General Practice 2022

Brain aneurysm: what é, symptoms, causes and treatment

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Brain aneurysm: what é, symptoms, causes and treatment
Brain aneurysm: what é, symptoms, causes and treatment

A cerebral aneurysm is a dilatation in one of the blood vessels that carry blood to the brain. When this happens, the dilated part usually has a thinner wall and therefore there is a high risk of rupture. When a brain aneurysm ruptures, it causes a hemorrhagic stroke, which can be more or less severe, depending on the size of the bleeding.

In most cases, a brain aneurysm does not cause any type of symptoms and, therefore, tends to be discovered only when it ruptures, causing an extremely intense headache that can appear suddenly or that increases over time. The feeling that the head is hot and that there is a 'leak' and that it feels like blood has spread, also happens in some people.

Brain aneurysm can be cured through surgery, but generally, the doctor prefers to indicate a treatment that helps regulate blood pressure, for example, reducing the chances of rupture. Surgery, on the other hand, is used more frequently for cases of aneurysms that have already ruptured, but it can also be indicated to treat specific aneurysms, depending on their location and size.

Main symptoms

A cerebral aneurysm does not normally cause any symptoms, being identified accidentally in a diagnostic examination of the head or when it ruptures. However, some people with an aneurysm may have signs such as constant pain behind the eye, dilated pupils, double vision, or tingling in the face.

Most commonly, symptoms appear only when the aneurysm ruptures or is leaking. In these cases the symptoms are similar to those of a hemorrhagic stroke and include:

  • Very intense and sudden headache that gets worse over time;
  • Nausea and vomiting;
  • Stiff neck;
  • Double view;
  • Seizures;
  • Fainting.

When these symptoms arise, and whenever there is a suspicion of a ruptured aneurysm, it is very important to call medical help immediately, calling 192, or take the person immediately to the hospital, to start the appropriate treatment.

There are also other problems that can cause similar symptoms, such as migraine, not necessarily being a case of aneurysm. Therefore, if the headache is severe and appears very frequently, you should consult a general practitioner or a neurologist to identify the correct cause and initiate the most appropriate treatment.

How to confirm the diagnosis

Generally, to confirm the presence of a brain aneurysm, the doctor needs to order diagnostic tests to evaluate the structures of the brain and identify if there is any dilation in the blood vessels.Some of the most used tests include computed tomography, magnetic resonance imaging or cerebral angiography, for example.

Possible causes of aneurysm

The exact causes that lead to the development of a brain aneurysm are not yet known, however, some factors that appear to increase the risk include:

  • Being a smoker;
  • Having uncontrolled high blood pressure;
  • Using drugs, especially cocaine;
  • Consuming alcoholic beverages in excess;
  • Having a family history of aneurysm.

In addition, some conditions that are present at birth can also increase the tendency to have an aneurysm, such as polycystic ovary disease, aortic narrowing, or brain malformation.

How the treatment is done

Aneurysm treatment is quite variable, depending not only on he alth history, but also on the size of the aneurysm and whether or not it is leaking. Thus, the most commonly used treatments include:

1. Unruptured aneurysm

Most of the time, doctors choose not to treat unruptured aneurysms, as the risk of rupture during surgery is very high. Therefore, it is normal to regularly assess the size of the dilation to ensure that the aneurysm is not increasing in size.

In addition, medication may be prescribed to relieve some of the symptoms, such as Paracetamol, Dipyrone, Ibuprofen, to reduce headache or Levetiracetam, to control the onset of seizures, for example.

However, in some cases, the neurologist may choose to perform endovascular surgery with stent placement, to prevent rupture, but because it is a very delicate procedure, due to the risk of rupture during the procedure, it needs to be very well evaluated and the risks must be well explained to the patient and family.

2. ruptured aneurysm

When the aneurysm ruptures, it is a medical emergency and, therefore, you should go to the hospital immediately to start the appropriate treatment, which is usually done with surgery to close the bleeding vessel inside the brain.The earlier the treatment, the lower the chances of developing lifelong sequelae, as the smaller the area of ​​the brain affected.

When the aneurysm ruptures, it causes symptoms similar to those of a hemorrhagic stroke. See which signs to watch out for.

Possible sequelae of aneurysm

A brain aneurysm can cause bleeding between the brain and the meninges that line it, in which case the hemorrhage is called subarachnoid hemorrhage, or it can cause a hemorrhage called intracerebral, which is bleeding that happens in the middle of the brain..

After an aneurysm, the person may not have any sequelae, but some may have neurological changes similar to a stroke, such as difficulty lifting an arm due to lack of strength, difficulty speaking or slow thinking, for example. People who have already had an aneurysm have a higher risk of having a new event.

See other possible sequelae that can arise when there is a change in the brain.

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