Aneurysm (Vessel Bubbles)

The diseases we call aneurysm are usually the disease of the arteries, that is, the vascular wall of the arteries, which occurs after weakening for many reasons and resembles a bubble in appearance. Cerebrovascular aneurysm may develop secondary to smoking, hypertension, diabetes , and atherosclerosis , as well as some inherited diseases ( such as polycystic kidney disease) in some patients. The most feared situation in aneurysm patients is bleeding. Sometimes this may be due to a sudden rise in blood pressure, or it may happen unexpectedly, even during sleep. Brain aneurysm bleeding occurs into the brain and the surrounding cerebrospinal fluid-filled space, that is, into the subarachnoid space. For this reason, they are called subarachnoid hemorrhage (SAH). Usually life threatening. For this reason, necessary treatment and follow-up of patients diagnosed with aneurysm should be done immediately.

Symptoms

1. Headache: Very severe headaches can be observed, especially in patients with bleeding.
2. Blurring of consciousness and coma: This condition is observed in patients who have had bleeding and can be life-threatening. Sometimes the patient may lose consciousness within seconds and fall into a coma.
3. Depending on the bleeding, different types of paralysis, weakness in the arms and legs, speech disorders, urinary and stool incontinence can be seen.
4. Due to the pressure of the aneurysm, drooping of the eyelid and gliding of the eyes can be seen.
5. Seizures (less common).

Diagnosis

occurs into the brain and the surrounding cerebrospinal fluid-filled space, that is, into the subarachnoid space. It is almost always a life-threatening event. The patient is often encountered in emergency clinics. The first requested examination is Brain Tomography (CT). Here, the location and amount of bleeding and other accompanying pathologies in the brain such as hydrocephalus can be detected . After detection of bleeding, CT- angio or MR- angio can be performed to see the vascular structures . One of the most sensitive examinations in which vascular structures are evaluated is DSA ( digital subtraction angiography ). With this radiological imaging , the vessels that feed the brain (arteries) and drain the blood ( veins and sinuses) can be seen in all details, together with vascular pathologies such as aneurysm, if any.

Treatment

In surgical treatment, the aneurysm is seen by opening the skull, it is stripped from the surrounding tissues, and the aneurysm neck is closed with clips to prevent blood filling into the aneurysm and bleeding . In endovascular treatment, the aneurysm in the brain is filled with special metals by entering as if DSA is made from the inguinal artery, thus preventing the blood from filling here and bleeding. The type of treatment is chosen after evaluation according to the location and size of the aneurysm, the patient's general health status, the patient's preference, and other conditions.