Cerebral Aneurysms: Overview, Risks, and Treatments

What Is a Cerebral Aneurysm?

• A weakening in the blood vessel wall causes a bulge or outpouching.
• Most commonly occur in the Circle of Willis, which surrounds the base of the brain.
• The bifurcations (forks) in blood vessels create turbulence points, making these areas vulnerable to aneurysm formation.

Susceptibility and Risk Factors

• Hypertension (high blood pressure):
  • Increases stress on vessel walls.
  • Promotes weakening and aneurysm development.
• Size and symptoms:
  • Usually small and asymptomatic.
  • Symptoms appear only if it ruptures.

Rupture and Its Effects

• Hemorrhage:
  • Blood irritates meninges and nerves → headaches.
  • Blood release causes vasospasms leading to ischemia.
  • Severe bleeds can increase ICP and cause brain damage.

Signs and Symptoms of Rupture

• Location-dependent:
  • Visual pathways: vision loss or disturbances.
  • Headache, photophobia.
  • Brain dysfunction: confusion, slurred speech.
  • Neck rigidity (nuchal rigidity): neck pain due to meningeal irritation.
  • Vomiting, seizures, loss of consciousness.
• High mortality:
  • 35% die from initial rupture.
  • 15% die after second rupture.

Prevention

• Control hypertension.
• Maintain a healthy lifestyle and avoid risk factors like smoking.
• Regular check-ups for early detection.

Treatment Options

• Surgical clipping:
  • Open surgery to place a clip around the aneurysm neck.
  • Causes aneurysm to atrophy and die.
• Endovascular coiling:
  • Thread a catheter into the aneurysm via angiogram.
  • Insert coils that induce clot formation inside the aneurysm.
• Bypass procedures (less common):
  • Redirect blood flow to prevent stress on aneurysm.

Diagnostic Techniques

• Angiogram:
  • Injection of contrast dye.
  • Visualizes blood vessels and aneurysm location.
• CT or MRI:
  • Confirm blood leakage or structural abnormalities.

Long-term Prevention

• Lifestyle modifications:
  • Managing blood pressure.
  • Avoiding smoking and drug use.

Summary

• Aneurysms are dangerous bulges that risk rupturing with catastrophic bleeding.
• Early detection and preventive management are key.
• Surgical and endovascular procedures are effective in preventing ruptures.