Brain aneurysm is the enlargement of blood vessels in the brain due to weak blood vessel walls. As blood flow presses against the blood vessel wall, the blood vessel will bulge like a balloon. This condition can develop very seriously when the brain aneurysm broke and subarachnoid hemorrhage occured. Brain aneurysm is a serious disease because it can cause brain damage or even death. Anyone can experience a brain aneurysm. However, this condition is generally suffered by women aged over 40 years.
Symptoms of Brain Aneurysm
Symptoms of a brain aneurysm in each sufferer vary, depending on the severity. In the case of a brain aneurysm that has not broken, new symptoms are shown when an aneurysm is so large that it presses the tissue or nerves of the brain. There are also symptoms in the form:
- Pain around the eyes.
- Difficult to speak.
- Balance interrupted.
- Difficult to concentrate or have short memory.
- Paralysis on one side of the face.
- Impaired vision. \ Eyelid down.
When the brain aneurysm has broken, the symptoms that appear can be:
- Nausea and vomiting.
- The neck becomes stiff
- Vision becomes blurred or has double vision.
- Severe headache.
- Loss of consciousness.
- Sensitive to light.
- Paralyzed or weak on either side of the body or legs.
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Causes of Brain Aneurysm
Brain aneurysm occurs when blood vessel walls weaken or thin out. The blood the brain needs is channeled through four blood vessels through the neck to reach the brain. Aneurysms often occur in weak branching of blood vessels.
The exact cause behind the weakening of blood vessel walls can not be ascertained. Nevertheless, several factors are thought to weaken blood vessel walls that trigger brain aneurysms. These factors include:
- High blood pressure. This condition increases the pressure on the blood vessel wall to trigger brain aneurysm. High blood pressure is susceptible to people who are obese or consume too much salt, caffeine, and alcohol.
- Age over 40 years. Brain aneurysms are more common in people over 40 years of age. This is due to the condition of blood vessel walls that weaken over time due to blood pressure that passes through the wall.
- Female sex. Most brain aneurysm sufferers are women. It is thought to be associated with a decrease in estrogen hormones that maintain the elasticity of blood vessels. This decrease usually occurs post menopause .
- Head injury. Although rare, severe brain injury may increase the risk of brain aneurysm.
- Alcohol consumption and drug abuse ( especially cocaine) .
- Non-congenital medical conditions , such as certain blood infections, arteriosclerosis (hardening of the arteries), and decreased levels of postmenopausal estrogen hormone.
- Congenital medical conditions, such as polycystic kidney disease , aortic coartase, arterial-vein malformations, and tissue disorders (eg in the case of Ehlers-Danlos syndrome and Marfan syndrome ).
- A history of brain aneurysm in the family.
Diagnosis of Brain Aneurysm
The diagnosis of a cerebral aneurysm can be ascertained by physical examination and multiple tests. The supporting tests include:
- Scanning. Methods used include CT scans combined with angiography (abbreviated to CTA) and MRI combined with angiography (abbreviated to MRA). CTAs are performed by doctors to ensure that allegations of vessel tearing and bleeding occur in the brain. While the examination with MRA is to see other blood vessels that are still intact.
- Examination of cerebrospinal fluid. Cerebrosipinal fluid is a fluid that surrounds the brain and spinal cord. Samples of cerebrospinal fluid to be examined, taken by performing lumbar puncture ( lumbar puncture ). This method of examination is used when the CTA is unable to detect any bleeding, but the patient's symptoms show it.
Treatment of Brain Aneurysms
Treatment of brain aneurysm aims to prevent the rupture of aneurysms, improve the condition of the patient, and prevent the occurrence of complications.
Efforts to prevent aneurysm rupture require careful consideration by age, family history, and patient's medical condition, particularly the location and size of the aneurysm, to determine the next course of action.
If the risk of aneurysm rupture is relatively small, then the doctor will only make observations on a regular basis. Patients will also be given blood pressure-lowering drugs, and are asked to change their diet and lifestyle, for example by stopping smoking, regular exercise, limiting caffeine consumption, and avoiding tough activities.
Whereas in patients with a high risk of aneurysm rupture, then the doctor will recommend surgery. This procedure aims to prevent blood flow from entering the aneurysm. One type of surgery performed is a blood clamping operation (neurosurgical clipping) . The goal is to close the aneurysm by using a metal-clip clip in the blood vessel that gives blood intake to the aneurysm, so that the aneurysm is not enlarged and burst. This procedure will be preceded by general anesthesia.
Another method of operation is to place the coils inside the aneurysm ( endovascular coiling ). This procedure begins by inserting a catheter tube from the artery in the thigh or groin to reach the location of the aneurysm. Furthermore, a coil made of platinum is inserted into the aneurysm. When blood flow can not enter the aneurysm because of this coil, it is expected that enlargement or rupture of the aneurysm can be prevented. Installation of the coils may need to be done repeatedly, but this procedure has a shorter recovery period compared to clamping.
For cases of aneurysm that have been broken, emergency care needs to be done immediately. Doctors can give drugs to relieve symptoms and deal with the risk of complications. Drugs given in the form of:
- Calcium channel blockers, which aim to prevent vasospasm which is a complication of brain aneurysms. Examples of drugs given are nimodipine.
- Pain relief medications, such as paracetamol , to relieve symptoms of dizziness.
- An antikejang drug for seizures caused by a ruptured aneurysm. Examples of these drugs are levetiracetam , phenytoin , and valproic acid .
- Vasopressor drugs to prevent stroke due to lack of blood supply to the brain due to resistance to narrowed blood vessels. The drugs of this class are usually given by intravenous injection.
Actions that can be done to deal with a ruptured brain aneurysm is by mounting a catheter tube and making a ventricular or lumbar draining catheters and shunt to remove fluid from the brain and spine to reduce the pressure on the brain.
Post-treatment of brain aneurysms, patients who experience subarachnoid hemorrhage is also recommended to undergo physiotherapy and speech therapy to restore the condition so it can return to the move.