What is Intracranial Aneurysm ?
An intracranial aneurysm is the result of a weakened artery wall in the brain, which bulges out due to the blood pressure.
Mostly an intracranial aneurysm may not result in any visible signs and symptoms. Although in certain cases the exceeding pressure on the bulging artery wall causes the aneurysm to burst and release the blood into the brain, leading to brain hemorrhage and eventually stroke.
If the brain aneurysm releases too much blood into the sub-cranial region then it might lead to brain damage and even death, depending on the severity of the hemorrhage.
The Circle of Willis, which is the network of blood vessels at the base of the brain, is the most common location for intracranial aneurysm.
What are the causes of Intracranial Aneurysm?
Mostly intracranial aneurysms are formed due to the development of atherosclerosis (hardening of the arteries) in the blood vessels in the brain as well as aging.
Certain risk factors can be controlled with several methods while others are difficult to do so.
These are some of the risk factors that increases the risk of development of an intracranial aneurysm, and the chances of a prevailing intracranial aneurysm to rupture:
- Heredity – A family history of intracranial aneurysm increases the chances of intracranial aneurysm in the person as well.
- Recurrence – Previous intracranial aneurysm increases the chances it recurring in the future.
- Sex – Women are at an increased risk of intracranial aneurysm than men.
- Ethnicity – African Americans are at more risk of developing intracranial aneurysm as compared to Caucasians.
- Higher Blood Pressure – The risk of intracranial hemorrhage increases with high blood pressure.
What are the signs and symptoms of Intracranial Aneurysm?
Mostly, intracranial aneurysm might not show any symptoms and may often be discovered when diagnosing for another condition or disorder. In some cases, the unbroken aneurysm may cause pressure on the brain and result in various complications. This often causes severe headaches, vision problems, speech difficulties, neck pain and these symptoms depend on the various areas affected by the aneurysm.
At times, a ruptured intracranial aneurysm may suddenly cause the symptom to arise. It is advisable to seek medical assistance urgently if any of the symptoms are noticed.
These are the commonly seen signs of an intracranial aneurysm:
- Instant and severe headache
- Neck pain
- Photo-sensitivity (sensitiveness towards light)
How is Intracranial Aneurysm diagnosed?
An intracranial aneurysm may often go unnoticed in case it does not cause any noticeable symptoms and may be discovered when testing for another unrelated medical disorder or disease.
In case the doctor suspects the presence of an intracranial aneurysm they might suggest these diagnostic tests:
- CT (Computerized Tomography) Scan – This diagnostic imaging test helps to distinguish hemorrhage (internal bleeding) in the brain. A lumbar puncture may also be used in case signs of a ruptured intracranial aneurysm are seen with hemorrhaging in the brain.
- CTA (Computerized Tomography Angiogram) Scan – This is a more accurate method of scanning the blood vessels in the brain than the conventional CT scan. It combines CT scanning method with contrast dye and uses a specialized computer unit to create a clear and more detailed image of the blood vessels.
- MRA (Magnetic Resonance Angiography) – This is similar to a CTA, and uses a magnetic field and radio waves to create clear and highly-defined images of the blood vessels.
- Cerebral Angiogram – This uses x-ray technique with injecting a contrast dye in the cerebral artery. This provides a detailed image of the nature of the blood vessel being tested.
How is Intracranial Aneurysm treated?
There are several methods of treating an intracranial aneurysm and the exact method will depend on various factors, such as the size and location of the aneurysm in the brain, the patient’s age, overall health status as well as several other factors.
In case the size of the aneurysm is small (less than 10 mm) then the doctor might choose to observe the aneurysm instead of taking the chances of the risk presented if surgery is performed on it.
However, if the aneurysm is larger in size, resulting is painful signs and symptoms then the doctor might suggest any of the following treatments for it:
This procedure requires the surgeon to insert a small tube (catheter) into the affected brain artery and guide it till the aneurysm’s location. In case of using Coil Embolization, the surgeon will use a tiny coil made from a medical-grade soft metal which is guided through the catheter and into the aneurysm itself. This coil acts as a support to the weakened arterial walls, thus decreasing the chances of it rupturing and causing brain hemorrhage (internal bleeding).
In case of Mesh Embolization method, the mesh is placed in the aneurysm area using the catheter technique. This mesh decreased the volume of the blood flow to the aneurysm and eventually decreases the chances of it rupturing due to pressure on the weakened walls of the artery.
This surgical technique requires placing a small metal clip at the base of the aneurysm to detach it from the vascular (blood supply) system. This automatically decreases the pressure on the weakened arterial walls and prevents it from breaking.
The factors that decide the need for this surgery are the location and size of the intracranial aneurysm as well as the patient’s overall health status.
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