Brain aneurysm

What is a brain aneurysm?       

A brain aneurysm is a cerebrovascular disease characterised by a dilatation of the arterial wall that can lead to a rupture or internal bleeding. It is estimated that 5% of the population have an unruptured aneurism, but they rarely produce any symptoms.      

A brain aneurysm may develop due to congenital factors, head trauma, a tumour, arteriosclerosis, an infection, or regular consumptions of toxic substances.       

Aneurysms are classified according to their size and shape, they can be saccular, fusiform, and lateral. All aneurysms run the risk of complications if there is a vessel rupture which could lead to a brain haemorrhage, which in turn could cause a cerebrovascular accident that could end up causing irreversible nerve damage.     

What are the symptoms?

Aneurysms tend to be asymptomatic and only manifest when they get bigger, filter blood, or rupture, causing severe headaches, nausea, vomiting, neck stiffness, seizures, or sudden loss of consciousness.    

If the aneurysm is putting pressure on the nerves, it could cause dropping eyelid, double vision, dilated pupils, pain above or behind the eye, and numbness or weakness on one side of the face or body.

Tests such as an angiography or a CT scan are used to diagnose a brain aneurysm.

What causes it?

Bulges that end up causing brain aneurysms cause weakness in the blood vessel walls which leads to an increase in size, which entails a risk of rupture and massive internal haemorrhage.

The main risk factors are: hypertension, smoking, certain diseases, family history, or central nervous system or brain infections, among others.    

How can it be prevented? 

The best way to avoid brain aneurysms is to control cardiovascular risk factors and conditions that weaken blood vessels, such as diabetes, cholesterol, and atherosclerosis, as well as maintaining a healthy lifestyle, avoiding stress, and avoiding tobacco and alcohol use.    

If and when an aneurysm is found, ultrasound scans should be performed regularly (every six months for example) to monitor its potential growth.

What is the treatment?

Treatment will depend on whether the aneurysm is intact or ruptured. In the case of the former an aneurysm clipping (also known as a microvascular clipping) or an endovascular repair (the injured vessel is repaired) will be performed. If the aneurysm has ruptured, immediate treatment is necessary which may require hospitalisation in the intensive care unit, complete bed rest, cerebral ventricular drainage, and drugs and medications.     

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