Aneurysm: Symptoms, Causes, Risks, Complications, Diagnosis, Treatment and Prevention

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1Overview

The blood vessels are the ones carrying blood that contains oxygen and nutrients to the different parts of the body. Vital organs like the heart and brain need oxygen to function. Without oxygen, it may lead to cell death.

The arteries carry oxygenated blood to the different tissues and cells in the body. However, due to some factors like chronic hypertension, the arterial walls become weak, leading to the formation of a balloon. When this ruptures, it may lead to serious consequences, including death.

An aneurysm is the enlargement of the artery caused by weakness in the wall. Most of the time, there are no symptoms. But when the aneurysm burst or ruptures, it can lead to fatal complications.

It is also called an abnormal ballooning or bulge in the wall of the blood vessel. It can rupture, leading to internal bleeding and often, death. Cerebral aneurysms is a common disorder caused by a weakness in the arterial wall in the brain. It may be caused by a congenital condition or a pre-existing disease such as atherosclerosis or high blood pressure.

The Centers for Disease Control and Prevention (CDC) report that an aortic aneurysm contributes more than 25,000 deaths in the United States alone every year. Approximately 30,000 cases of brain aneurysms rupture in the same country each year. Of these cases, roughly 40 percent of these cases cause death within just 24 hours.

2Symptoms

Aneurysms develop slowly over many years. Often, most of the people with the condition do not experience any symptom at all.

The signs and symptoms of an unruptured aneurysm include:

  • Double vision or loss of vision
  • Numbness or weakness on one side of the face
  • Pain around or above the eye
  • Hard time speaking
  • A headache
  • Balance problems
  • Difficulty concentrating

The signs and symptoms of a ruptured aneurysm include:

  • Dizziness
  • Cold clammy skin
  • Pain
  • Nausea and vomiting
  • Low blood pressure
  • Palpitations or rapid pulse rate
  • Shock
  • Sudden confusion
  • Sensitivity to light
  • Feeling sick
  • Blurred vision
  • Loss of consciousness
  • Seizures

A ruptured aneurysm is life-threatening. This is an emergency. Call the emergency or 911 when these symptoms surface.

3Causes

Although the exact cause of an aneurysm is still unclear, some factors may contribute to the condition. For instance, the damaged tissue in the arteries can contribute to the formation of an aneurysm. When the arteries are blocked by fatty deposits, they can make the heart pump harder to push the blood past the blockage. As a result, some parts of the arterial wall become weak due to the chronic increased pressure, leading to the formation of a bulge or balloon.

Brain aneurysms are usually caused by a weakness in the walls of blood vessels in the brain. The brain needs a large supply of blood containing oxygen and nutrients for its processes. Most aneurysms develop at the points where the blood vessels branch off.
These areas are usually weaker.

The common causes of an aneurysm include:

Atherosclerotic Disease

Atherosclerosis is the condition wherein the arteries are filled up with fatty plaque, leading to the blockage of blood flow to the vital organs such as the brain and heart.

Hypertension

High blood pressure or hypertension may become a cause of an aneurysm. When there is a blockage in the arteries, the blood exerts a force on the walls to get past the blockage. As a result, it may lead to the weakness of the blood vessel wall.

4Risk Factors

Many factors may increase the risk of developing a brain aneurysm, including:

High blood pressure – Hypertension can increase the pressure exerted on the walls of the blood vessels. This can increase the risk of developing an aneurysm.

Smoking – Smoking tobacco can heighten one’s risk of developing a brain aneurysm. The risk increases more in families with a history of a brain aneurysm.

Family history – Having a family history of an aneurysm may increase one’s risk of having the condition, too.

Age – People who are more than 65 years old are at a higher risk of having an aneurysm. The risk of developing the condition increases when the person gets older, with most individuals getting the diagnosis after the age of 40.

Sex – Women are at a greater risk of having a brain aneurysm than men. This is due to the decrease of estrogen, a female hormone, after menopause.

Pre-existing weakness in the blood vessels – People who have previous weaknesses in the blood vessels, which are usually present from birth, may become susceptible to having a brain aneurysm.

Cocaine abuse – Cocaine use may increase the risk of a brain aneurysm. The drug can produce inflammation on the vessel wall and may significantly increase the blood pressure, leading to the formation of an aneurysm.

Severe head injury – In some cases, a brain aneurysm may develop after a brain injury if the blood vessels are affected.

Body tissue disorders – The risk of developing a brain aneurysm can increase if a person has a condition that can affect the body tissues such as Marfan syndrome and Ehlers-Danlos syndrome.

Coarctation of the aorta – The individuals who have the condition called coarctation of the aorta, may have an increased risk of developing a brain aneurysm. In this condition, there is a narrowing of the major artery, the aorta, which is present from birth.

Autosomal dominant polycystic kidney disease

Autosomal dominant polycystic kidney disease (ADPKD) is a congenital and genetic condition that leads to the formation of many cysts on the kidneys. The condition has been linked to the development of a brain aneurysm.

The other risk factors include:

  • Being overweight or obese
  • Family history of high blood pressure
  • African or Caribbean descent
  • Not eating fruits and vegetables
  • Sedentary lifestyle
  • High sodium (salt) diet
  • Too much coffee or caffeine-based drinks
  • Excessive alcohol intake
  • Age (65 years and above)

5Complications

A ruptured brain aneurysm can be fatal, if it’s not treated immediately. The first signs of an aneurysm could be complications upon rupture and during this stage, it’s already serious. Usually, an unruptured aneurysm has no symptoms at all.

Any rupture of an aneurysm may cause pain, rapid heart rate, low blood pressure and lightheadedness. Most individuals with the condition will not experience complications. However, a ruptured brain aneurysm is fatal and may cause death, if medical treatment is not applied.

6Diagnosis

When there is an aneurysm, the patient may be referred to a surgeon. Most of the time, these are the procedures recommended:

Physical assessment – The doctor will conduct a comprehensive physical assessment including taking the blood pressure, vital signs, and listening to the blood flow sounds.

Imaging tests – Imaging tests are used to identify the shape, location, and size of an aneurysm. This can help in the treatment of an aneurysm. The usual tests used are ultrasound, echocardiography and magnetic resonance imaging (MRI).

Lumbar puncture – In this diagnostic test, the doctor acquires a sample of the cerebrospinal fluid and sends it to the laboratory to determine if there is a ruptured brain aneurysm. Usually, there is blood in the fluid sample to diagnose the condition.

Angiography – A catheter is inserted through the artery in the groin area. A contrast dye is injected and a machine will visualize the blood and arteries.

7Treatment

A ruptured aneurysm is a medical emergency. It is important to seek medical attention immediately because it can be fatal.

For unruptured brain aneurysm, those who are diagnosed will work closely with the healthcare professional.

Brain aneurysms can be treated through surgery if they’ve ruptured or there is a big risk that they will. Also, preventive surgery is conducted if there is a high risk of bursting or rupture.

Preventive surgery

If preventive treatment is needed, the two procedures used are neurosurgical clipping and endovascular coiling.

Neurosurgical clipping – Neurosurgical clipping is conducted in the operating room under general anesthesia. An incision is made on the scalp or in the area above the eyebrow and a small part of the bone is removed.

When an aneurysm is identified, the doctor will use a metal clip to seal and clamp an aneurysm. In time, the blood vessel lining will heal and will permanently seal it, preventing a rupture in the future.

Endovascular coiling – Endovascular coiling is also done under general anesthesia. The procedure is done through the insertion of a thin tube into the artery in the groin or leg area. The tube will go through the vessels into the head area. When it reaches the brain, tiny platinum coils are passed into an aneurysm and one it has coils, blood can’t enter it, sealing off the main artery.

8Prevention

Prevention is better than cure. Preventing an aneurysm is not always possible because some people are born with the condition. However, lifestyle practices and choices can affect the risk.

Stop smoking – Smoking is a big risk factor for an aneurysm. Quitting or stopping smoking can significantly reduce the risk of a severe aneurysm.

Maintain a healthy weight – Being overweight and obese may increase the risk of an aneurysm. Maintaining a healthy weight or losing weight is important.

Manage blood pressure – High blood pressure is a major culprit in an aneurysm, managing healthy blood pressure is important.

Eating a healthy diet – Eating a healthy diet rich in fruits and vegetables may reduce the risk of having a brain aneurysm.