Aneurysm

Aneurism . It is a localized and permanent dilation that occurs in the walls of the arteries , located in the different sections of the aortic vein .

This dilation appears in a weakened area of ​​the wall. It can occur at any point in the aorta, but it mostly appears in the abdominal section. However, there are aneurysms that also appear outside the aorta. Many of them are the effect of hereditary weakness or arteriosclerosis ; Others are due to external factors, such as stab wounds or firearms, and also due to bacterial infections in the arterial wall. This word comes from the Greek ανευρυσμα .

Summary

[ hide ]

  • 1 Causes
  • 2 Symptoms
  • 3 Complications
  • 4 Types of aneurysm
  • 5 Diagnosis
  • 6 Treatment
  • 7 Prevention
  • 8 Sources

Causes

This disease weakens the aortic wall until the pressure inside this artery causes it to widen and protrude outward. Normally, along with the aneurysm, the blood clot (called a thrombus) also appears.

The formation of aneurysms increases when you have high blood pressure and with the habit of smoking, but also with trauma or if you have an inflammatory disease of the aorta. The infection that causes trauma can start anywhere in the body, although it usually starts at the heart valve ( endocarditis ).

Symptoms

They depend on the type, size and location. Those located at the base of the brain are symptomatic and only cause symptoms when they burst, which can vary according to location, such as:

  • Sight loss.
  • Pain in the eye
  • Pain in the nail cuticle .
  • Vomiting .
  • Pain in the neck.
  • A severe headache (often described as “the worst headache in life”) is a symptom that an aneurysm has ruptured.

A dissecting aneurysm in the same area manifests with very strong pain that can be mistaken for a heart attack. If the aneurysm is located in the abdominal aorta , it may present abdominal pain and a pulsatile lump might even be noticed.

If due to its location it puts pressure on the bones of the spine, it can cause severe pain in the back. The greatest risk of aneurysms is that they cause bleeding that collapses the circulatory system, as would occur in the case of an aortic aneurysm, which is usually fatal.

Complications

The main complications of an aneurysm are, among others:

  • Compression of nearby structures, such as nerves, which can lead to weakness and numbness (more common with aneurysms that occur in the popliteal artery ).
  • Infection, which can lead to systemic disease and rupture.
  • Rupture, which can cause heavy bleeding that can lead to death.

Profuse bleeding is common with abdominal aortic aneurysms, mesenteric artery aneurysms, and splenic artery aneurysms .

Rupture of brain aneurysms can cause stroke, disability, and death.

If the width is less than 5 centimeters, the chances of it breaking are very low, if it is more than 5 centimeters the break will be more likely.

Brain aneurysm.

Types of aneurysm

  • Aneurysm of the abdominal aorta:They occur in the segment of the aorta that runs through the abdomen. They usually measure more than seven centimeters, so they have a greater chance of breaking.
  • Aneurysm of the thoracic aorta: theycross the thorax . The most frequent are those that dilate from the point where it leaves the heart .
  • Aortic dissection:In this case, the inner lining of the aorta is torn, but the outer one remains intact, and when blood enters this duct, it lifts the existing middle layer, creating a new channel in the aortic wall.

Diagnosis

In an aneurysm, pain is usually a very useful symptom to diagnose the disease; unfortunately, it appears late and delays diagnosis. There are many cases in which aneurysms do not have any symptoms. Therefore, they will only be seen during a physical examination by chance or when x-rays are done for some other reason. If the aneurysm has grown rapidly and is about to rupture, or when they are pressed during a medical examination of the abdomen, it will hurt spontaneously.

To diagnose an aneurysm, an x-ray of the abdomen may be performed, which will show an aneurysm with calcium deposits on its wall; an ultrasound, which will allow establishing the size of the aneurysm; a computed tomography (called CT), especially if you have injected an intravenous contrast, and an MRI, which is very accurate as well.

Treatment

To locate and determine the intensity of an aneurysm, there are several studies that can be carried out. To corroborate the presence of arachnoid bleeding , there is nothing better than a lumbar puncture . But the study may also be focused on brain computed tomography or magnetic resonance imaging, which will confirm both the presence of bleeding and presuppose the location of the ruptured aneurysm.

Cerebral angiography is a study focused on the exact visualization and location, as well as its relation with other neighboring vessels or its morphological characteristics. The usual treatment admits two main phases: the first, as soon as the patient is accepted in an inpatient service, preferably in an intensive care service, where the general condition of the patient will be taken care of. In addition, specific medication will be administered to control high blood pressure, avoid vasospasm or hypoxia with the intention of mitigating the damage caused by bleeding and preventing the recurrence of new bleeding, in addition to preparing the patient for treatment. surgical or endovascular.

Once the diagnosis has been made and the patient has been compensated, the neurosurgeon takes sides, who will decide on conventional open surgery and the placement of a clip (small metal clasp) that will close the ruptured aneurysm so that it does not bleed again, or the procedure endovascular.

Although catheterization is the least traumatic solution, there are aneurysms that can be solved in this way, and others that will inevitably have to be resolved by conventional surgery with the aid of the surgical microscope and micro-neurosurgery instruments.

Prevention

Controlling high blood pressure can help prevent some aneurysms. Following a healthy diet, exercising regularly, and keeping cholesterol at a healthy level can also help prevent aneurysms or their complications. Do not smoke. If you do, quitting smoking will reduce your risk of an aneurysm.

Leave a Comment