Aneurysms are swellings in the veins caused by the weakness of the blood vessel walls, usually where the veins are concentrated. As blood continues to flow through weakened blood vessels, the existing blood pressure causes a small area to balloon outward. It may even be possible to rupture the vessels that are weakened more than necessary. Aneurysms can occur anywhere in the body.
However, it is much more likely to be seen in the brain with the artery that transmits blood from the heart to other parts of the body, namely the abdominal aorta. Studies have proven that aneurysms are more common in adults. Although aneurysm is very likely to occur and carries a life-threatening risk, it is a disease that is not considered very important among the people. In particular, it has been proven that brain aneurysms cause quite serious problems. Brain aneurysm, which will occur due to weakening of any of the vessels in the brain, has the possibility of causing cerebral hemorrhage.
What is a Brain Aneurysm?
A brain aneurysm is the swelling and ballooning of a weakened blood vessel in the brain. This type of aneurysm is also called a cerebral aneurysm. A brain aneurysm often resembles a round fruit on a branch. An aneurysm that forms in the brain can rupture the blood vessel, causing a brain hemorrhage. This bleeding can also lead to paralysis in some cases.
The rupture of a brain aneurysm is called a subarachnoid hemorrhage. Depending on the severity of the bleeding, brain damage may occur or this bleeding may result in death. It is not possible to pre-diagnose which aneurysm will burst. The most common site for brain aneurysms is in the blood vessel network at the base of the brain, called the circle of Willis.
Aneurysms are generally very small in size. The size of the aneurysm varies from 0.3 cm to 2.54 cm. Aneurysms larger than 2.54 cm are called giant aneurysms. Such giant aneurysms carry a high risk and are very difficult to treat. Therefore, aneurysms can be detected in the early stages. It is vital to be diagnosed and treated. Studies have shown that cerebral aneurysms increase by 0.2-3 percent each year.
What are the Symptoms of Brain Aneurysms?
Most brain aneurysms only cause obvious symptoms when they burst. This situation is worrying for patients. Because the rupture of the aneurysm leads to serious risks. Aneurysms that burst in this way are called "ruptured aneurysms" and the main symptoms are;
- Sudden and very severe headache,
- Nausea and subsequent vomiting,
- Neck stiffness,
- Blurred or double vision,
- Sensitivity to sunlight or other lights,
- drooping eyelids,
- It is loss of consciousness.
Polycystic kidney disease is an inherited disease that causes the kidneys to fill with fluid, increasing blood pressure. An increase in blood pressure can cause an aneurysm. Some people may have narrow aorta genetically. This condition is called aortic coarctation and has been shown to increase the risk of aneurysms. A disease called cerebral arteriovenous malformation, which causes an abnormal connection between veins and arteries in the brain, thus interrupting blood flow, increases the risk of a brain aneurysm. In addition, patients with a family history of brain aneurysm are more likely to have this disease. A number of tests are performed considering the risk of brain aneurysm. The purpose of these tests is to find out if a ruptured aneurysm is present. Major diagnostic tests include computed tomography (CT), cerebrospinal fluid testing, magnetic resonance imaging (MRI), and cerebral angiogram. Computed tomography is a very advanced medical imaging technology. It is often one of the first tests used to determine if there is a brain hemorrhage. The test provides a three-dimensional visualization of the entire structure of the brain.
Before starting CT, the patient is injected with a fluid that makes it easier to observe blood flow and can indicate the presence of an aneurysm. If the brain aneurysm has ruptured or is leaking blood, there will likely be red blood cells in the cerebrospinal fluid. If no ruptured aneurysm is found as a result of CT, this test is applied. The cerebrospinal fluid is withdrawn from the back with the help of a needle and examined in a laboratory environment. This procedure is called a lumper puncture. MRI is a medical imaging method used to image the lobes of the brain in 3D using magnetic fields and radio waves.
By imaging the veins and arteries in the brain in detail, it can be determined whether any aneurysm has developed. Cerebral angiogram or cerebral erythema In the method called ogram, a thin, flexible tube is inserted into a large artery (usually in the groin). This tube is passed through the heart and delivered to the arteries in the brain. A special dye injected into the catheter is provided to reach the brain vessels. Then, a series of X-ray images are used to detect the brain aneurysm, if any. These are the most common diagnostic methods of cerebral aneurysm.
What are Brain Aneurysm Treatment Methods?
There are two different surgical methods applied for the treatment of ruptured brain aneurysm. One of them is called surgical clipping and is a method based on closure of the aneurysm. In this method, the neurosurgeon detects the aneurysm and opens part of the skull to find the vessel feeding the aneurysm. A small piece of metal is then placed at the site of the aneurysm to stop the blood flow. The other treatment method is the endovascular dressing. In this method, the aneurysm in the brain is reached by placing a catheter into the artery in the groin. Then, a soft platinum wire is pushed through the catheter with another wire and the aneurysm is wrapped from the inside of the vessel.
Thus, the aneurysm is closed from the artery. Both treatment methods carry certain risks. Since the blood flow in the brain is likely to stop for a while, it is possible to observe different situations. However, if left untreated, an aneurysm can cause more serious conditions. Surgical clips or endovascular dressing and flow diverting drugs are used for the treatment of brain aneurysms that have not yet burst. However, these treatment methods to be applied can sometimes cause more serious problems than the benefits they will provide. Because the brain is one of the most sensitive organs in the body, and each treatment to be performed on the brain has the potential to harm the brain. For this reason, whether the patient is suitable for treatment is determined by the joint work of specialists such as a neurologist, neurosurgeon and neuroradiologist.
In cases where the patient is suitable for treatment and the treatment does not carry any risk, the treatment is started by applying the necessary procedures. If a brain aneurysm is detected in the early stages, its treatment can only be done with drugs that stabilize blood pressure. For this reason, it is important to be examined without wasting time in case of any symptoms.
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