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Aneurysm

Aneurysm

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Overview

An aneurysm is a swelling formed by the weak walls of the blood vessels responsible for supplying blood to the brain. It is somewhat like a balloon in the brain. When this balloon bursts or ruptures, it causes bleeding in the brain, also known as haemorrhage. Brain aneurysms occur when the wall of a blood vessel in the brain bursts, causing a bleed into the surrounding tissue.

They can occur at any age and are especially common in older people. Aneurysms are frequently misdiagnosed as bleeding from other sources or conditions, resulting in lost time and potentially life-threatening complications. Even though comparatively older people are at higher risk of contracting aneurysms, anybody can get it. Even teenagers. It can be life-threatening if it isn't diagnosed early and treated adequately.

Types of Aneurysm

Aneurysms can be of the following types:

  • Abdominal Aortic Aneurysm: This aneurysm occurs in the aorta, which carries blood from the heart to the body. They are usually mistaken for a heart attack and can have symptoms like severe pain in the jaw, backache, etc.
  • Cerebral Aneurysms: Commonly known as brain aneurysms, they are little bulges occurring above the aorta present in the brain. They aren't an issue of concern until they become big and rupture.
  • Thoracic Aortic Aneurysms: These aneurysms occur in parts of the aorta that go through the chest. They are usually asymptomatic, making it difficult to be diagnosed on time.

Aneurysm Causes

Aneurysms can be caused by the following:

  • High blood pressure: High blood pressure can cause aneurysms. Blood pressure refers to the force of blood flowing through the blood vessels. Blood pressure is measured by how much pressure it places on artery walls. The blood vessels may be weakened or enlarged if the pressure increases above an average rate.
  • Atherosclerotic Diseases: People with atherosclerosis have a form of plaque buildup in their arteries. Plaque is a hard substance that comprises cholesterol, fat, and other substances that damages the arteries and prevents blood from flowing freely.
  • Other Factors: Certain risk factors can increase the chances of contracting aneurysms. Smoking frequently, being obese, pregnant, and following a diet high in cholesterol and fat can cause an aneurysm. Any family history of heart conditions also increases the chances of getting an aneurysm.

Aneurysm Symptoms

Symptoms of aneurysms may vary depending on the type of aneurysm one suffers. They are:

Cerebral Aneurysm Symptoms 

  • Nausea.
  • Vomiting.
  • Seizures.
  • Drooping eyelid.
  • Confusion.
  • Loss of consciousness.
  • Stiff neck.
  • Severe headache.
  • Numbness on one side of the face.
  • Dilated pupils.
  • Double vision.

Abdominal Aneurysm Symptoms

Thoracic Aortic Aneurysm Symptoms

  • Trouble while swallowing food.
  • Low blood pressure.
  • Loss of consciousness.
  • Shortness of breath.
  • Severe pain in the arms, neck, and jaw.

The doctor will suggest a few diagnostic tests to confirm the occurrence of an aneurysm.

Aneurysm Diagnosis

Aneurysms can be diagnosed with the help of the following diagnostic tests, they are:

  • CT Scans: The computer-generated X-ray, known as a CT scan, is used to look inside the body. The process involves passing an X-ray through the body, which takes many minutes. A CT scan can show the presence of an aneurysm and provide insights into if the aneurysm has burst, detecting blood that has leaked into the brain.
  • MRI Scans: MRI is a powerful tool for imaging the brain. MRI uses magnetic fields to create images of brain tissue. This type of scan is valuable in determining the effects of blood vessel abnormalities and the anatomy of aneurysms and other vascular lesions.
  • Angiogram: Angiogram uses X Rays to click clear images of blood vessels. Here, a catheter is inserted into the arteries to deliver the dye. This test is instrumental in diagnosing strokes, clots, aneurysms, etc.
  • Lumbar Puncture: This test is usually ordered when there's a possibility of a ruptured aneurysm. Here, a small fluid from in between the space between the spinal cord and its protective cover is extracted by the doctors. The blood in the fluid could indicate brain hemorrhage, bleeding, and even aneurysms.
  • Ultrasound: Abdominal ultrasound can help to detect abdominal aneurysms. An ultrasound uses sound waves to get a clear image of the abdomen.

The results of the above-mentioned diagnostic tests are usually available on the same day. A healthcare specialist will map treatment plans based on the results of these tests. Few tests might require not consuming any food at least twelve hours before it. The healthcare service provider will inform about such special requirements well.

Aneurysm Treatment

Treatment for an aneurysm may involve:

  • Endovascular Treatment: It is relatively less invasive than surgical clipping. Here, a catheter is inserted into one of the arteries and threaded through the patient's body until it reaches the aneurysm. Once found, several devices are used to destroy the aneurysm.
  • Surgical Clipping: Here, a part of the skull is removed to get proper access to the aneurysm and locate the blood vessel that's feeding the aneurysm. The neck of the aneurysm is then clipped to restrict further blood flow.
  • Medications: Pain relievers, calcium channel blockers, and anti-seizure medications may also be a part of the treatment plan for aneurysms.
  • Lumbar Drainage Catheters: This surgery helps reduce the pressure on the brain from excess hydrocephalus associated with the ruptured brain. The catheter is placed in the space filled with fluids or in the area surrounding the spinal cord and brain to drain the excess fluid into an external bag.
  • Shunt Surgery: A shunt system consisting of a flexible silicone rubber tube and a valve is sometimes introduced. It creates a drainage channel from the brain to the abdominal cavity.
  • Rehabilitative Therapy: Damages caused to the brain may require the patient to relearn certain skills. Hence, the doctor may prescribe physical, speech, and occupational therapy.
  • Treatment for Unruptured Aneurysms: Unruptured aneurysms can be treated with the help of an endovascular coil or a flow diverter.

Doctors will choose the right treatment option after considering the aneurysm's size, location, and nature. The patient's general health, age, family history with aneurysms, and presence of congenital diseases that could increase certain risks are also considered while making a treatment plan.

Aneurysm Prevention

One can take certain preventive measures to reduce the risk of contracting an aneurysm. They are:

  • Quitting smoking.
  • Maintaining a balanced diet.
  • Giving up on the consumption of alcohol and recreational drugs.
  • Controlling high blood pressure with the help of medications and other lifestyle changes.
  • Exercising regularly.
  • Maintain a healthy weight.
  • Sleep well.
  • Try to reduce stress.

Outlook

Somebody with an unruptured aneurysm can live comfortably without noticing it. But it can be fatal once it ruptures. Ruptured aneurysms can induce coma, cause hemorrhagic stroke, and long or short-term brain damage. Full recovery is possible but completely dependent upon the aneurysm's extent and nature and the patient's overall health.

Those diagnosed with unruptured aneurysms can work actively towards reducing the risk of rupture by making certain lifestyle changes along with the prescribed treatment. Regular checks can detect aneurysms at their early stages and provide necessary treatment.

Consult the doctor immediately in case of any symptoms relating to the aneurysm.

Reviewed & Updated On

Reviewed by Dr. Amit Gupta, Principal Consultant, Neurosciences, Neurosurgery, Spine Surgery on 18-July-2023.

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