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ANEURYSM OF THE BRAIN

DEFINITION OF A BRAIN ANEURYSM

A brain aneurysm is a “cerebrovascular disorder in which weakness in the wall of a cerebral artery or vein causes a localized dilation or ballooning of the blood vessel.”

An aneurysm is a balloon shaped enlargement of an artery. It can involve veins as well as arteries. It will usually form at the base of the brain at the artery branch due to the fact that this part of the vessel has the least strength.

ANEURYSMS AND STROKES

Aneurysms which are 7 mm or larger are the most dangerous since this size has a significantly greater chance of rupture than a smaller sized aneurysm. Rupture involves blood leaking through a hole in an aneurysm. Blood accumulates in the spaces (subarachnoid space) around the brain and results in pressure on the brain equal to the pressure in the vessel. If the pressure is high, loss of consciousness will result. An equally severe complication is the possibility of a stroke.

A stroke usually occurs when there is a spasm of the vessel. A person may have loss of feeling, strength and temperature sensation on one side of their body. If the hemorrhage is not recognized, this person will have a 75 % chance of a second hemorrhage within one month which may result in death. If a person survives the initial hemorrhage, it is highly likely that he or she will experience neurological symptoms. A patient who experiences the best outcome will be able to resume their normal activities with a few weeks with no lingering effects.

Most of the deficits that are observed with the onset of a stroke will decrease over time with healing and therapy. It is encouraging that many stroke victims are able to recover and regain most of their functions. More severe hemorrhagic patients might suffer more serious and longer effects. Each patient has a unique set of circumstances and all are different.

THE WORST HEADACHE OF YOUR LIFE

Brain aneurysms occur in about 2% of the population. Usually, they are not recognized until they rupture. The first symptom of an aneurysm, usually due to its rupture, results in the worst headache of one’s life. Coma, paralysis or sudden death is also the result of a brain aneurysm. If a  younger person dies with no known explanation, an autopsy may be performed. It is at this time that an aneurysm may be discovered.

A small unruptured intracranial aneurysm is often “incidental”. They are usually very small, measuring 2-5 mm diameter. Unless an aneurysm is pressing upon a vital structure, an individual may have no symptoms. Most aneurysms occur spontaneously and are due to increased blood pressure, weakness of the arterial wall or a combination of both. If someone has had an aneurysm, it is more likely that their family members will have an aneurysm than individuals in the general population. This leads one to the conclusion that genetics may have a lot to do with aneurysms.

DIAGNOSIS

Patients with a ruptured aneurysm are usually seen in the emergency room of a hospital. A CT scan of the brain may be performed in the ER. The diagnosis of hemorrhage of an aneurysm is high with a CT. However, an aneurysm may not be visualized if it is very small. Partial clotting within an aneurysm may also conceal its location and size. Further evaluation by an MRI may be performed for better delineation of a brain aneurysm. Another method for delineation is an MRA (magnetic resonance angiogram).

TREATMENT

Treatment for a brain aneurysm is supportive. This means that the patient’s vital signs are monitored and medication will be administered if their blood pressure is high. Note that high blood pressure is what usually causes an aneurysm to rupture. If the diagnosis of a brain aneurysm is definite, radiological interventional may be necessary. A radiologist can insert a coil into the artery where an aneurysm is located. This may resolve the instance of rebleeding of an aneurysm.

If this is not an option, surgery may be necessary. Initial control of a patient’s blood pressure as well as control of the spasm in the vessels by medication is performed. After hospitalization, the patient will often experience long-term rehabilitation.

WHAT YOU CAN DO

To avoid the possibility of having a brain aneurysm you should make sure that your blood pressure is under control. Have it checked by your primary physician. You can always take your pressure at one of the kiosks located in pharmacies.

If your pressure is high, discuss it with your physician. If you are put on medications to control your pressure, take your medication. At the same time consistently check your pressure. Prescribing medication doses is not an exact science. It often takes trial an error by the patient and the physician to bring blood pressure to the normal levels.

Be aware of the activities and perhaps foods that may affect your pressure. Be vigilant so your pressure will not be a factor in causing a brain aneurysm to rupture. Make sure your diet contains the necessary vitamins and minerals that will help to improve the health of your body. You can help to avoid the possibility of having the worst headache of your life as well as the possibility of having a ruptured brain aneurysm.


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