Symptoms of cerebral aneurysm.Treatment, causes, operations, consequences

Update: October 2018

Cerebral vascular aneurysm is the swelling of the source
the walls of one of the arteries of the brain, filled with blood. Those y
who it is, have a “time bomb” inside the skull.
The wall of the artery in the place where this protrusion formed does not have
the muscle layer and the membrane that causes the lack of this
place of elasticity and strength of the vessel.

The particular danger of the disease is due to the fact that
the thinned wall of the artery can break at any second,
resulting in cerebral hemorrhage. Also
aneurysm can compress nearby brain tissue and
nerves.

What are its causes?

As a result, many studies have identified several
factors that increase the risk of aneurysms in
to a large extent.

  • Hereditary factor – with a deficiency of type III collagen
    thinning of the muscular layer of the arteries occurs. Especially
    in this case, aneurysms form in the zone of bifurcations (split)
    arteries and in places where a large tortuosity of the arteries. Accompanied by
    This and other pathologies, for example, coarctation of the aorta, hypoplasia
    renal arteries
  • Injury arteries in history
  • Hyalinosis of the vascular walls
  • Smoking
  • Drug use
  • High blood pressure
  • Artery embolism – transfer of small “pieces” through the bloodstream
    malignant tumors or conglomerate fungal or
    bacterial microorganisms
  • The effect of radiation of any duration
  • Atherosclerosis of cerebral vessels
  • Brain vessel aneurysm is a disease of adults 30-60
    years old
  • Women are prone to aneurysm more often than men
  • High risk of its development with hereditary location
  • In the USA, for example, every year 27,000 patients experience it.
    gap

Aneurysm classification

Эндоваскулярная операция аневризмы мозга

Endovascular surgery of cerebral aneurysm

I – in the form:

  • Bagular aneurysm – has a rounded shape, connects with
    artery trunk neck. It occurs most often in adults.
  • Lateral aneurysm – looks like a flat tumor
    formation on the vessel.
  • Spindle-like aneurysm – appears when the wall expands
    vessel at a specific site.

II – in size:

  • Small aneurysm – diameter less than 11 mm.
  • Medium aneurysm – diameter from 11 mm to 25 mm.
  • Giant aneurysm – more than 25 mm in diameter.

Symptoms of aneurysm

Often, while the aneurysm is small in size, it may not
manifest in any way and the patient about it may not even
guess. This is the cunning of the disease – patients
they are unaware of their diagnosis, the person is not disturbed by anything and
perhaps with this he can live his whole life. Clinical manifestations
arise when the aneurysm is large or
gapается.

With a large aneurysm, brain tissue can be squeezed and
nerve trunks, which entails a number of possible symptoms
cerebral vascular aneurysm:

  • Pain in the eyeballs
  • Blurred vision
  • Loss of sight fields
  • Facial numbness
  • Hearing loss
  • Expansion of one of the pupils (mydriasis)
  • Paralysis of the facial muscles on one side

При gapе аневризмы и внутричерепном кровоизлиянии будут
following symptoms:

  • Sharp unbearable headache
  • Nausea, vomiting
  • Possible loss of consciousness
  • Sensitivity to light, noise
  • In severe cases – coma
  • Paralysis of the muscles of the limbs on one side
  • Impaired speech function
  • Swallowing disorder
  • Loss of coordination
  • Impaired defecation and urination
  • Psychological changes – anxiety, agitation, anxiety
  • Cramps

Effects аневризмы сосудов мозга — опасность gapа

In most cases, aneurysm for a long time does not give about itself
know. For many years, a person can live with this “bomb” in his head and
узнает о ней лишь, когда произойдет gap аневризмы сосудов
головного мозга (риск gapа примерно 1% каждый год). Mortality in
this case is not less than 50%, disability is 25% and
только четверть всех, перенесших кровоизлияние в мозг из-за gapа
aneurysms remain able-bodied people. Effects
diseases:

  • Hemorrhagic stroke
  • Vasospasm
  • Coma
  • Hydrocephalus (see brain hydrocephalus in adults –
    symptoms, treatment)
  • Irreversible brain damage

Hemorrhage can be in the brain’s brain spaces or in
ventricles of the brain. In any case, there is swelling of the brain,
increases intracranial pressure. Blockage may occur
cerebrospinal fluid paths with subsequent displacement of brain structures.
Blood begins to decay over time, its decay products
cause an inflammatory reaction in the brain tissue that leads to necrosis
these sites. This means that the functions for which they were responsible
these areas of the brain will be lost.

When subarachnoid hemorrhage may occur such
complication like cerebral angiospasm. That is, peripheral
brain vessels are sharply reduced, resulting in blood flow
it slows down or becomes impossible, leading to ischemia
brain tissue.

Diagnostic methods

Rarely can aneurysm be detected by random examination
до ее gapа. Но обычно methods диагностики применяются уже после
ее gapа.

  • Angiography – X-ray method using
    contrast agents. A drug is injected intravenously, which
    allows you to see in the pictures all the vessels of the brain, their places
    narrowing, crimpiness, determine exactly where
    aneurysm.
  • Computed tomography (CT) is a non-invasive research method,
    allows you to determine which part of the brain hemorrhage occurred,
    volume of damaged tissue.
  • CT angiography is a combination of the two previous methods.
    Computed tomography with preliminary contrast
    substances.
  • Magnetic resonance imaging (MRI) – allows you to more accurately
    visualize the vessels. With MRI you can pinpoint
    localization and size of the aneurysm.
  • The study of liquor – under local anesthesia is carried out
    spinal puncture and sampling liquor. With hemorrhage with a breakthrough in
    ventricles or subarachnoid hemorrhage in the cerebrospinal
    fluid will be blood.

In the absence of aneurysm symptoms, frequent diagnosis is not
justified, only if there are 2 or more
Relatives with this disease are recommended regular
screening as well as regular diagnostics is indicated to patients already
имевшими gap аневризмы, поскольку риск развития новой аневризмы
is 1-2 percent per year.

Aneurysm Treatment Methods

In the case of an unexploded aneurysm, possibly, treatment
not required immediately. Most often, only monitoring is required.
condition and regular examination of the patient. When deciding on
treatment of cerebral aneurysm is associated with risks from
оперативного вмешательства и риск ее gapа. This takes into account
the size and type of aneurysm, the patient’s age, its location, condition
patient’s health and heredity.

Even the most experienced specialist in the diagnosis of aneurysm is not
сможет прогнозировать — будет когда-либо ее gap или нет.
Effects ее gapа очень серьезны, практически смертельны, но к
the decision to conduct surgery should be approached
very individual, since the surgical treatment of aneurysm
(surgery) also represents a considerable risk for the patient. On
Based on numerous studies, scientists have concluded that
при размере аневризмы меньше 10 мм вероятность ее gapа не
great, and in this case, the operation carries a greater risk. By different
According to experts, the occurrence of complications after surgery
make up 4-15 percent, and death rate 0-7 percent.

With cerebral aneurysm operations can be two
species:

1. Clipping the aneurysm with craniotomy. Complex
neurosurgical operation, its purpose is to turn off the aneurysm
from the general bloodstream. It does not disrupt the blood flow in the vessel, on
where it is located. In this case, the cranial is opened.
box in the desired projection, there is a vessel with an aneurysm. On ее
The neck is superimposed by a clip. It uses a special
microscope and microsurgical technique.

2. Endovascular surgery. In this case, the access is
through the femoral artery. A catheter is inserted into it, at the end of it.
there is a balloon or spiral that is held up to the vessel with
aneurysm under CT control. In this place is set cylinder
or spiral, which allow you to turn off the damaged from the bloodstream
vessel. It does not entail any consequences for
blood supply to the brain, because every part of the brain
blood supply from several sources. This type of operation
considered preferable because it is less traumatic.

Rehabilitation

After treatment of aneurysm patients need restorative
treatment. Those who have suffered a hemorrhage need more
thorough, long and intensive rehabilitation treatment
consequences. It includes physical therapy, massage,
physiotherapy, speech gymnastics, electrostimulation and others
methods.

Автор: Ревус Олеся Григорьевна врач-невролог

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