occurrence of a rupture. The protrusions in the blood vessels are often accidentally detected while some other condition is being diagnosed. If a cerebral aneurysm is suspected, doctors may carry out further scans to examine its current state. The diagostic tests, which are used to detect brain aneurysm and also find out the cause of bleeding in the brain, include:

  • CT scan of the head
  • MRI of the head
  • Cerebrospinal fluid exam (spinal tap)
  • Electroencephalogram (EEG)

A spiral CT scan angiography or Cerebral angiography helps reveal the size and location of the aneurysm. It involves use of a dye to scrutinize blood vessels.

An examination of the eye may also be conducted as a diagnostic test. This can help detect raised intracranial pressure (build up of pressure in the brain), including inflammation of the optic nerve or release of blood into the retina of the eye. A examination of the neurological system and brain may indicate abnormalities in strength, speech, sensation or eye movement.

Cerebral Aneurysm Treatment

The treatment of this condition depends on several factors, such as:

  • Age of the individual
  • His or her health
  • Size of the aneurysm
  • Location of the aneurysm

If doctors suspect a rupture of a brain aneurysm, they should immediately treat patients on an emergency basis. In such cases, treatment should primarily aim at stopping loss of blood as quickly as possible to prevent further damage.

An aneurysm is commonly repaired with the aid of two methods, which include:

Clipping

It is the most common method used to repair an aneurysm. It is performed at the time of an Open Brain Surgery.

Endovascular repair

It is a less invasive method used to cure some aneurysms and mostly involves coiling. This technique is preferred more for repairing a brain aneurysm rupture.

Once the cerebral aneurysm is repaired, it may be necessary to prevent occurence of stroke from a spasm of blood vessel. This can be done by using:

  • Intravenous fluids
  • Medicines that help reduce blood pressure and control headaches
  • Anti-zeizure medications
  • Drugs to control headaches

Patients may need complete bedrest. They may also be recommended to restrict all heavy activities that may increase the risk of complications.

Even if no symptoms are experienced, doctors may use treatment to prevent occurence of a potentially fatal episode of rupture in future.

Only a few types of aneurysms require immediate treatment. Lumps that are extremely small, and even less than 3 mm, are less likely to rupture. Doctors can help consider whether it is safer for patients to have an operation to shut off the aneurysm before it can break open. Surgery may be too dangerous to conduct in case of a badly located aneurysm or in people who are too ill to undergo the stress of an operative procedure.

Cerebral Aneurysm Home Remedies

Individuals having a nonruptured cerebral aneurysm or a family history of this condition can avert the risk of a brain aneurysm rupture by making a few changes in their manner of living. These include:

Giving up smoking

Not smoking or non-use of recreational drugs can help you a lot in avoiding this condition. If that is difficult for you, consider joining an appropriate treatment program that may help you quit the habit.

Following a good diet

A healthy diet, comprising of lots of fresh fruits and vegetables, can boost your system and strengthen your blood vessels.

Regular exercise

Exercising on a regular basis can help you maintain your blood pressure and improve your metabolism. However, you should avoid overstressing yourself with workouts as it will raise blood pressure.

Cerebral Aneurysm Prognosis

The outcome of this condition varies from person to person. It is better to avoid rupture of a brain aneurysm. Following an aneurysm rupture, patients who enter into deep comas usually show poor outcome than those with less acute symptoms. Of all cases of ruptured cerebral aneurysms, around 50% of sufferers die within 1 day to about 3 months. Approximately 25% of those who survive are found to suffer from some type of permanent disability.

Cerebral Aneurysm Complications

The primary complications of this condition include:

  • Stroke
  • Seizures
  • Increased pressure inside the skull
  • Subarachnoid hemorrhage
  • Loss of motion in one or more regions of the body
  • Loss of sensation of any area of the face or body

Cerebral Aneurysm Prevention

There is no definite way to prevent the formation of a cerebral aneurysm. However, certain measures can help avoid the problem. These include:

  • Managing high blood pressure
  • Avoiding smoking
  • Avoiding drug abuse

If you are suffering from a severe or sudden headache along with seizures, nausea or vomiting, seek immedaite medical attention. If unruptured aneurysms are timely detected, they can be cured before any problems arise.

References:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002387/

http://www.mayoclinic.com/health/brain-aneurysm/DS00582

http://www.ninds.nih.gov/disorders/cerebral_aneurysm/cerebral_aneurysms.htm

http://emedicine.medscape.com/article/1161518-overview

By   Last updated December 10th, 2011

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