According to statistics, such a problem as cerebral aneurysm occurs in 5% of the population. Often such an anomaly occurs covertly and is discovered only through the efforts of a pathologist. In half of the cases, aneurysms, which are small in size, do not rupture. Moreover, such a condition is extremely dangerous, since if a gap in education nevertheless occurs, the person runs the risk of becoming disabled, or even the matter may even end in death.
What is a ruptured brain aneurysm and who can it threaten?
The essence of the problem
An aneurysm is an enlargement of a section of the lumen of an artery. A rupture is called a serious complication when, due to damage to the formation, blood begins to flow into the brain, leading to irreversible changes in it. Experts say that in a third of cases, a breakup ends in the death of the person.
From a physiological point of view, the process is as follows: in the area where the aneurysm has formed, the vessels become inelastic, weaken and do not resist blood flow. It is because of this that a protrusion is formed, i.e. a small sac literally filled with blood. If the education is small, a person may not know about it. But the problem is that it can increase in size over time, and this leads to a violation of the integrity of the blood vessels. The weak point of an aneurysm is called the apex - this is where it ruptures most often.
Bleeding in the damaged area lasts literally seconds, but this is enough for serious disorders to begin in the brain. At first, the body tries to cope on its own, reflexively spasming the artery so that a blood clot forms, which will stop the release of blood and save life. But it also happens that this process is delayed. And in such a situation the prognosis is unfavorable.
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4.Treatment
For partial, chronic, gradually progressive disorders of cerebral circulation, it is prescribed strictly according to indications and taking into account a number of individual factors, i.e. self-medication is strictly contraindicated and deadly! – various effective therapeutic regimens, including stimulants of cerebral hemodynamics and neurometabolism (nootropics), protectors of cognitive functions, thrombolytics, antiplatelet agents, vitamin complexes.
It is mandatory to normalize your lifestyle, exercise and sleep patterns, and give up bad habits.
However, in the most acute and severe cases of embolism, the only choice is neurosurgical intervention to restore the patency of the cerebrovascular vessels and eliminate the consequences of ischemia. At the same time, timely seeking specialized help and strictly following the recommendations of a neurologist in most cases allows one to avoid such an outcome. The brain is not an organ that can be risked by waiting for natural or non-medical healing.
Symptoms of a rupture
As doctors note, a ruptured aneurysm has a clear clinical picture. All signs appear suddenly. A sharp headache occurs, which many characterize as unbearable. The situation may also be accompanied by vomiting, and in particularly severe cases, loss of consciousness and coma follow.
A breakup can occur against the backdrop of some emotional events and upheavals, or it can happen spontaneously. There is a risk of re-bleeding. So, after the first rupture, a blockage of the wall may occur, but after 2-3 weeks the situation can repeat. Doctors note that after repeated hemorrhage, the prognosis becomes unfavorable. After the person returns to consciousness, he or she experiences weakness, dizziness, and poor orientation in space. Rapid breathing and increased heart rate may also occur. In addition, stiff neck muscles, problems with oculomotor functions, loss of speech, and paralysis may occur.
The general condition of a person in such a situation is regarded as serious - he needs emergency medical care.
Principles of treatment
Aneurysm treatment is carried out by a neurologist. The operation is performed only by a neurosurgeon. Surgical methods are aimed primarily at preventing aneurysm rupture, which can result in the death of the patient. Conservative therapy for this pathology is used to slow the progression of the disease.
Surgical treatment of a cerebral aneurysm involves two types of main operations: clipping and endovascular occlusion. Surgery prevents the aneurysm from rupturing. A radical method of treatment is the removal of arteriovenous malformation during a microsurgical operation.
Aneurysm clipping
Aneurysm clipping is an open operation during which the neurosurgeon blocks blood flow in a certain area of the vessel and applies a clip. At the stage of preparation for surgery, specialists prescribe a procedure that allows them to stabilize the patient’s condition and minimize the risk of possible complications. Preventive examination makes it possible to identify possible disorders and diseases that can lead to adverse consequences of surgical intervention.
The operation is performed using modern microsurgical techniques through a small trepanation hole. During surgery, the neurosurgeon prevents rupture of the wall of the malformation.
After isolating the neck of the aneurysm, the specialist places a clip on it. Additional control with Doppler ultrasound allows you to assess the state of blood flow and ensure the effectiveness of the operation.
Treatment of an aneurysm using the clipping method is considered quite complex and should only be performed by an experienced neurosurgeon. A qualified specialist will do everything possible to ensure accurate and technically correct application of the clip. Otherwise, dangerous complications and a long rehabilitation period cannot be avoided.
The clip is applied to the neck of the aneurysm vessel. The accuracy of the neurosurgeon’s actions is confirmed by conducting high-quality diagnostics (Dopplerography) during the procedure.
Endovascular occlusion
During endovascular occlusion of an aneurysm, the neurosurgeon blocks the lumen of the dilated vessel with a special implant. The operation is used when clipping is not possible, for example, when the aneurysm is spindle-shaped. During surgery, a specialist inserts a catheter balloon through the femoral artery using angiographic control. It closes the lumen of the aneurysm. You can also use a microspiral to perform thrombosis. The choice remains with the attending physician. The microspiral in the cavity of the affected vascular area forms blood clots, which clog the lumen of the vessel and shut off the aneurysms from the blood circulation.
Risk factors
The question of why some aneurysms are asymptomatic and do not lead to serious consequences, while others rupture, worries many doctors and scientists. Based on a number of studies, risk factors have been identified that increase the likelihood of rupture. Among them:
- age point - risks increase for people over 50 years of age;
- location of the formation - if the aneurysm is located in the middle or anterior cerebral artery;
- size of the formation - aneurysms larger than 5 mm become dangerous.
If a person has such risks, it is important to begin treatment as quickly as possible in order to prevent a potential disaster.
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Provoking factors
If there are any disorders in the body, the following factors can provoke a rupture of the vessel:
- Obesity.
- Smoking.
- Depressive state.
- Incorrect diet, fasting.
- Vascular disorders.
- Constant stress, emotional instability.
- Overwork, both physical and mental.
- Large quantities of alcohol.
- Hypertensive crises.
- Acute intoxication with drugs or chemicals.
- Sunstroke, overheating.
- Traumatic brain injury.
Most often, a sick person does not even suspect that he has a damaged vessel in his head. But, for example, if a serious traumatic brain injury occurs, the walls of such a vessel burst and hemorrhage occurs.
Why does the gap occur?
There are several reasons why a cerebral aneurysm begins to rupture. One of them is genetics. Here we are talking about the fact that weakness of the artery wall is inherited. Also on the list of causes that provoke the problem are kidney pathologies, injuries, cancer, and atherosclerosis.
The following factors can damage the integrity of the vessel wall::
- increased physical activity;
- a history of arterial hypertension;
- emotional tension;
- drinking alcohol;
- development of infections accompanied by high fever.
Possible consequences
The prognosis is relatively unfavorable. The negative consequences of a condition where a vessel in the brain has burst are most often associated with swelling and dislocation of brain structures. Along with heart failure, which occurs in acute form, these are the main causes of death in the event of hemorrhagic stroke. Unfavorable factors that influence the outcome are long-term coma (longer than 12 hours), the patient's age over 65 years, and the location of the hemorrhage near the ventricular system.
Hemorrhagic stroke, also known as intracerebral hemorrhage or rupture of a cerebral artery, is a pathological process that threatens the health and life of the patient, which can occur for various reasons. Timely diagnosis and correct treatment will help avoid serious consequences.
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How are they treated?
First you need to provide first aid to the person. Naturally, urgent hospitalization will be required, but it is impossible to leave the situation unattended until the ambulance arrives. The patient should be laid so that the head is elevated - this will ensure the necessary outflow of blood and prevent the development of brain swelling. You should also worry about the flow of oxygen; accordingly, you need to relieve the neck - unbutton your shirt, loosen your tie, etc. If you lose consciousness, you should protect the person by clearing the airways - remove dentures, turn your head to the side. It is also worth applying cold objects to the head to reduce the risks of swelling and hemorrhage.
Aneurysm treatment is predominantly treated surgically. The method is selected depending on a number of parameters - the location of the formation, the person’s condition, the severity of the violations and the time that has passed since the moment of rupture.
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The following treatment options are used for therapy::
- Clipping is a microsurgical method that involves placing a clip on the base or body of the aneurysm: this will shut it off from the bloodstream.
- Endovascular method - here an intervention is performed by inserting a catheter through the femoral artery.
- Combined method - first a blood clot is injected into the aneurysm, and then it is clipped.
There is such a nuance that it is important to perform the operation in the first 72 hours after the start of bleeding, since the risk of recurrent hemorrhage is high. If you are late, spasm begins to increase, ischemia develops, and the operation will not make sense.
How is it diagnosed?
Since an arterial aneurysm can occur without significant symptoms, it is necessary to pay special attention to the first signs in women and men. A neurologist must diagnose the disease based on the examination, the diagnostic results obtained and the study of cerebrospinal fluid.
During a neurological examination, focal and meningeal symptoms are detected. Based on the location of complaints, it is possible to determine presumably where the pathological focus is located.
The neurologist obtains accurate information about the patient’s condition using the following studies:
- X-ray of the skull. A cerebral aneurysm is characterized by signs of bone tissue destruction.
- Computed tomography, magnetic resonance imaging of the brain.
- Angiography. Basic information about the location, shape and size of the brain aneurysm can be obtained.
- Lumbar puncture. The study reveals blood in the cerebrospinal fluid, which indicates the presence of hemorrhage.
Specialists carry out differential diagnosis of cerebral aneurysm. It is important to make an accurate diagnosis in a short time. This will avoid the adverse effects of a brain aneurysm. It is necessary to differentiate an aneurysm from tumor-like processes, cysts and abscesses.
Consequences of a breakup
Of the most common consequences if a person remains alive, the following points:
- paralysis and paresis;
- problems with speech if the hemorrhage is in the left hemisphere;
- problems urinating or constipation if damage occurs in the corresponding brain structures;
- mental problems - aggression, rage, apathy, depression may appear;
- cognitive disorders - memory problems, inability to remember new information;
- epilepsy.
So you should worry about your health in advance in order to prevent the appearance and, especially, rupture of a defect.
