Description

A brain aneurysm (AN-yoo-riz-um) is a bulge or ballooning in a blood vessel in the brain. It is also known as a cerebral aneurysm or intracranial aneurysm. A type of aneurysm of the call berry or saccular aneurysm looks like a berry hanging on a stem.

Experts believe that brain aneurysms form and grow because the blood flows through the blood vessels increases the pressure on a weak area of the vessel wall. This can increase the size of the aneurysm in the brain. If an aneurysm in the brain leaks or ruptures, causing bleeding in the brain, known as a hemorrhagic stroke.

More often, a ruptured brain aneurysm occurs in the space between the brain and the thin tissues that cover the brain. This type of hemorrhagic stroke is called a subarachnoid hemorrhage.

Brain aneurysms are common. But most brain aneurysms are not serious, especially if they are small. Most brain aneurysms do not rupture. They generally do not cause symptoms or may cause health problems. In many people, the brain aneurysms are found during testing for other conditions.

However, if an aneurysm ruptures can quickly become life threatening and requires emergency treatment.

If a brain aneurysm is not broken, the treatment may be adequate for some people. There are many factors to keep in mind. If it is considered that the risk is less than that in the future the risk of rupture of the aneurysm, then the treatment of a ruptured brain aneurysm can be recommended. Talk about your treatment options with your health care professional.

Types of

  • Saccular aneurysm. Also known as a berry aneurysm, this type of aneurysm looks like a berry hanging from a vine. It is a round, blood-filled sac that protrudes from the main artery or one of its branches. Usually forms in the arteries at the base of the brain. A berry aneurysm is the most common type of aneurysm.
  • Aneurysm fusiform. This type of aneurysm causes protrusion on all sides of the artery.
  • Mycotic aneurysm. This type of aneurysm is caused by an infection. When an infection that affects the arteries in the brain, it can weaken the wall of the artery. This can cause an aneurysm of the way.

Symptoms

Most brain aneurysms that have not broken do not cause symptoms, especially if they are small. Brain aneurysms can be found during imaging tests performed for other conditions.

If an aneurysm ruptures, this is a very serious condition, it usually causes a severe headache. And if an aneurysm do not press against brain tissue or nerves, and can cause pain and other symptoms.

Rupture of aneurysm symptoms

A sudden and severe headache is the key symptom of a ruptured aneurysm. This headache is often described by people as the worst pain I have ever experienced.

In addition to a severe headache, symptoms of a ruptured aneurysm can include:

  • Nausea and vomiting.
  • Stiffness in the neck.
  • Blurred or double vision.
  • Sensitivity to light.
  • Seizures.
  • The loss of consciousness.
  • Confusion.

'Leak' of aneurysm symptoms

In some cases, an aneurysm may lose a small amount of blood. When this happens, the more severe the break frequency in the following way. Leaks can occur days or weeks before a more serious rupture.

Brain aneurysm brain, symptoms can include a sudden, extremely severe headache that can last several days and up to two weeks.

Rupture of aneurysm symptoms

A ruptured brain aneurysm may not have any symptoms, especially if it is small. However, a greater rupture of an aneurysm can press the tissues of the brain and the nerves.

The symptoms of a ruptured brain aneurysm can include:

  • The pain above and behind the eyes.
  • Dilation of the pupil.
  • A change in vision or double vision.
  • Numbness of one side of the face.
  • Seizures.

When to see a doctor

Seek medical attention right away if you develop a sudden, extremely severe headache. If you're with someone who complains of a sudden, severe headache or loses consciousness, or has a seizure, call 911 or your local emergency number.

Causes

Brain aneurysms are caused by the thinning of the walls of the arteries. Aneurysms tend to form on the forks or branches in the arteries due to which the areas of the vessels are weaker. Although aneurysms can occur anywhere in the brain, they are most common in the arteries at the base of the brain.

Risk factors

There are several factors that can cause weakness in an artery wall. These factors can increase the risk of a brain aneurysm, or aneurysm rupture. Some of these risk factors develop over time, while others are present at birth.

The risk factors include:

  • Age. Brain aneurysms can occur at any age. However, it is more common in adults between the ages of 30 and 60.
  • The fact of being a woman. Brain aneurysms are more common in women than in men.
  • Smoking cigarettes. Smoking is a risk factor for cerebral aneurysms in the manner and for cerebral aneurysms to rupture.
  • The high blood pressure. This condition can weaken the arteries. Aneurysms are more likely to form and to rupture in a weakened arteries.
  • The use of drugs, in particular the use of cocaine. The use of drugs increases the blood pressure. If illicit drugs are used in a vein, it can lead to an infection, which can cause an aneurysm.
  • The excessive use of alcohol. This can also increase the blood pressure.
  • Hereditary connective tissue conditions, such as Ehlers-Danlos syndrome. These conditions weaken the blood vessels.
  • Polycystic kidney disease. This inherited condition results in fluid-filled sacs in kidneys. It can also increase blood pressure.
  • A narrow aorta, also called coarctation of the aorta. The aorta is the large blood vessel that carries oxygen-rich blood from the heart to the body.
  • Cerebral arteriovenous malformation, also called a brain AVM. In this condition, the arteries and veins in the brain are entangled. This affects the flow of blood.
  • A family history of cerebral aneurysm. The risk is higher if you have family members who have had a brain aneurysm. This is particularly true if two or more first-degree relatives — as a father, brother or son — to have had a brain aneurysm. If you have a family history, ask your health care provider about screening for brain aneurysm.

Some types of aneurysms can occur after a head injury or certain infections of the blood.

The risk factors for a rupture of the aneurysm

There are a few factors that make it more likely that an aneurysm will rupture. They include:

  • Have a great aneurysm.
  • Have aneurysms in certain places.
  • Have an irregular shape of the aneurysm or to have a bag in the aneurysm, it is called a daughter sac.
  • Smoking cigarettes.
  • Having untreated high blood pressure.

Complications

When a brain aneurysm ruptures, the bleeding usually lasts only a few seconds. However, the blood can cause direct damage to the surrounding cells and can kill brain cells. It also increases the pressure within the skull.

If the pressure is too high, can interrupt the supply of blood and oxygen to the brain. The loss of consciousness or even death may occur.

The complications that may develop after rupture of an aneurysm include:

  • Re-bleeding. An aneurysm that has ruptured or has filtered is at risk of bleeding again. Re-bleeding can cause more damage to the brain cells.
  • Narrowing of the blood vessels in the brain. After a brain aneurysm ruptures, blood vessels in the brain contract and narrow. This is known as vasospasm. The vasospasm can cause an ischemic stroke, which does not restrict the flow of blood to the brain cells. This can cause more cell damage and loss.
  • A buildup of fluid within the brain, known as hydrocephalus. More often, a ruptured brain aneurysm occurs in the space between the brain and the thin tissues that cover the brain. The blood can block the movement of the cerebrospinal fluid that surrounds the brain and the spinal cord. As a result, an accumulation of fluid puts pressure on the brain and can damage tissue.
  • Change in the level of sodium. Bleeding in the brain can alter the balance of sodium in the blood. A drop in blood sodium levels can lead to swelling of brain cells and permanent damage.

Prevention

In many cases, brain aneurysms can't be prevented. But there are some changes you can make to reduce your risk. They include stopping smoking if you smoke. Also work with your healthcare provider to reduce your blood pressure if it is high. Do not drink large amounts of alcohol or use of drugs such as cocaine.

Diagnosis

Tests and procedures used to detect and diagnose brain aneurysms are:

  • Computed tomography.This specialized X-ray is usually the first test used to assess the bleeding in the brain or in another type of stroke. The test produces images that are 2D slices of the brain. A computed tomography angiography can create detailed images of the arteries provide the blood flow in the brain. The test involves injecting a contrast dye into the vein, which makes it easier to observe the flow of blood. It can also detect the presence of an aneurysm.
  • Lumbar puncture, also known as a spinal tap.If you have had a subarachnoid hemorrhage is more likely to be red blood cells in the fluid that surrounds the brain and the spine. This fluid is called the cerebrospinal fluid. If you have symptoms of a ruptured aneurysm, but a CT scan shows no evidence of bleeding, a proof of his cerebrospinal fluid can help make a diagnosis. The procedure to extract the cerebrospinal fluid of his back with a needle called a lumbar puncture.
  • The magnetic resonance imaging.This imaging test uses a magnetic field and radio waves to create detailed images of the brain. These images can be in 2D or 3D images, and it can show if there is bleeding in the brain. A type of magnetic resonance imaging that captures images of the arteries in detail is called MR angiography. This type of magnetic resonance imaging can detect the size, shape, and location of an aneurysm.
  • Cerebral Angiography.During this procedure, a thin flexible tube called a catheter is used. The catheter is inserted into an artery, usually in the groin or the wrist. The catheter wire past his heart to the arteries of the brain. A special dye is injected through the catheter travels to the arteries around the brain. A series of X-rays can reveal details about the conditions of the arteries and to detect an aneurysm. A cerebral angiogram, also called a cerebral arteriogram — is generally used when other diagnostic tests do not provide enough information.

Computed tomography. This specialized X-ray is usually the first test used to assess the bleeding in the brain or in another type of stroke. The test produces images that are 2D slices of the brain.

A computed tomography angiography can create detailed images of the arteries provide the blood flow in the brain. The test involves injecting a contrast dye into the vein, which makes it easier to observe the flow of blood. It can also detect the presence of an aneurysm.

Lumbar puncture, also known as a spinal tap. If you have had a subarachnoid hemorrhage is more likely to be red blood cells in the fluid that surrounds the brain and the spine. This fluid is called the cerebrospinal fluid. If you have symptoms of a ruptured aneurysm, but a CT scan shows no evidence of bleeding, a proof of his cerebrospinal fluid can help make a diagnosis.

The procedure to extract the cerebrospinal fluid of his back with a needle called a lumbar puncture.

The magnetic resonance imaging. This imaging test uses a magnetic field and radio waves to create detailed images of the brain. These images can be in 2D or 3D images, and it can show if there is bleeding in the brain.

A type of magnetic resonance imaging that captures images of the arteries in detail is called MR angiography. This type of magnetic resonance imaging can detect the size, shape, and location of an aneurysm.

Cerebral Angiography. During this procedure, a thin flexible tube called a catheter is used. The catheter is inserted into an artery, usually in the groin or the wrist. The catheter wire past his heart to the arteries of the brain. A special dye is injected through the catheter travels to the arteries around the brain.

A series of X-rays can reveal details about the conditions of the arteries and to detect an aneurysm. A cerebral angiogram, also called a cerebral arteriogram — is generally used when other diagnostic tests do not provide enough information.

The detection of cerebral aneurysms

Detection of rupture of cerebral aneurysms is normally only used if you are at high risk. Talk with your health care provider about screening tests if you have:

  • A family history of brain aneurysms or a hemorrhagic stroke. Particularly if two first-degree relatives — parents, siblings or children — have had a brain aneurysm or hemorrhagic stroke.
  • A condition that increases the risk of developing a brain aneurysm. These disorders include polycystic kidney disease, coarctation of the aorta or Ehlers-Danlos syndrome, down syndrome, among others.

Most aneurysms do not rupture. And for many people, a ruptured aneurysm will never cause symptoms. But if the aneurysm ruptures, several factors may affect the outcome, which is known as forecasting. They include:

  • The person's age and health.
  • If the person has other conditions.
  • The size and location of the aneurysm.
  • How much bleeding has happened.
  • How much time passed before receiving medical attention.

Approximately 25% of people who experience a ruptured aneurysm die within 24 hours. Another 25% of the complications that lead to death within six months.

Treatment

The repair of a ruptured aneurysm requires surgery or endovascular treatment. Endovascular treatment means an aneurysm is treated from the inside of the artery. Also can you give treatments to relieve the symptoms.

If you have an aneurysm not, talk with your health care professional about possible treatments. Talk about whether the risk of leaving the aneurysm alone is greater than the risk of treating the aneurysm.

The factors that health care professionals consider that before making treatment recommendations include:

  • The size of the aneurysm, the location and general appearance of the aneurysm.
  • Your age and general health.
  • A family history of ruptured aneurysm.
  • The conditions in which you were born with that increase the risk of rupture of the aneurysm.

Surgery

There are two common treatment options for repair of a ruptured brain aneurysm. For some people, these procedures can be considered for the treatment of an unruptured aneurysm. However, the treatment potential risks may be greater than the potential benefits for some unruptured aneurysms.

Surgical clipping

Surgical clipping is a procedure to close an aneurysm. The neurosurgeon removed a section of his skull to access the aneurysm. The neurosurgeon then locate the blood vessel that feeds the aneurysm. The surgeon places a small metal clip on the neck of the aneurysm to stop the flow of blood in it.

Surgical clipping can be very effective. Normally, the aneurysms that were clipped not return. The risks of surgical cut, which include bleeding in the brain, or loss of blood flow to the brain. These risks are low.

The recovery of the surgical cut, it usually takes around 4 to 6 weeks. When surgical clipping is performed by a ruptured aneurysm, many people can leave the hospital a day or two after the surgery. For those who have surgical clipping because of a ruptured aneurysm, the length of the hospital stay is typically much more time to recover from the rupture of the aneurysm.

Endovascular Treatment

This is a procedure less invasive than the surgical cutting, and can be more secure. Endovascular treatment consists of the access to the aneurysm by inserting a small plastic tube (catheter) through the artery. The catheter is advanced in the arteries of the brain. Then, the coils can be placed.

  • Endovascular coils. During this procedure, a surgeon inserts the catheter into an artery, usually in the groin or wrist. Then, the surgeon threads through the body to the aneurysm. A small coil in the form of a spiral that is placed inside the aneurysm. This prevents blood from flowing into the aneurysm. The coil also makes the blood that is in the aneurysm to clot.
  • The stents in endovascular. A stent is a small tube that can be used with an endovascular coil for some types of brain aneurysms. A stent may hold the coil in place.

As surgical clipping, endovascular treatment carries the risk of bleeding in the brain, or loss of blood flow to the brain. Also, there is a risk that the aneurysm may reappear over time. If that happens, the procedure can be repeated. It is likely that you will need follow-up imaging tests to ensure that the aneurysm has not returned.

Flow diversion

Flow diversion is an endovascular treatment option for the treatment of a brain aneurysm. The procedure involves the placement of a stent into the blood vessel to divert blood flow away from the aneurysm. The stent is placed is called a diverter flow.

With less blood flow that goes to the aneurysm, there is less risk of rupture. It also allows the body to heal itself. The stent prompts the body to grow new cells to seal the aneurysm.

Flow diversion can be especially useful in large aneurysms that cannot be treated with other options and in the places that are more difficult to treat with surgery or standard endovascular treatments.

Other procedures for the rupture of aneurysms

Other procedures for the treatment of ruptured aneurysms and the complications of the rupture may include:

  • The angioplasty. This is a procedure to expand a narrowing of the blood vessels in the brain caused by vasospasm. The procedure can also help prevent a stroke.
  • Ventricular or lumbar drainage catheters, and bypass surgery can decrease pressure in the brain of an accumulation of cerebrospinal fluid. A catheter may be placed in the spaces which are full of fluid inside the brain. Or it can be placed on the area that surrounds the brain and the spinal cord. The catheter drains the excess fluid in an external bag or in the abdomen for more permanent drainage.

Drugs for the rupture of cerebral aneurysms

The drug can be used after a rupture of an aneurysm in the brain to relieve symptoms and manage complications. Medications may include:

  • Pain relievers, such as acetaminophen (Tylenol, others), can be used to treat the headache.
  • Calcium channel blockersprevent the entry of calcium into the cells of the walls of the blood vessels. These medicines can decrease the risk of having symptoms of the narrowing of the blood vessels, known as vasospasm. The vasospasm can be a complication of a ruptured aneurysm. One of these drugs, nimodipine (Nymalize), has been shown to reduce the risk of a delay in brain injury caused by insufficient blood flow. This can happen after subarachnoid hemorrhage from a ruptured aneurysm.
  • Medications to open the blood vessels. A medicine can be administered to dilate the blood vessels. This can be given through an IV in your arm or with a catheter directly in the artery that supply the brain. This can help to prevent a stroke, allowing the blood to flow freely. The blood vessels can also be expanded by the use of medications known as vasodilators.
  • Anti-epileptic drugs can be used to treat seizures related to the rupture of the aneurysm. Drugs that are not normally given if an attack has not happened.

Calcium channel blockers prevent calcium from entering the cells of the walls of the blood vessels. These medicines can decrease the risk of having symptoms of the narrowing of the blood vessels, known as vasospasm. The vasospasm can be a complication of a ruptured aneurysm.

One of these drugs, nimodipine (Nymalize), has been shown to reduce the risk of a delay in brain injury caused by insufficient blood flow. This can happen after subarachnoid hemorrhage from a ruptured aneurysm.

Rehabilitation therapy can be used after a brain aneurysm ruptures. The damage to the brain of a subarachnoid hemorrhage can result in the need for physical, speech and occupational therapy to re-learn skills.

The treatment of the rupture of cerebral aneurysms

A clip surgical, endovascular coil or a diverter flow can be used to close a ruptured brain aneurysm. This can help to prevent a future breakdown. However, the risk of rupture can be very low in some unruptured aneurysms, and the known risks of the procedures may be greater than the potential benefits.

A neurologist working with a neurosurgeon or interventional neuroradiologist can help you decide if the treatment is right for you.

Lifestyle and home remedies

If you have a ruptured brain aneurysm, you can decrease the risk of rupture by making these lifestyle changes:

  • Do not smoke cigarettes. If you smoke, talk with your health care professional. They can suggest strategies or a treatment program to help you stop smoking.
  • Control your blood pressure if you have high blood pressure.
  • Eat a healthy diet and exercise. Changes in diet and exercise can help to lower blood pressure. Talk with your health care professional about the changes that are right for you.
  • Do not use alcohol in excess.
  • Do not use recreational drugs such as cocaine, methamphetamine or the other. If you make use of these drugs and would like to quit smoking, talk to your health professional.

Coping and support

The Brain Aneurysm Foundation offers more information on connecting with support groups in many states and in other countries.

Preparing for your appointment

If the test results indicate that you have a brain aneurysm, you will need to speak with a specialist in the brain and nervous system conditions. These specialists include neurologists, neurosurgeons and neuroradiologists.

Here's some information to help you prepare for your appointment.

What you can do

  • Be conscious of any thing you need to do ahead of time. At the time you make the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
  • Write down any symptoms you have, including those that do not seem to be related to the reason for which you scheduled the appointment.
  • Write important personal information, including major stresses or recent life changes.
  • Make a list of all the medicines, vitamins, and supplements you are taking and the dose.
  • Have a family member or friend. It can be difficult to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
  • Write questions to ask their health care team.

Your time with your health care team is limited, so preparing a list of questions can help you make the most of their time together. A list of questions from most important to least important in case time runs out. By rupture of cerebral aneurysms, some basic questions to ask include:

  • What do you know about the size, location and general appearance of the aneurysm?
  • How likely is it that my aneurysm rupture?
  • What treatment do you recommend at this time? What are the risks of treatment?
  • If the treatment is not currently indicated, how often do I need to have follow-up scans for the aneurysm?
  • What steps can I take to reduce the risk of rupture of an aneurysm?

Do not hesitate to ask other questions.

What to expect from your doctor

Be prepared to answer questions, such as:

  • Do you smoke cigarettes?
  • How much alcohol do you drink?
  • Do you use recreational drugs?
  • You are being treated for high blood pressure?
  • Do not take their medications as prescribed by your health care professional?
  • There is a history of a brain aneurysm or cerebral aneurysm rupture in your family?
  • What is your medical history?
Symptoms and treatment of Brain aneurysm