Cerebral aneurysm: symptoms and therapies

Not always symptomatic, if it breaks it can cause serious consequences. Surgery is a way to go, but it is not the only one.

Not always symptomatic, if it breaks it can cause serious consequences. Surgery is a way to go, but it is not the only one.

A blood vessel inside the brain, usually an artery, dilates: this is how a brain aneurysm forms. This condition does not always manifest itself with obvious symptoms, but identifying it in time is crucial to prevent any serious damage.

Signals to watch for

An aneurysm is formed because the wall of a blood vessel is too weak and cannot withstand the pressure of the blood passing through it. When the artery gives way, it causes the swelling called an aneurysm.

The aneurysm does not always cause symptoms that are easy to spot unless it is quite large. In this case, in fact, it could press against nerves and other areas of the brain, giving disturbances such as:

  • visual problems, such as doubled vision or changes in the visual field
  • painful sensation on or around the eyes
  • tingling or loss of sensation on one side of the face
  • difficulty speaking
  • headache
  • loss of balance
  • difficulty concentrating or short term memory problems.

These signals represent a wake-up call that should not be ignored. Consult your doctor immediately and follow his instructions.

How is it diagnosed?

The certain diagnosis of aneurysm is obtained thanks to a series of tests, sometimes carried out for other reasons, which can lead to the discovery of a vascular swelling, making it visible to the doctor.

The techniques used are:

  • CT scan of the encephalon, which can make its presence “suspect”. The confirmation can be had with an angioTAC, or a CT performed with the injection of a contrast medium, a substance that allows to visualize the aneurysm
  • magnetic resonance imaging (MRI), which occasionally allows to highlight the appearance of aneurysm. Also in this case, to obtain the certainty of the diagnosis the angioRM is fundamental, that is a resonance with the injection of a contrast medium
  • cerebral angiography, which represents the litmus test for a certain diagnosis because it allows to visualize the entire cerebral blood flow. It is performed by introducing a catheter through the femoral artery, until it reaches the blood vessels inside the head. It is performed under local anesthesia.

What to do after the diagnosis?

The aneurysm itself is not an immediate health hazard. The real problem is whether the bulge wall breaks, allowing the blood to invade the brain tissue. In this case there is a real haemorrhage, which can cause very serious damage, depending on the extent and duration.

Once the aneurysm has been identified, there can be three ways to choose:

  • keep it under strict periodic observation
  • intervene with drugs that reduce blood pressure
  • schedule surgery.

Isolate the aneurysm with a clip

When the neurosurgeon decides to proceed with surgery, there are two options:

  • microsurgery
  • endovascular treatment.

With the microsurgical approach the vascular bulge is isolated by placing one or more “clips” (small clips) at the level of the malformation. This technique is performed with the help of latest-generation microsurgical instruments, indicated for extremely precise treatments.

The endovascular treatment instead foresees a normal angiography: it reaches the interested cerebral vessel through the femoral artery and it proceeds to literally fill the aneurysm with small titanium filaments or positioning stent. In this way the malformation is in fact excluded from the entire cerebral circulation, thus eliminating the problem.

Know the risk

Some people are more at risk of developing an aneurysm than others. Why? Often it depends on wrong habits, but according to some studies also from DNA.

In fact, the factors that increase the probability of meeting this cardiovascular problem are:

  • high blood pressure
  • cigarette smoke
  • genetic predisposition, or if someone else in the family has suffered from aneurysms in the past.

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