Cerebral Aneurysm: Symptoms, Diagnosis and Treatment

An aneurysm or abnormal ballooning of a section of blood vessel in the brain is termed cerebral aneurysm. This ballooning might be the result of a weakness in the wall of a cerebral artery or vein.
The Circle of Willis forms a loop of arteries joining a circle at the base of the brain, sending out branches to every region. Nutrition is provided to the entire brain through these arteries that branch out. There are junctions where these arteries come together and these areas form weak spots having a high probability  of developing cerebral aneurysms, specifically the anterior part of the Circle of Willis. 

This type of aneurysm is caused due to congenital defects, or high blood pressure and atherosclerosis and may also result from a head trauma. Cerebral aneurysm is found to be more prevalent in adults than children and more common in women than in men. The two kinds of cerebral aneurysm are ruptured cerebral aneurysm and unruptured cerebral aneurysm.

Symptoms

Small unchanging aneurysms cause no visible symptoms unless of course the blood vessel ruptures and bleeds into the brain. When the aneurysm pushes on nearby structures in the brain, symptoms start to become visible for the physician to deduce the cause as cerebral aneurysm. In the wake of this push the primary effect might be the patient experiencing an unusually severe headache, most have described this to be the worst headache in their life. Other symptoms include nausea, vision impairment, vomiting and loss of consciousness. In some cases, the patient might be asymptomatic. The onset of this fatal aneurysm is usually sudden and without warning. A general list of symptoms associated with this aneurysm is given below:

• Sleepiness, confusion or lethargy
• Speech impairment
• Seizures
• Muscle weakness
• Headaches accompanied by nausea
• Irritability or impulsivity (which might be out of character)
• Loss of vision or double vision.

Exams and Tests

A patient complaining of the ‘worst headache of his life’ typically leads the physician to order a CT scan of the head. In more than 90% of the cases the aneurysm will be visible in this scan. Otherwise the physician will perform a lumbar puncture(LP) to identify the blood in the cerebrospinal fluid. Other tests include MRI of the head, cerebral angiography to locate the aneurysm and electroencephalogram in the case of seizures.

Treatment

The treatment invovles repair of the blood vessels that caused the aneurysm in the first place.  

• Clipping: The surgeon cuts open the skull, identifies the damaged blood vessel and puts a clip across the aneurysm thus preventing any further blood leakage or growth of the aneurysm. 
• Coiling: A tube is threaded through the arteries, identifying the aneurysm, which is then filled with latex or platinum wire coils. This also prevents further blood from entering the aneurysm.

It has to be noted that both these methods  have the accompanied risk of further damage to the blood vessel which may result in more bleeding. Attention is paid at all times to avoid this. Vital signs are monitored frequently with heart monitors to watch for abnormalities in the rhythmic beating of the heart. Some complications that may arise include permanent loss of sensation in any part of the face or body, seizures, stroke, neurological problems, loss of movement in some part of the body, or increased fluid pressure inside the skull.

First aid

• Immediately rush to the emergency room or call for medical help in the case of severe headaches accompanied by vomiting, seizures, nausea or other neurological symptoms. There is no known way to impede a cerebral aneurysm other than monitoring your blood pressure and following cholestrol-free diet so as to prevent any chance of blockage happening in your cranial arteries. Unruptured arteries can be treated before it causes any problems.