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A cerebral aneurysm is an enlargement 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 hemorrhagic stroke, which can be more or less severe, depending on the size of the bleeding.
In most cases, cerebral aneurysm does not cause any symptoms and, therefore, it tends to be discovered only when it breaks, causing an extremely intense headache that may appear suddenly or that increases over time The feeling that the head is hot and that there is a 'leak' and that it seems that the blood has spread also happens in some people.
Cerebral aneurysm can be cured through surgery, but generally, the doctor prefers to recommend a treatment that helps regulate blood pressure, for example, reducing the chances of rupture. Surgery is used more often for cases of aneurysms that have already ruptured, but it can also be indicated to treat specific aneurysms, depending on the location and size.
Main symptoms
Cerebral aneurysm does not usually cause any symptoms, being accidentally identified in a diagnostic exam on the head or when it breaks. However, some people with aneurysms may experience signs such as constant pain behind the eye, dilated pupils, double vision or tingling in the face.
The most common is that the symptoms appear only when the aneurysm ruptures or is leaking. In such cases the symptoms are similar to those of a hemorrhagic stroke and include:
- Very intense and sudden headache, which worsens with time;
- Nausea and vomiting;
- Stiff neck;
- Double vision;
- Convulsions;
- Fainting.
When these symptoms appear, and whenever an aneurysm rupture is suspected, it is very important to immediately call for medical help by calling 192, or taking the person immediately to the hospital, to begin appropriate treatment.
There are also other problems that can cause similar symptoms, such as migraine, not necessarily an aneurysm. So if the headache is severe and appears very often, you should consult a general practitioner or a neurologist to identify the correct cause and start the most appropriate treatment.
How to confirm the diagnosis
Generally, to confirm the presence of a brain aneurysm, a doctor needs to order diagnostic tests to assess brain structures and identify whether there is any dilation in the blood vessels. Some of the most used exams include computed tomography, magnetic resonance or cerebral angiography, for example.
Possible causes of aneurysm
The exact causes that lead to the development of a cerebral aneurysm are not yet known, however, some factors that seem to increase the risk include:
- Being a smoker;
- Have uncontrolled high blood pressure;
- Using drugs, especially cocaine;
- Excess alcohol consumption;
- Having a family history of aneurysm.
In addition, some diseases that are present at birth can also increase the tendency to have an aneurysm, such as polycystic ovary disease, narrowing of the aorta or cerebral malformation.
How the treatment is done
The treatment of the aneurysm is quite variable and may depend not only on the health history, but also on the size of the aneurysm and whether or not it is leaking. Thus, the most used treatments include:
1. Aneurysm not ruptured
Most of the time, doctors choose not to treat unbroken aneurysms, since the risk of rupture during surgery is very high. Thus, it is normal to make a regular assessment of the size of the dilation to ensure that the aneurysm is not increasing in size.
In addition, remedies may also 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 have endovascular surgery with placement of stent, to prevent rupture, however, 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 the family.
2. Ripped aneurysm
When the aneurysm ruptures, it is a medical emergency and, therefore, one must immediately go to the hospital to start the appropriate treatment, which is usually done with surgery to close the bleeding vessel inside the brain. The sooner the treatment is done, the lower the chances of developing lifelong sequelae, since the smaller the area of the brain affected will be.
When the aneurysm breaks, it causes symptoms similar to a hemorrhagic stroke. See what signs to watch out for.
Possible sequels of the aneurysm
A cerebral aneurysm can cause bleeding between the brain and the meninges that line it, in which case the hemorrhage is called a subarachnoid, or it can cause a hemorrhage called intracerebral, which is bleeding that occurs in the middle of the brain.
After an aneurysm the person may not have any sequelae, but some may have neurological changes similar to that of a stroke, such as difficulty in raising an arm due to lack of strength, difficulty in speaking or slowness in thinking, for example. People who have already had an aneurysm have a higher risk of suffering a new event.
See other possible sequelae that can arise when there is a change in the brain.