Brain Aneurysm: Definition, Causes, Symptoms, Diagnosis, Treatment and Preventions

A brain aneurysm is an enlargement or protrusion of a blood vessel in the brain due to a weakening of the vessel wall. These protrusions will look like hanging berries.

A brain aneurysm that enlarges and ruptures can cause bleeding and brain damage. For example, if it occurs in the brain stem, a brain aneurysm can cause a brain stem stroke. Although it can affect anyone, brain aneurysms are most common in women over the age of 40.

Causes of Brain Aneurysm

A brain aneurysm occurs when the walls of a blood vessel weaken or thin. The cause behind the weakening of the walls of blood vessels has not been ascertained. However, there are several factors that are thought to increase the risk of this condition, namely:

  • Suffering from hypertension or high blood pressure
  • Over 40 years old
  • Female gender, especially those who have gone through menopause
  • Have a history of head injury
  • Have a history of consuming excessive amounts of alcohol or using drugs (especially cocaine)
  • Have a smoking habit
  • Have a family history of brain aneurysm

In addition to these factors, there are several diseases that can increase the risk of a brain aneurysm, namely:

  • Polycystic kidney disease
  • Koartasio aorta
  • Arterial-venous malformations
  • Ehlers-Danlos Syndrome
  • Marfan Syndrome

Symptoms of Brain Aneurysm

Symptoms of a brain aneurysm in each patient can be different. Brain aneurysms that are small and have not ruptured often do not cause symptoms. However, as the size of the aneurysm increases, some symptoms will appear, such as:

  • Pain around the eyes
  • Numbness on one side of the face
  • Dizziness and headache
  • Difficulty speaking
  • Balance is disturbed
  • Difficulty concentrating or have a weak memory
  • Visual impairment or double vision

Brain aneurysms are also at risk for rupture and cause bleeding in the brain. Symptoms of an aneurysm rupture can include:

  • Headaches that come on suddenly and are very painful (“severe headaches”)
  • Blurred vision or double vision
  • Nausea and vomiting that spurts
  • Paralysis or weakness on one side of the body or leg
  • Difficult to speak
  • Difficult to walk
  • Lower eyelids (ptosis)
  • Seizure
  • Loss of consciousness

When to go to the doctor

Consult with your doctor if you experience the symptoms mentioned above, especially if you have risk factors, such as suffering from hypertension, having a family history of brain aneurysm, or having experienced a blow to the head before.

You should go to the ER immediately if you experience symptoms of a ruptured brain aneurysm characterized by a sudden, severe headache. Leaking or rupturing a brain aneurysm is an emergency that requires immediate treatment.

Brain Aneurysm Diagnosis

To diagnose a brain aneurysm, the doctor will ask questions about the complaints experienced, including medical history, drug use, and family history of the patient. The doctor will then perform a thorough physical examination.

To confirm the diagnosis, the doctor will ask the patient to perform several supporting examinations, such as:

Scan

Some types of scans that can be done on people with brain aneurysms are:

  • MRI, to detect the presence or absence of a brain aneurysm.
  • CT scan, to determine whether there is bleeding in the brain due to rupture or leaking of a brain aneurysm.
  • Brain angiography, to confirm the presence or absence of abnormalities in the blood vessels of the brain, including detecting brain aneurysms. Angiography can be done with a CT scan (CTA) or with an MRI (MRA).

Cerebrospinal fluid examination

If necessary or if a subarachnoid hemorrhage is suspected , the doctor will ask the patient to examine the cerebrospinal fluid, which is the fluid that surrounds the brain and spinal cord. This examination is done to detect the presence or absence of bleeding in the brain.

Cerebrospinal fluid examination is usually done if the patient has symptoms of a ruptured brain aneurysm, but the CT scan results do not show any bleeding in the brain.

Brain Aneurysm Treatment

Treatment of a brain aneurysm aims to prevent the rupture of the aneurysm, relieve symptoms experienced, and prevent complications.

Prevention of aneurysm rupture

Efforts to prevent aneurysm rupture require careful consideration based on age, family history, medical condition of the patient, and the location and size of the aneurysm.

If the risk of aneurysm rupture is low, the doctor will only conduct periodic observations. Patients will be given blood pressure-lowering drugs, and asked to change their diet and lifestyle by:

  • Stop smoking
  • Doing exercise regularly
  • Limiting caffeine consumption
  • Avoid strenuous physical activity

If the risk of aneurysm rupture is high enough, the doctor will recommend surgery. This procedure aims to stop blood flow to the aneurysm. Surgery can be performed by clamping the blood vessels ( neurosurgical clipping ) or placing a coil at the site of the aneurysm ( endovascular coiling ).

By stopping the flow of blood into the aneurysm, it is hoped that the aneurysm will not swell or burst.

Treatment of a ruptured aneurysm

If an aneurysm ruptures, emergency treatment needs to be done immediately. Doctors can give medication to relieve symptoms and prevent complications. The drugs given can be:

  • Drug antagonist kalsim ( calcium canal blocker )
    administration of drugs, calcium antagonists is aimed at preventing vasospasm (stiffness) which is a complication of a brain aneurysm. An example of a drug that will be given is nimodipine.
  • Pain relievers
    These drugs are given to relieve headaches experienced by patients, for example paracetamol.
  • Drug vasopressor
    drug works to prevent stroke due to lack of blood supply to the brain. Examples of these drugs are norepinephrine, epinephrine and dopamine.
  • Antiseizure
    drugs These drugs aim to relieve seizures caused by a ruptured aneurysm. Examples of these drugs are levetiracetam, phenytoin, and valproic acid.

In addition to medication, doctors can treat a ruptured brain aneurysm by inserting a catheter and creating ventricular or lumbar draining catheters and shunts to drain fluid from the brain and spine. That way, the pressure on the brain will be reduced.

After the ruptured brain aneurysm is treated, the patient will need to undergo physiotherapy to restore his condition.

Complications of Brain Aneurysm

A ruptured brain aneurysm can cause bleeding in the brain and damage brain tissue. In addition, the following complications can arise from rupture of a brain aneurysm:

  • Hydrocephalus
    Bleeding that occurs due to rupture of an aneurysm can block the flow of cerebrospinal fluid (brain fluid and spinal cord), causing hydrocephalus. This condition can increase the pressure in the cavity of the head and damage brain tissue.
  • Vasospasm e
    When a brain aneurysm ruptures, the blood vessels will automatically narrow to reduce bleeding. This narrowing will cause other parts of the brain to lack oxygen and nutrients.
  • Hyponatremia
    Rupture of a brain aneurysm that causes bleeding in the brain can also upset the sodium ion balance and cause hyponatremia .

In addition to these complications, a leaky brain aneurysm can cause recurrent bleeding. This condition can cause further damage to brain tissue.

Brain Aneurysm Prevention

Prevention of this condition is done by doing regular control if you have a disease that can increase the risk of brain aneurysm, such as hypertension. In addition, to reduce the risk of a brain aneurysm, you are also advised to:

  • Quit smoking
  • Not using drugs
  • Reduce alcohol consumption
  • Eat a balanced diet
  • Exercise regularly
  • Maintain an ideal weight

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