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Cerebral Aneurysm
About Cerebral Aneurysm
Aneurysm of the brain, also called cerebral aneurysm, is a common cerebrovascular disorder caused by a weakness in the wall of a cerebral artery or vein. The disorder may result from congenital defects or from preexisting conditions such as hypertensive vascular disease and atherosclerosis (build-up of fatty deposits in the arteries), or from head trauma.
Cerebral aneurysms occur more commonly in adults than in children and are slightly more common in women than in men, however, they may occur at any age.
Before an aneurysm ruptures, the individual may experience such symptoms as a sudden and usually severe headache ("worst headache of my life"), nausea, vision impairment, vomiting, and loss of consciousness, or the individual may be asymptomatic experiencing no symptoms at all. Onset is usually sudden and without warning. Rupture of a cerebral aneurysm is dangerous and usually results in bleeding in the brain or in the area surrounding the brain, leading to an intracranial hematoma (a mass of blood-usually clotted-within the skull). Rebleeding, hydrocephalus (the excessive accumulation of cerebrospinal fluid), vasospasm (spasm of the blood vessels), or multiple aneurysms may also occur.
Emergency treatment for individuals with a ruptured cerebral aneurysm generally includes restoring deteriorating respiration and reducing intracranial pressure. Surgery iDr. Aniruddh Kulkarniwithin the first 3 days to clip the ruptured aneurysm and to reduce the risk of rebleeding. In patients for whom surgery is considered too risky, microcoil thrombosis or balloon embolization may be performed. Other treatments may include bed rest, drug therapy, or hypertensive-hypervolemic therapy (hypervolemic hemodilution) to control vasospasm.
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Arteriovenous Malformation
Cerebral Arteriovenous Malformation (AVM)
Cerebral arteriovenous malformation (AVM) is an abnormal tangle of blood vessels in the brain which can cause bleeding in the brain, seizures, or stroke-like symptoms (weakness, numbness, tingling). The cause of AVMs is unknown.
Symptoms
Brain AVMs can bleed in the brain in which case patients may have a severe headache, nausea and vomiting, blurred vision, stiff neck, or loss of consciousness. They can also cause seizures. They may also cause stroke-like symptoms such as paralysis, weakness, numbness, vision problems, balance or coordination problems, or speech difficulties.
Diagnosis
The diagnosis of a brain AVM is made by CT scan, MRI, and a cerebral angiogram.
Treatment
The treatment of a brain AVM is either by surgery (opening the skull and surgically removing the AVM from the brain ), embolization (injecting substances into the AVM to block off the abnormal vessels via tiny plastic tubes inserted in the patient's groin and navigated to the brain by x-ray guidance and not requiring surgery), or radiosurgery (a one-time treatment of high-focused radiation to the brain AVM).
Brain AVMs are either treated after they have caused bleeding, or in some patients, an AVM is found before it has bled, and is treated to prevent it from bleeding.
Prognosis
Once a patient recovers from an AVM bleeding, he or she can have a good recovery depending on the severity of the bleed and any disability caused by the bleed.
Angiogram showing a mass of tangled vessels
Angiogram showing a mass of tangled vessels
