Notes

Aneurysm

Bulge in weak blood vessel wall.VeinsEncyclopedia Entry for Aneurysm :Aneurysm in the brain. Aneurysms in the brain occur when there is a weakened area in the wall of a blood vessel. An aneurysm may be present from birth (congenital). Or, it may develop later in life, such as after a blood vessel is injured. There are many types of brain aneurysms. The most common type is called a berry aneurysm. This type can vary in size from a few millimeters to over a centimeter. Giant berry aneurysms can be bigger than 2.5 centimeters. These are more common in adults. Berry aneurysms are passed down through families more often than other types of aneurysms. Cerebral aneurysm Watch this video about: Cerebral aneurysm Other types of cerebral aneurysms involve widening of an entire blood vessel. Or, they may appear as a ballooning out of part of a blood vessel. Such aneurysms can occur in any blood vessel that supplies the brain. Hardening of arteries ( atherosclerosis ), trauma, and infection can all injure the blood vessel wall and cause cerebral aneurysms. About 5% of people have a brain aneurysm, but only a small number of these aneurysms cause symptoms or rupture. Risk factors include: Family history of cerebral aneurysms Medical problems such as polycystic kidney disease , coarctation of the aorta , and endocarditis High blood pressure, smoking, alcohol, and illegal drug use.A person may have an aneurysm without having any symptoms. This kind of aneurysm may be found when an MRI or CT scan of the brain is done for another reason. A brain aneurysm may begin to leak a small amount of blood. This may cause a severe headache that a person may describe as 'the worst headache of my life.' It may be called a thunderclap or sentinel headache. This means the headache could be a warning sign of a future rupture that may occur days to weeks after the headache first started. Symptoms may also occur if the aneurysm pushes on nearby structures in the brain or breaks open (ruptures) and causes bleeding into the brain. Symptoms depend on the location of the aneurysm, whether it breaks open, and what part of the brain it is pushing on. Symptoms may include: Double vision Loss of vision Headaches Eye pain Neck pain Stiff neck Ringing in the ears A sudden, severe headache is one symptom of an aneurysm that has ruptured. Other symptoms of an aneurysm rupture may include: Confusion, no energy , sleepiness , or stupor Eyelid drooping Headaches with nausea or vomiting Muscle weakness or difficulty moving any part of the body Numbness or decreased sensation in any part of the body Problems speaking Seizures Stiff neck (occasionally) Vision changes (double vision, loss of vision) NOTE: A ruptured aneurysm is a medical emergency. Call your local emergency number, such as 911.An eye exam may show signs of increased pressure in the brain, including swelling of the optic nerve or bleeding into the retina of the eye. A brain and nervous system exam may show abnormal eye movement, speech, strength, or sensation. The following tests may be used to diagnose a cerebral aneurysm and determine the cause of bleeding in the brain: Cerebral angiography or spiral CT scan angiography of the head to show the location and size of the aneurysm Spinal tap CT scan of the head EEG MRI of the head or MRI angiogram.Two common methods are used to repair an aneurysm that has not yet ruptured: Clipping is done during open brain surgery (craniotomy). Endovascular repair is most often done. It usually involves a coil or coiling. This is a less invasive way to treat some aneurysms. Not all aneurysms need to be treated right away. Those that are very small (less than 3 mm) are less likely to break open. Your provider will help you decide whether or not it is safer to have surgery to block off the aneurysm before it can break open. Sometimes people are too ill to have surgery, or it may be too dangerous to treat the aneurysm because of its location. A ruptured aneurysm is an emergency that needs to be treated right away. Treatment may involve: Being admitted to the hospital's intensive care unit (ICU) Complete bed rest and activity restrictions Drainage of blood from the brain area (cerebral ventricular drainage) Drugs to prevent seizures Drugs to control headaches and blood pressure Drugs through a vein (IV) to prevent infection Once the aneurysm is repaired, treatment may be needed to prevent a stroke from a blood vessel spasm.How well you do depends on many things. People who are in a deep coma after an aneurysm rupture do not do as well as those with less severe symptoms. Ruptured cerebral aneurysms are often deadly. Of those who survive, very few have some sort of permanent disability.Complications of aneurysm in the brain may include: Increased pressure inside the skull Loss of movement in one or more parts of the body Loss of sensation of any part of the face or body Seizures Stroke Subarachnoid hemorrhage.Go to the emergency room or call the local emergency number (such as 911) if you have a sudden or severe headache, especially if you also have nausea, vomiting, seizures, or any other nervous system symptom. Also call if you have a headache that is unusual for you, especially if it is severe or your worst headache ever.There is no known way to prevent a berry aneurysm from forming. Treating high blood pressure may reduce the chance that an existing aneurysm will rupture. Controlling risk factors for atherosclerosis may reduce the likelihood of some types of aneurysms. People who are known to have an aneurysm may need regular doctor visits to make sure the aneurysm is not changing size or shape. If unruptured aneurysms are discovered in time, they can be treated before causing problems. The decision to repair an unruptured cerebral aneurysm is based on the size and location of the aneurysm, and the person's age and general health.Aneurysm - cerebral; Cerebral aneurysm; Aneurysm - intracranial.Brain aneurysm repair - discharge Headache - what to ask your doctor.Cerebral aneurysm Cerebral aneurysm Cerebral aneurysm Cerebral aneurysm.Bowles E. Cerebral aneurysm and aneurysmal subarachnoid hemorrhage. Nursing Standard. 2014;28(34):52-59. journals.rcni.com/nursing-standard/cerebral-aneurysm-and-aneurysmal-subarachnoid-haemorrhage-ns2014.04.28.34.52.e8694. Accessed July 19, 2016. National Institute of Neurological Disorders and Stroke. Cerebral aneurysms fact sheet. Updated December 20, 2016. www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Cerebral-Aneurysms-Fact-Sheet. Accessed June 12, 2017. Szeder V, Tateshima S, Duckwiler GR. Intracranial aneurysms and subarachnoid hemorrhage.Encyclopedia Entry for Aneurysm :Aneurysm. It is not clear exactly what causes aneurysms. Some aneurysms are present at birth (congenital). Defects in some parts of the artery wall may be a cause. Common locations for aneurysms include: Major artery from the heart (the aorta ) Brain ( cerebral aneurysm ) Behind the knee in the leg (popliteal artery aneurysm) Intestine (mesenteric artery aneurysm) Artery in the spleen (splenic artery aneurysm) High blood pressure, high cholesterol, and cigarette smoking may raise your risk for certain types of aneurysms. High blood pressure is thought to play a role in abdominal aortic aneurysms. Atherosclerotic disease (cholesterol buildup in arteries) may also lead to the formation of some aneurysms. Pregnancy is often linked to the formation and rupture of splenic artery aneurysms.The symptoms depend on where the aneurysm is located. If the aneurysm occurs near the body's surface, pain and swelling with a throbbing lump is often seen. Aneurysms in the body or brain often cause no symptoms. Aneurysms in the brain may expand without breaking open (rupturing). The expanded aneurysm may press on nerves and cause double vision, dizziness, or headaches. Some aneurysms may cause ringing in the ears. If an aneurysm ruptures, pain, low blood pressure, a rapid heart rate, and lightheadedness may occur. When a brain aneurysm ruptures, there is a sudden severe headache that some people say is the 'worst headache of my life.' The risk of death after a rupture is high.The health care provider will perform a physical exam. Tests used to diagnose an aneurysm include: CT scan Ultrasound Angiogram.Treatment depends on the size and location of the aneurysm. Your doctor may only recommend regular checkups to see if the aneurysm is growing. Surgery may be done. The type of surgery that is done and when you need it depend on your symptoms and the size and type of aneurysm. Surgery may involve a large (open) surgical cut. Sometimes, a procedure called endovascular embolization is done. Coils of metal are inserted into a brain aneurysm to make the aneurysm clot and reduce the risk of rupture. Other brain aneurysms may need to have a clip placed on them to close them off and prevent a rupture. Aneurysms of the aorta may be reinforced with surgery to strengthen the blood vessel wall.Call your provider if you develop a lump on your body, whether or not it is painful and throbbing. With an aortic aneurysm, go to the emergency room or call 911 if you have pain in your belly or back that is very bad or does not go away. With a brain aneurysm, go to the emergency room or call the local emergency number (such as 911) if you have a sudden or severe headache, especially if you also have nausea, vomiting, seizures, or any other nervous system symptom.Controlling high blood pressure may help prevent some aneurysms. Follow a healthy diet, get regular exercise, and keep your cholesterol at a healthy level to also help prevent aneurysms or their complications. DO NOT smoke. If you do smoke, quitting will lower your risk of an aneurysm.Aneurysm - splenic artery; Aneurysm - popliteal artery; Aneurysm - mesenteric artery.Cerebral aneurysm Cerebral aneurysm Aortic aneurysm Aortic aneurysm Intracerebellar hemorrhage - CT scan Intracerebellar hemorrhage - CT scan.Airhart N, Curci JA. Arterial aneurysms.