Cerebral Aneurysm

By Kayleigh Burns

A cerebral aneurysm, which is a thin area inside the brain that causes the space to fill up with blood, places pressure on the brain tissue [1]. Additionally, it has a blister-like dilation [2]. A cerebral aneurysm can escalate to more serious effects, such as comas, brain damage, and death. When this aneurysm ruptures, it is known as a subarachnoid hemorrhage [2]. However, this is not always the case, as it depends on the size of the aneurysm. Some patients might have significantly smaller cerebral aneurysms without any dangerous effects [1]. These aneurysms tend to form around the skull’s subarachnoid space, but they are not limited to this area.

There are numerous causes that may lead to a cerebral aneurysm, like smoking, family history, hypertension, and injuries [2]. Those who are older in age are also at a higher risk. The symptoms between a ruptured and unruptured aneurysm are notable. Patients who experience an unruptured aneurysm might feel weakness, experience difficulty in vision, and paralysis in the face. Conversely, those who have a ruptured aneurysm might have double vision, vomiting, neck pain/stiffness, seizures, and cardiac arrest [1].

Specifically, there are three types of cerebral aneurysms. The fusiform aneurysm tends to balloon out of an artery. The mycotic aneurysm happens due to an infection the patient has. The infection can affect the arteries in their brain, leading to a mycotic aneurysm [1]. Similar to the fusiform aneurysm, the mycotic aneurysm also bulges out. Lastly, the saccular aneurysm is seen as attached to a main artery or its branches. It has an appearance similar to a berry hanging on a vine. The saccular aneurysm is significantly more common than the mycotic and fusiform aneurysms [1].

In order to be diagnosed, a patient must undergo a typical physical exam. However, they also undergo a computed tomography scan (CT Scan), magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), or a digital subtraction angiography (DSA). Once diagnosed, a patient’s treatment will differ based on their personal circumstances [3]. Physicians have to acknowledge the patient’s age, gender, family history, and symptoms. The goal of the treatment is to lessen the risk of a future hemorrhage. However, in certain cases, surgery might be necessary as well [3].

The two surgeries available are an open craniotomy and endovascular coiling. In an open craniotomy, the surgeon removes an area of the skull. By doing this, the surgeon is able to view the aneurysm and prevent blood flow by placing a metal clip across the aneurysm [3]. On the other hand, in endovascular coiling, a catheter is used and goes into the blood vessels within the brain. Small platinum coils, which travel through the catheter, match the aneurysm’s shape. The goal of the procedure is to prevent any ruptures from occurring. When compared to an open craniotomy, the endovascular coiling is much less invasive [3].

If an aneurysm does rupture, there will be complications to follow. Hydrocephalus, which is caused when there is too much cerebrospinal fluid within the brain, could occur due to blood being blocked in a subarachnoid hemorrhage [1]. This might cause a patient to enter a coma or die. Furthermore, seizures and rebleeding may also take place due to a rupture. However, to prevent these events from happening, research is being done. The National Institute of Neurological Disorders and Stroke (NINDS) completes research to learn more regarding cerebral aneurysms. They have found that genetics tend to play a role in some patients who endure a cerebral aneurysm. Although the NINDS does not fully understand the connection between genetics and the aneurysm yet, they are working towards learning more.

References

1. Cerebral Aneurysms Fact Sheet. (n.d.). Retrieved December 14, 2020, from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Cerebral-Aneurysms-Fact-Sheet

2. Cerebral Aneurysm. (n.d.). Retrieved December 14, 2020, from https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Cerebral-Aneurysm

3. Cerebral Aneurysm. (2020, August 18). Retrieved December 14, 2020, from https://www.columbianeurology.org/neurology/staywell/cerebral-aneurysm