Symptoms in the event of an aneurysm rupture are immediate and the most representative of these is headache. The causes of a cerebral aneurysm are different: very often, at its origin there is a bad lifestyle, but it is not excluded that there may also be a congenital predisposition.
The diagnosis must be rapid and precise, as the treatment to be given to the patient must be immediate. In fact, surgery and pharmacological treatments, if applied promptly, can save the patient's life.
WHY IS IT RIGHT IN THE BRAIN? WHERE EXACTLY?
An aneurysm can form in any blood vessel in the human body. However, there are places, such as the abdominal aorta and the brain, where this formation is more frequent, due to the specific anatomy of the vascular system present there.
The most dramatic consequence of a cerebral aneurysm, or haemorrhagic stroke, usually occurs in the space between the skull, the meninges and the brain (subarachnoid space): in these cases we speak of subarachnoid hemorrhage and stroke subarachnoid hemorrhagic.
TYPES OF CEREBRAL ANEURISM
Cerebral aneurysms with a sac-like appearance are the most common, but they are not the only ones. There is, in fact, another different type of aneurysms, the fusiform ones.
- Saccular (or saccular) aneurysms: these are the most frequent, similar to berries or balloons. They consist of a neck (at the base) and a bulging dome. They protrude from one side of the affected arterial vessel only.
- Fusiform aneurysms: they are less common than the previous ones and consist of a swelling of the entire vessel. A neck and a dome cannot be distinguished, but they are however well evident.
Figure: a saccular or saccular (above) and fusiform (below) shaped cerebral aneurysm. From the site: www.neuros.net.
EPIDEMIOLOGY
According to some Italian statistics, about 1% of the population suffers from a cerebral aneurysm.
Of this fraction, 0.2-0.3% undergoes subarachnoid haemorrhage during life. Each year, the number of people prone to subarachnoid hemorrhage is 10-15 per 100,000.
20-30% of people who suffer a ruptured aneurysm die before reaching the hospital; 50% die within 30 days of the event.
The age group most affected is the one that goes from 40 to 60 years, even if each individual (young or adult) is potentially at risk.
Finally, a greater predisposition on the part of women was noted: the ratio with men is 3 to 2.
By non-treatable risk factors, on the other hand, we mean certain characteristics of the patient that cannot be modified, such as age, population, genetic predisposition, etc.
Treatable risk factors:
- High blood pressure (arterial hypertension)
- Overweight and obesity
- Hardening of the arteries (arteriosclerosis)
- Smoke
- Taking drugs, especially cocaine
- Brain trauma
- Alcohol abuse
- Certain blood infections
- Physical inactivity
The untreatable risk factors:
- Old age
- In women, the low level of estrogen after menopause
- Family history of aneurysm
- African, Asian or Caribbean population (these are populations predisposed to suffer from hypertension)
RISK FACTORS PRESENT AT BIRTH
Alongside the treatable and non-treatable risk factors, there is a third category of causes, of a congenital nature, i.e. present from birth. These are particular pathologies, often characterized by anomalies of the blood vessels of the circulatory system.
- Ehlers-Danlos syndrome. It is an inherited disease, which affects the connective tissue and makes the blood vessels weaker.
- Polycystic kidney. It is a hereditary pathology, characterized by cysts in the kidneys. It causes chronic hypertension.
- Aortic coarctation. This is an abnormal narrowing of the aorta, which can cause high blood pressure.
- Arteriovenous malformation in the brain. Sufferers are born with an "abnormal connection between arteries and veins, such that the flow of blood through them is interrupted.
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As long as the cerebral aneurysm remains intact and does not rupture, it is rare for the patient to experience particular symptoms or signs. If this occurs it is because either the aneurysm is particularly large or because there is still a small loss of blood, despite the wall. is intact.
SYMPTOMS OF A BREAKDOWN OF THE ANEURISM
The most characteristic symptom of a ruptured brain aneurysm is a headache, or headache. It is a pain that certainly does not go unnoticed, as it is characterized by sudden onset and considerable severity. Often, it is defined by the affected individual as the strongest headache ever suffered in life.
In addition to headache, the patient may complain of:
- Nausea and vomit
- Stiff neck
- Blurred and double vision
- Difficulty moving your eyes
- Sensitivity to light
- Epilepsy
- Drooping eyelid
- Confusion
- Difficulty moving part of the facial muscles
Obviously, to trigger the aforementioned symptoms is the cerebral hemorrhage. It lasts a few seconds. However, this short period of time is sufficient, because the leaked blood floods the surrounding brain areas, compressing them and causing their death. As already mentioned, the most common hemorrhage is that which occurs in the subarachnoid space.
SYMPTOMS OF A SLIGHT BLOOD LOSS
A cerebral hemorrhage can also occur when the vessel wall of the aneurysm remains intact.
This is a small loss, but it can cause severe headache with sudden onset.
In fact, this situation is the prelude to an imminent rupture of the aneurysm. Therefore, it is also difficult to diagnose.
THE SYMPTOMS OF AN UNBREAKED BRAIN ANEURISM
The only cerebral aneurysms not yet ruptured, which cause a certain symptomatology, are the very large ones. The reason is simple: a large aneurysm compresses the brain tissue and surrounding nerves.
In these cases, the patient warns:
- Pain above and behind the eyes
- Dilated pupils
- Strange changes in vision or double vision
- Fall asleep, weakness and paralysis of the facial muscles
- Drooping eyelid
WHEN TO SEEK YOUR DOCTOR
If action is not taken promptly and promptly, the rupture of an aneurysm has lethal consequences. Therefore, as soon as an abnormal headache is felt, as it is sudden and very strong, it is good not to delay and immediately seek help.
COMPLICATIONS
When an aneurysm ruptures in the brain, the complications associated with it are mainly due to "haemorrhage. This last one, in fact, in addition to irreparably damaging the brain tissue, can have several other consequences.
Intracranial pressure increases, causing the patient to lose consciousness or causing hydrocephalus.
It can cause vasospasm, which is the reduction in the caliber of arterial vessels. This can cause, in the brain, a lack of blood supply and the onset of further damage (ischemic stroke).
Hyponatremia can develop after brain damage has spread to the hypothalamus.
It can cause the patient to lose some motor skills and the ability to speak (this depends on the area of the brain affected and the amount of time elapsed between the onset of symptoms and the start of treatment).
What are hydrocephalus and hyponatremia?
The term hydrocephalus indicates a pathological condition in which the cerebrospinal fluid increases dramatically within the subarachnoid space of the brain. This accumulation occurs when previously intracranial pressure (hypertension) has increased. Possible causes of hypertension are: tumor brain, cerebral haemorrhage, meningitis, encephalitis, CNS malformations etc.
Hyponatremia, on the other hand, is a condition characterized by low levels of sodium in the blood. Sodium is a fundamental electrolyte, which allows the cells of our body to function.
THE DANGER OF ANOTHER BLOODING
The bleeding that follows the rupture of an aneurysm lasts a few seconds. However, the likelihood of the episode recurring is considerable, as the vessel wall has weakened even more. Therefore, a first bleeding is often followed by other similar events.
MORE: Cerebral Aneurysm - Diagnosis, Therapy, Prevention
