All About Brain Aneurysm: Causes, Signs, Symptoms and Risk factors

A brain aneurysm, also known as intracranial aneurysm or cerebral aneurysm, is a medical condition that occurs when a weak spot in the wall of the blood vessel inside the brain bulges out and fills with blood. It is like a berry hanging on a stem. Sometimes, a brain aneurysm leaks or ruptures, and bleeding of the blood vessels leads to hemorrhagic stroke. This condition can be life-threatening and needs urgent medical attention.

Causes of a brain aneurysm:

A brain aneurysm generally occurs in the arteries at the base of the brain. It is mostly formed at the fork end of the arteries (branches of the arteries) as these points are considered to be the weakest and most susceptible to rupture.

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Signs and Symptoms of a brain aneurysm:

The condition of a brain aneurysm can be characterized by the following signs and symptoms:

• Severe headache
• Nausea and vomiting
• Stiff neck
• Double or blurred vision
• Seizure
• Sensitivity to light
• Drooping eyelids
• Loss of consciousness
• Confusion
• A leaking aneurysm (blood leaking) may also be represented by a severe headache
• An unruptured aneurysm causes pain above or behind the eye, dilated pupil, double vision, and numbness on one side of the face

Risk factors involved in a brain aneurysm:

A brain aneurysm is more common in adults, especially in women than in men. Numerous risk factors can contribute to the weakness of the arterial walls and also increase the risk of a brain aneurysm. Some of them are as follows:

• Old age
• Cigarette smoking
• Hypertension (high blood pressure)
• Use of illicit drugs like cocaine
• Alcohol consumption
• Inherited connective tissue disease such as Ehlers-Danlos syndrome
• Polycystic kidney disease
• Abnormalities at birth such as coarctation of the aorta (abnormally narrow aorta), cerebral arteriovenous malformation (Brain AVM), etc.
• Family history of brain aneurysm
• Cancer or tumour in head or neck

Complications involved in a brain aneurysm:

When a brain aneurysm ruptures, it causes bleeding and the blood can damage or kill the surrounding cells. An aneurysm can also increase the pressure inside the skull. An elevated pressure disrupts the oxygen and blood supply to the brain causing loss of consciousness or even death.

Other complications related to a brain aneurysm may include:

• Rebleeding
• Vasospasm
• Hydrocephalus (accumulation of cerebrospinal fluid)
• Hyponatremia (drop in blood sodium level)

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Diagnosis of a brain aneurysm:

Doctors, at Yashoda Hospital and Research Centre, Nehru Nagar Ghaziabad, conduct various diagnostic tests to locate aneurysms in patients who have a family history of the disease.

Doctors may also advise various imaging tests like CT scans (Computed Tomography), and MRI (Magnetic Resonance Imaging) to take pictures of the brain tissues and arteries.

• CT scan provides a 3D image of the brain by taking several X-rays.
• MRI uses radio waves and magnetic fields to create an image of the brain tissues and arteries.
• Doctors may also perform cerebrospinal fluid tests to check the presence of red blood cells in the cerebrospinal fluid surrounding the brain and the spine.
• A cerebral angiogram can also be used to detect the presence of a brain aneurysm.

Treatment of a brain aneurysm:

Treatment of an aneurysm depends on several factors such as size, location, severity, and whether the aneurysm is ruptured or not.

A ruptured aneurysm needs urgent treatment. Various surgical procedures can stop the flow of the blood into the aneurysm.

• Surgical clipping is a medical procedure in which a section of the skull is removed and a metal clip is placed in the aneurysm to cut off the blood flow. After this procedure, the skull is sealed off.
• Endovascular coiling is an invasive medical procedure in which a catheter is inserted into the groin to reach the affected blood vessel where the aneurysm is located. Tiny platinum coils are placed into the aneurysm through the inserted tube to stop the blood flow.
• Flow diverter surgery is another medical procedure used when other surgical procedures fail to work. In this procedure, a stent is inserted inside the artery to divert the flow of blood.

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To manage symptoms and prevent complications of aneurysm doctors may suggest the following:

• Pain-relieving medicines such as acetaminophen to treat headaches
• Medications such as calcium channel blockers prevent blood vessels from narrowing and preventing calcium from entering cells of the blood vessel walls
• Use of anti-seizure medications to treat seizures
• Reducing the pressure on the brain by using ventricular or lumbar draining catheters
• Shunt surgery
• Rehabilitative therapy can help patients relearn skills that might have been lost due to damage caused to the brain

Conclusion:

The best way to treat brain aneurysm is early diagnosis. It is often recommended to be alert while monitoring the warning signs of an aneurysm. Immediate medical attention and timely treatment for a rupture increase the chances of survival and recovery rate are much higher. Recovery from an unruptured aneurysm is generally very quick. A ruptured aneurysm may involve various surgeries and a person may take longer to recover depending on the severity of the damage.

Dr. (Brig.) Yadvendra Singh Sirohi is a distinguished neurologist with 24+ years of expertise. He has excelled in apex national institutes. Renowned for clinical excellence, empathy, and dedication, he is a Senior Consultant in Neurology at Yashoda Hospital & Research Centre, Ghaziabad. Dr. Sirohi is a master in addressing diverse neurological conditions with utmost proficiency.

Dr. Shishir Kumar is a highly skilled Neurosurgeon, Neurointerventionist, and Endoscopic Spine Surgeon in Delhi/NCR, with over 9 years of experience. He holds fellowships in Neurointervention, Endovascular Surgery, and Minimally Invasive Spine Surgery. With extensive training, he provides comprehensive neurosurgical care for various conditions, emphasizing patient education and a collaborative approach. Currently, Dr. Kumar is serving at Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad.

Dr. Atul Gupta is an expert doctor with an experience of 29 years in the field of neurosurgery. He specializes in performing surgeries like brain tumors, cerebrovascular, epilepsy, and spine surgery.

Dr. Puneet Malik is on the list of neuro experiences with severe numbness of complex brain and spinal cord surgeries. He specializes in removing clots, conducting tumor surgeries, brain bleed stoppage, etc. with great precision and care.