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What Is Cerebral Aneurysm? Causes, Symptoms, Risk Factors, Diagnosis And Treatments

A cerebral aneurysm is known by many names such as brain aneurysm and intracranial aneurysm. Aneurysm in the brain is defined as dilations (widening) that occur at weak sites in the arterial circulation or say, walls of the blood vessels of the brain. It is often identified as ballooning or bulging of the blood vessels. [1]

The majority of brain aneurysms are silent and are only diagnosed by chance during neuroimaging or autopsy.

The condition often leads to expansion, thinning and rupturing of the blood vessels, known as subarachnoid haemorrhage. The haemorrhage results in haemorrhagic stroke or bleeding inside the brain, which is associated with a high risk of morbidity and mortality.

According to the recent news reports, the Chinese President Xi Jinping has a 'cerebral aneurysm' and was hospitalised in 2021 due to his declining condition. [2]

Here's all about a cerebral aneurysm in detail. Take a look.

Types Of Cerebral Aneurysm

There are three types of cerebral aneurysm:

1. Saccular aneurysm: It is one of the common forms of cerebral aneurysm and is characterised as a round sac filled with blood and attached to the main artery.
2. Fusiform aneurysm: It is characterised as a ballon or a bulge from all sides of the artery.
3. Mycotic aneurysm: It resembles a fleshy fungus as it occurs mainly as a result of infection. [3]

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Causes Of Cerebral Aneurysm

When the walls of the arteries in the brain become thin and fragile, cerebral aneurysms occur. The weakening may occur at any age and due to multiple factors. Some of the factors that may lead to the development of the condition are:

  • Genetic diseases like alpha-glucosidase deficiency, Ehlers-Danlos syndrome, Fibromuscular dysplasia, Polycystic kidney disease (PCKD) and Klinefelter syndrome. [4]
  • Untreated heart diseases like blood pressure and atherosclerosis.
  • Chronic alcohol consumption.
  • Chronic use of illicit drugs like cocaine
  • Chronic cigarette smoking. [5]
  • Brain tumour
  • Infection in the blood vessels of the brain (mycotic aneurysm).
  • Head trauma.
  • Chronic diseases like diabetes. [6]

Symptoms Of Cerebral Aneurysm

Some of the symptoms of a cerebral aneurysm (unruptured) may include:

  • Headache
  • Change in vision
  • Eye pain

Symptoms due to rupture of the aneurysm may include:

  • Thunderclap headache or sudden and painful headache. [1]
  • Nausea
  • Vomiting
  • Stiffness in the neck.
  • Drowsiness
  • Loss of consciousness
  • Loss of coordination. [7]
  • Dysfunction of ears, nose, eyes or tongue
  • Photophobia or sensitivity to light.
  • Dilated pupils.

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Risk Factors Of Cerebral Aneurysm

Not all brain aneurysms result in haemorrhagic stroke. Some of the factors that may lead to rupture of the aneurysm are:

  • Family history of aneurysm.
  • The large size of aneurysms (between 11 to 25 mm or more).
  • Age over 40. [8]
  • Aneurysms located mainly in the front and back of the brain compared to those at other locations.
  • Aneurysms which have a tendency to grow at an increased rate.
  • People have high blood pressure.

Complications Of Cerebral Aneurysm

Some of the complications of a cerebral aneurysm may include:

  • Seizures
  • Permanent brain damage.
  • Coma
  • Sudden death

Diagnosis Of Cerebral Aneurysm

In most cases, unruptured brain aneurysms are diagnosed incidentally during neuroimaging. Some of these methods are:

  • Magnetic resonance imaging (MRI): It helps view changes in the brain tissues.
  • Cerebral angiography: To detect problems in the blood vessels. [9]
  • Computed tomography scan (CT scan): To identify the location of the aneurysms and whether it has burst.
  • Cerebrospinal fluid (CSF) analysis: To detect bleeding around the brain.

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Treatments Of Cerebral Aneurysm

Some of the treatment methods for cerebral aneurysms may include:

  • Microsurgical clipping (MSC): It helps prevent the blood leak inside the brain and blocks it using a metal clip. [10]
  • Platinum coil embolization: It is less invasive than MSC. here, coils are used to block the aneurysms and prevent blood leaks inside the brain.
  • Medications: It includes medications like anticonvulsants.

To Conclude

A cerebral aneurysm is a life-threatening condition; around 25 per cent of people who has a ruptured brain aneurysm do not survive the first 24 hours, and another 25 per cent dies from complications within six months. Subarachnoid haemorrhage can cause lasting neurological damage in certain people. This makes early diagnosis and treatment of a brain aneurysm important to improve the chances of a full recovery. [11]