Aneurysm

Brain aneurysm is simply a ballooning or bulging of one of the blood vessels in the brain. This video shows how it is treated by surgical clipping.

What is a brain aneurysm? Why does an aneurysm rupture? What are the symptoms of brain aneurysm?

Brain aneurysm or cerebrovascular aneurysm is like a balloon that is filled with so much blood at great pressure that it is likely to burst, if it is stretched beyond its resistance. They can either remain unruptured or leak or rupture. When they remain unruptured, they are generally diagnosed incidentally. Occasionally relatively large aneurysms may remain asymptomatic or cause symptoms because of pressure on neighbouring structures. Generally, brain aneurysms are diagnosed because of symptoms that are caused when they leak or rupture.

A leak or burst in the brain aneurysm can lead to blood clot in the space between the blood vessel and brain. This leads to “the worst headache of my life”, nausea and vomiting, stiffness in the neck, irritability, convulsions, loss of consciousness etc. An unruptured aneurysm is generally asymptomatic if it is small; but a large one may cause pressure on surrounding nerves that supply the eyes, leading to “behind the eye pain”, double vision, numbness in one side of face or a squint.

Where are brain aneurysms located?

They are generally located wherever there is a forking or branching of the blood vessels, because this is where there is lot of turbulence in the blood. They can appear anywhere but are mostly seen at the base of the brain.

How is a brain aneurysm diagnosed?

When a brain aneurysm is suspected, a CT angiography or a Digital Subtraction Angiography DSA is performed to know for sure. This also helps in knowing the size, number of aneurysms present and its location.

What are the risk factors?

Old age, smoking, high Blood pressure and certain inherited familial disorders are associated with a higher incidence.

What is the treatment of brain aneurysm?

Brain aneurysms can either be clipped surgically or coiled. In the video here, Dr Jaydev Panchwagh shows surgical clipping. One or more clips are applied to the base of the aneurysm so that no blood enters it. This prevents any further rupture.

What are the complications of Brain aneurysm rupture?

A rupture of the aneurysm itself can lead to severe bleeding into the brain, increased pressure within the skull severe headache, convulsions, and loss of consciousness or death. If the patient survives the initial rupture, the presence of the leaked blood itself can lead to severe narrowing of the surrounding blood vessels, called vasospasm, which can lead to multiple problems.

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