Cerebral aneurysm is a frequent pathology within arteriovenous malformations; however, very few of us are aware of the several factors that can lead to this disease. For this reason, we invite you to learn a little more about this condition that threatens the health of thousands of people around the world.

Many times, young people think that they are invincible, that nothing bad can happen to them, and sometimes they choose to lead a somewhat disordered life. But the truth is that both physical and mental health should never be an aspect that we leave aside, but rather a priority. In short, diseases do not discriminate against anyone, since on various occasions we have learned that young and apparently healthy people have suffered from some condition.

Likewise, there are some diseases that are somewhat silent and not very popular in our society; however, without realizing it, they are one of the main causes of mortality in the world. Specifically, this is the case of brain aneurysm, a disease that -if you didn’t know- the actresses Emilia Clark, star of “Game of Thrones” and Sharon Stone, of “Basic Instincts” suffered.

What is an aneurysm?

As explained by Dr. José Luis Acha, a vascular neurosurgeon at Clinica Ricardo Palma, a cerebral or intracranial aneurysm is the dilation of the wall of a blood vessel in the brain, which sometimes ruptures and causes a cerebral hemorrhage that seriously endangers the patient. For this reason, prompt medical attention should be received to reduce the risk of death or permanent neurological sequelae.

Indeed, it is estimated that every year 500,000 people die from this disease and half of the victims are under 50 years of age, according to reports from the World Health Organization (WHO).

In addition, the specialist points out that, when the aneurysm ruptures, it produces a sudden and intense headache that can be described as the worst pain you could ever have. Likewise, it may be accompanied by nausea, vomiting, stiff neck, blurred or double vision, sensitivity to light, seizures, drooping eyelids, loss of consciousness, and death.

On the other hand, when a rupture does not occur, symptoms may also occur; especially when they are larger than usual and compress other structures. For example, pain in the upper and back of one eye, dilation of the pupil, changes in vision or double vision, and numbness on one side of the face.

Who is more likely to have an aneurysm?

It should be noted that, although the exact cause of the formation of aneurysms is unknown, there are some factors that favor their development: high blood pressure, smoking, cocaine use and excessive alcohol intake. Some aneurysms can also arise from brain trauma or infections.

In the same way, certain congenital conditions predispose its appearance, as in the case of Ehlers-Danlos syndrome, which weakens the blood vessels. Likewise, polycystic kidney disease, aortic stenosis, cerebral arteriovenous malformation, and a family history of first-degree cerebral aneurysm (father, mother, brother, or child) may be central causes for understanding the origin of this disease.

Diagnosis

If you have a sudden, severe headache or other related symptoms, you can perform the following diagnostic tests:

• Non-contrast CT scan: Helps determine if there is bleeding or another type of stroke.
• Cerebral CT angiography: If subarachnoid hemorrhage is found on the CT scan, the blood vessels are reconstructed by injecting contrast to observe cerebral blood flow.
• Cerebrospinal fluid analysis: If there are symptoms of rupture, but no bleeding is seen on the CT scan, a lumbar puncture is ordered to analyze the cerebrospinal fluid.
• MRI: An evaluation of the cerebral arteries is performed to detect the presence of an aneurysm.
• Cerebral angiography: it is an invasive study in which a catheter is inserted into an artery in the groin or wrist, it reaches the arteries of the brain and contrast is injected to observe the aneurysms. Currently, this study is often used when the other tests do not provide enough information.

Treatment

Regarding the treatments for an aneurysm, there are two options:

• Surgical clipping of the aneurysm: a craniotomy is performed and the aneurysm is accessed to place a clip and close it completely.
• Endovascular treatment: the surgeon inserts a catheter into an artery (in the wrist or groin) and reaches the aneurysm inside the artery, in order to close it.

Certainly, the type of procedure that is decided depends solely on the characteristics and conditions of each particular case. The neurologist indicates that both procedures have possible risks, especially possible bleeding or stroke.

Dr. José Luis Acha
Vascular neurosurgeon at Clínica Ricardo Palma

Source: elcomercio.pe