Brain aneurysm or cerebral aneurysm is a ballooning or a bulge in a blood vessel inside the human brain. This usually resembles a berry that is hanging from a stem.
Hemorrhagic stroke (bleeding in the brain) may occur due to a leak or rupture resulting from brain aneurysm. Between the tissues covering the brain and the brain is the location where brain aneurysm occurs. Subarachnoid hemorrhage is the name given to this type of hemorrhagic stroke.
Prompt medical treatment is necessary when aneurysm rupture occurs because it becomes life-threatening rapidly.
It is uncommon for most brain aneurysm to rupture but symptoms or other health issues occur. When conducting other test on an individual is the time when this type of aneurysm will be detected.
Rupturing of an un-ruptured aneurysm can be prevented from occurring if appropriate treatment is administered appropriately.
What Causes Brain Aneurysm or Cerebral Aneurysm?
When the walls of the brain arteries become thin brain aneurysm occurs. Branches or folks are often formed in arteries owing to the fact that they are weaker.
Arteries found at the base of the brain are commonly affected by aneurysm despite the fact that it can come up in any side of the brain.
What are the Signs and Symptoms of Brain Aneurysm or Cerebral Aneurysm?
Below are the Signs and symptoms of ruptured aneurysm:
The main symptom of a ruptured aneurysm that is ruptured is a headache that is severe and sudden. The description of the headache that results has been called the "worst headache" ever to be experienced.
A ruptured aneurysm always exhibits the following common symptoms:
- Headache that is extremely severe and sudden
- Vomiting and nausea
- Stiff neck
- Double vision (blurred)
- Light sensitivity
- An eyelid that drops
- Losing consciousness
- Being confused.
Leaking Brain Aneurysm
A small amount of blood can leak as a result of aneurysm leak. Severe headache that is sudden can only be caused by the leaking (sentinel blood).
A leaking is always followed by a more serious rupture.
Un-Ruptured Brain Aneurysm
If the un-ruptured aneurysm is small it may not cause any symptoms at all. Nerves and tissues on the brain can be pressed by un-ruptured aneurysm that is large and it causes:
- Pain behind and above the eye
- The pupil is normally dilated
- Double vision or change in visibility
- One side of the face will be weak and numb or paralyzed
- The eyelid will droop.
Development of a sudden headache that is extremely severe must prompt you to seek medical attention immediately.
What are the Risk Factors for Brain Aneurysm or Cerebral Aneurysm?
Brain aneurysm or Cerebral aneurysm which results due to weakness of the artery can be due to various factors that contribute to this. Women are commonly affected more than men and mainly adults that children
The risks factors are sometimes present during birth and some are developed overtime.
Risk factor developing overtime are:
- Hypertension (high blood pressure)
- Arteriosclerosis (hardening of arteries)
- Abusing drugs, particularly cocaine
- Injury to the head
- Alcohol addiction
- Blood infections
- Drop in the level of estrogen post menopause.
Risk Factors of Brain Aneurysm or Cerebral Aneurysm that is Present at Birth
Following are the risk factors of brain aneurysm or cerebral aneurysm present at the time of child birth:
- Connective tissue disorder that is inherited, for example Ehler-danlos syndrome, which bring about weakening of blood vessels.
- Kidney inherited disorder called polycystic kidney disease which increases blood pressure due to fluid-filled sacs inside the kidney.
- Aorta that is abnormally narrow (coactation of the aorta) which is the main supplier of oxygenated blood to the body from the heart.
- One can have interruption of blood flow in the brain due to abnormal connection between the veins and arteries which results due to a condition known as cerebral arterivenous malformation (brain AVM).
- If an immediate family member like brother or sister or parent had brain aneurysm.
What are the Complications Involved in Brain Aneurysm or Cerebral Aneurysm?
Bleeding will only last for a few seconds when there is a rupture due to brain aneurysm. Cell that surrounds the rupture can die and also it can easily be damaged. The skull's pressure will increase as a result.
Death may occur or you lose consciousness because of elevated pressure which hinders the supply of oxygen and blood.
After an aneurysm rupture the following complications can develop:
- Re-bleeding. A ruptured aneurysm has high chances of bleeding again. Brain cells can further be damaged by re-bleeding.
- Vasospasm. Erratically narrowing of the brain vessels can accrue following a rupture caused by brain aneurysm.
- Hydrocephalus. Subarachnoid hemorrhage is the bleeding the gap between the brain and the tissues surrounding it. This results after an aneurysm of the brain. The flow cerebrospinal fluid which is the fluid surrounding spinal cord and brain can be blocked. Tissue will be damaged (hydrocephalus), as a result of the pressure exerted by the cerebrospinal fluids.
- Hyponatremia. Sodium balance on the body can be disrupted if a ruptured brain aneurysm gives rise to subarachnoid hemorrhage. The area nearing the base of the brain known as the hypothalamus may be damaged.
Permanent damage of the brain can result due to swelling of the brain cells when the blood sodium drops (hyponatremia).
What Tests are Conducted to Diagnose Brain Aneurysm or Cerebral Aneurysm?
You will have to go through a series of test to ascertain the type of brain aneurysm or cerebral aneurysm you have or if you have had a bleeding between the space in the brain and tissues surrounding (subarachnoid hemorrhage). This is always if you have any symptoms that are exhibit characteristics of a ruptured aneurysm or headache that is sudden and severe.
Your emergency care attendants will determine the cause of the bleeding of the brain if it was due to a ruptured brain aneurysm or ruptured cerebral aneurysm.
The same test will be conducted if you have experience symptoms of brain aneurysm that has not ruptured for example paralysis on one side of your face, vision changes, pain at the back of the eye.
The diagnosis procedures include:
Computerized Topography (CT) for Brain Aneurysm or Cerebral Aneurysm
This is the first test of determining if a bleeding has occurred in the brain. A CT scan mainly entails an X-ray test. 2-D images are produced that are the brain's "slices".
Cerebrospinal Fluid Exam for Brain Aneurysm or Cerebral Aneurysm
Your cerebrospinal fluid (fluid around the brain and the spine) will be having red blood cells for brain aneurysm or cerebral aneurysm,if subarachnoid hemorrhage has occurred.
If evidence of bleeding has not been shown by a CT scan then your doctor will order a cerebrospinal fluid test for a ruptured aneurysm.
A spinal tap or lumbar puncture is the process of drawing cerebrospinal fluid using a needle your back.
MRI (Magnetic Resonance Imaging) for Brain Aneurysm or Cerebral Aneurysm
2-D or 3-D images of the brain will be created through radio wave and magnetic field used by an MRI for brain aneurysm or cerebral aneurysm.
A ruptured aneurysm can be detected by an MRI which assesses the arteries precisely (MRI angiography).
Cerebral Angiogram for Brain Aneurysm or Cerebral Aneurysm
This procedure is also known as cerebral arteriogram and it entail the insertion of thin tube that is flexible (catheter) into an artery that is large. This passed via your groin and then goes through the heart to the arteries in the brain. A dye injection goes through the body to the brain in a specialized manner to detect brain aneurysm or cerebral aneurysm.
Detecting Brain Aneurysm through Screening
It is not recommended in general to use imaging tests when screening for brain aneurysm or cerebral aneurysm that is un-ruptured. It is worth discussing the benefits that might accrue if you have:
- If you have a family member with ruptured brain aneurysm or cerebral aneurysm particularly if they are two members.
- Increased risk of brain aneurysm due to a congenital disorder.
How is Brain Aneurysm or Cerebral Aneurysm Treated?
Surgery for Brain Aneurysm or Cerebral Aneurysm
Two viable surgical options for treatment of brain aneurysm or cerebral aneurysm are available.
- Surgical clipping for brain aneurysm or cerebral aneurysm:An aneurysm can be closed off through a process called surgical clipping. A section or the skull is removed by the neurosurgeon in order to access the aneurysm and in the process locating the blood capillary feeding the aneurysm. The bleeding will be stopped by a metal clip placed on the aneurysm's neck.
- Endovascular coiling for treating brain aneurysm or cerebral aneurysm: Surgical clipping is more invasive as compared to endovascular coiling. A hollow plastic (catheter) is inserted by the surgeon through the artery. This is usually through the groin to the aneurysm via the other parts of the body. A platinum wire is guided by a guide wire through the catheter and to the aneurysm. Blood will clot when the wire which has coiled in the aneurysm disrupts the flow of blood. In essence, the aneurysm is sealed off from the artery by the clotting.
Loss of blood flow or bleeding is the risks that are posed by both procedures. It may be safe to use endovascular procedure but it is less invasive. It may be necessary to perform extra procedure of re-bleeding occurs subsequently.
New and alternative treatment such as flow diverters is available for aneurysm of the brain. This may be viable for aneurysm that proves too risky to use other treatment options.
Your neurologist collaborating with your intervention neuroradiologist or neurosurgeon will recommend basing on the location, the general appearance, size of the brain aneurysm and the procedure you are able to undergo among other factors.
Other Treatments for Brain Aneurysm or Cerebral Aneurysm
Complication management and relieving symptoms are the aims of other treatments procedures of ruptured brain aneurysm or ruptured cerebral aneurysm.
- Headache pain because of brain aneurysm or cerebral aneurysm can be treated painkillers like acetaminophen (Tylenol, others).
- The walls of the blood vessels are guarded from calcium through calcium channel blockers. The narrowing of the blood vessels (vasospasm) can be lessened through this medication. Subarachnoid hemorrhage caused by a ruptured aneurysm can be reduced by nimodipine (Nymalise) which one of this medications.
- The resistance caused by a narrowed blood vessel can be elevated by injecting vasopressor which is a drug for intervening stroke that occur due to insufficient flow of blood.
- Angioplasty is another alternative of preventing stroke because of brain aneurysm or cerebral aneurysm. A narrowed blood vessel in your brain is inflated through the use of a catheter by a surgeon. Vasodilator causes the expansion of the blood vessel and they can be delivered via a catheter.
- Seizures that accrue as a result of ruptured aneurysm may be treated with anti-seizure medications. These treatment medicine are phenytoin (Dilantin, phenytek, others), valproic acid (Depakene), leveticetam (Keppra) and others.
- The pressure exerted by cerebrospinal fluid (hydrocephalus) due to a ruptured brain aneurysm or ruptured cerebral aneurysm can be lessened by using lumbar or ventricular draining catheters and having a shunt surgery. The excess fluid can be drained into a bag by inserting a catheter in the fluid filled space of the spinal cord or the brain (ventricles). Shunt system can be introduced after this. This is made up of silicon rubber that is flexible (shunt) with a valve which makes a draining channels emanating from the brain to the abdominal cavity.
- Rehabilitative therapy. You will need to learn skill again if you have had a subarachnoid hemorrhage, such as speech, occupation and physical therapy.
Treatment for Unruptured Brain Aneurysm or Cerebral Aneurysm
The un-ruptured brain aneurysm or cerebral aneurysm can be sealed off with endovascular or surgical clipping to prevent re-rupturing. The benefits can be outweighed by the risk involved in the procedure.
The determination of the appropriate treatment for you will be for your intervention neuroradiologist, neurosurgeon or your neurologist.
The recommendations for unruptured brain aneurysm or cerebral aneurysm will be made based on:
- The overall appearance, the size and the location of your aneurysm.
- Your general health and age.
- History of ruptured brain aneurysm in your family.
- Risks of ruptured aneurysm can be increased congenital condition.
In case of high blood pressure it is recommended that your doctor is aware of the medication of managing the condition. Controlling properly the blood pressure reduces risks of rupturing of the brain aneurysm or cerebral aneurysm.
The risk factor that has been known is that smoking cigarette increases the growth, formation and rupturing of aneurysm. Thus, is wise to control your provider on how to stop the habit.
Prevention of Brain Aneurysm Or Cerebral Aneurysm
The following are the factors that are not in the individuals hands when it comes to brain aneurysm or cerebral aneurysm:
- A family history of brain aneurysm or cerebral aneurysm.
- Race (as African Americans has greater chance of brain aneurysm or cerebral aneurysm)
Factors which are in your control:
- Avoid smoking
- Avoid alcohol consumption
- Regular exercise
- Eliminate stress entirely
- Maintain healthy weight.