Aneurysm of vessels of a brain, intracranial, or cerebral, aneurysm – the so-called small education that appears on the blood vessel of the brain. The tumor is growing rapidly and filling with blood.
Aneurysm is quite rare. It diagnosed in 5 percent of the world population (40 out of thousands). Most often the disease occurs in women aged 30-60 years. In children the tumor is diagnosed very rarely (2% of all cases), mainly if it is innate. Have 5-10 people out of 10 thousand ruptures intracranial aneurysms.
The tumor may appear in any part of the brain. But most often it is formed in place of branching arteries.
The structure of the aneurysm
Cerebral aneurysm consists of neck, body and dome. The neck is the strongest part, as it preserves the three-layer structure. The body of the aneurysm does not contain a muscular layer and elastic membrane it is broken. The dome is the thinnest and weakest point. Its walls consist only of connective tissue. It is in the dome and observed the rupture of the aneurysm.
Classification of aneurysms
Depending on external signs distinguish 3 types of intracranial aneurysms:
- saccular or "berry" – has the form of a rounded pouch filled with blood attached to the artery, resembles a berry hanging on a stem;
- side – you can detect it in the wall of the vessel, in appearance it resembles the swelling;
- spindle – begins in a place where there is an expansion of the blood vessel.
Mainly formed saccular tumor.
Depending on the origin of the aneurysm are:
- a true aneurysm is formed by the protrusion of the artery wall;
- about cavity tumors located near the artery, is not part of the blood vessel, the blood it enters through the hole that appeared in the wall of the vessel;
- exfoliating – cavity is formed inside the blood vessel wall, blood flows inside it through the hole in the wall.
If the aneurysm due to infectious diseases and purulent damage to the blood vessel wall, it is called an infected or mycotic.
At the time of occurrence of isolated congenital (approximately 20%) and acquired lesions.
Depending on the number of aneurysms can be single and multiple.
Number of cameras neoplasms are divided into single and multi-chamber.
Depending on the size of the aneurysm are:
- small (less than 11 millimeters in diameter);
- medium (diameter varies in the borders 11-25 ml);
- giant (over 25 mm diameter).
The location distinguish arterial and arteriovenousneoplasms.
Arterial aneurysms occur when the walls of the arteries protrude in the form of a bag or spheres. They are mostly located in the area willisau circle. In this place there is a maximum branching of the arteries.
Arteriovenous aneurysms are formed in those places where the vein expands to form a ball and connected to the arteries.
Kind anevrizmu are arteriovenous aneurysm of the vein of Galen. They are very rare. But the third of these cases are diagnosed in infants and in young children. Moreover, in boys, these tumors are found in 2 times more often than girls. The signs of the disease in half of the children are absent. In some cases, may develop heart failure or
Brain aneurysm: causes
Aneurysms occur when the wall of arteries and veins is disturbed three-layer structure and observed a disappearance of the muscular layer or the submucosal membrane.
To the formation of a cerebral aneurysm can result in:
- genetic predisposition;
- the intertwining of veins and arteries;
- tortuosity and abnormal curves of the vessels;
- damage to collagen fibers and elastic membrane;
- pathological changes in the muscular layer of blood vessels;
- violations of circulation of blood;
- coarctation of the aorta;
- calcification of blood vessels;
- disease, developing in the connective tissue;
- injury of the head;
Brain aneurysm: symptoms
With unruptured aneurysm a person can live their whole lives unaware of its existence. Mainly small cerebral aneurysms do not manifest themselves and they can only be detected when they increase in size and will manifest itself by the pressure exerted on the surrounding tissue, or after will be their gap.
Only 25% of patients have symptoms of the disease, characterized by:
- pain that appear around the eyes;
- numbness or paralysis of the face;
- double vision;
- the appearance of ptosis – drooping of the upper eyelid;
- the contraction or expansion of the field of view;
- clouded vision;
- the distortion of objects;
- dilated pupils.
Symptoms of the diseases, when the protruding portion of the aneurysm presses on the surrounding tissue and nerve endings.
A particularly dangerous aneurysm rupture, leading to hemorrhage of the brain. The larger the tumor size, the higher the risk of hemorrhage.
The signs that accompany the rupture of the aneurysm, very much like the symptoms of a stroke.
Bleeding the patient:
- there are very strong pain attacks;
- there is a feeling of heat;
Diagnosis of aneurysm
Sometimes detect an aneurysm, when conducting a survey of a person regarding other diseases. If any of the family members found an aneurysm, all close relatives are advised to undergo examination.
For the diagnosis of intracranial aneurysm used several methods:
- X-rays of the vessels, in which the use of a contrast agent called
The treatment of aneurysms of cerebral vessels
To get rid of an aneurysm is possible only by surgery. But it is carried out in extreme cases, as is associated with many risks. In the operation process corruption may occur in other blood vessels. Besides often develop postoperative seizures or re-formed aneurysm.
In each case, selected individual therapy.
Upon detection of a small aneurysm is usually applied expectant management: risk associated with the presence of the aneurysm, is equal to risk of surgery. For the growth and development of tumors have repeatedly observed, in time to start treatment. Sick 1-2 times a year is a diagnosis and constantly monitors their well-being, not to miss the symptoms indicating the rupture of the aneurysm.
If the aneurysm is too large or growing quickly, you need surgery. But to carry out the operation only needs highly skilled professionals with expertise.
Surgical intervention is produced in two ways: by direct intervention and by means of endovascular embolization.
With the open intervention making a craniotomy – bone-plastic trepanation of the skull. Then produce the clipping, bypass surgery, or strengthen the walls of the aneurysm.
When you put clipping on the aneurysm clip to shut down the affected area of circulation, and out flowed the blood.
If you do the bypass, then pull the affected vessel, and blood flow redirected by using a shunt.
When strengthen the walls of the affected area is wrapped in surgical gauze. As a result of treatment of the connective tissue capsule is formed.
Endovascular embolization does not require opening of the skull: in the aneurysm via the femoral administered microspiral or cylinders, which close the lumen of the artery and exclude the aneurysm from the circulatory system. This technique is today the most progressive. Control produced using angiography. But there is this method and disadvantages: it makes it impossible to remove blood clots and is too expensive. After surgery possible vasospasm and the development of hypoxia. Moreover, in 20% of cases microspiral shrink and blood flowis restored, that leads to re-intervention.
In some cases, and conservative treatment.
The patient can be assigned:
- anti-nausea medications;
- means to control blood pressure;
- anticonvulsant medicines;
- calcium channel blockers – lead to the stabilization of blood vessels and prevent cramps.
Prognosis of a brain aneurysm
Unfortunately, mostly aneurysm detected only after hemorrhage. Aneurysm rupture leads to disastrous results: 10-15% of patients die before receiving medical care, 5% after surgery, 50% of death occurs during the month after a breakup. But even in the case of a favorable outcome, many people have observed disorders in the brain. 12% of the operated there is clear neurological deficits.
The bleeding can cause serious complications: hemorrhagic and ischemic stroke, cerebral vasospasm, hydrocephalus, vasospasm, brain edema, inflammation and necrosis of certain parts of the brain, coma and even death. In 22% of cases rupture of the aneurysm is accompanied by the formation of intracerebral hematoma.
Basically the blood flows into the subarachnoid space. But it is also possible bleeding in the ventricles of the brain (in 14% of cases), which is the most dangerous and often fatal.
The risk of death significantly increases if the aneurysm is very large or is in the acute stage. With repeated hemorrhage, the risk of death increases.
Even if the patient survives the hemorrhage, he has:
- constantly have a headache;
- there are problems with the perception;
- develop cognitive dysfunction;
- disturbed behaviour;
- there may be attacks of epilepsy;
- diagnosed the presence of mental disorders;
- appear trouble swallowing;
- impair hearing, sight and speech;
- perhaps the manifestation of enuresis;
- manifested paresis and paralysis.
Only a third of survivors are able to self-care.
The prognosis after rupture of the aneurysm is influenced by the location of the aneurysm, extent of bleeding, age and health status of the patient, the time elapsed from the rupture to medical care.
Rehabilitation after aneurysm
A few days after surgery, the patient remains in the hospital. Then it is recommended to undergo rehabilitation in a specialized sanatorium. The rehabilitation period takes several weeks to 18 months.
The patient re-teach living skills, establish physical,social and moral functions. Hold special classes for training of speech, memory and cognitive skills.
It is necessary to ensure the patient hygiene care, rational nutrition, mobility (often in a wheelchair).
The patient attributed physiotherapy treatments: balneotherapy, acupuncture, electrical stimulation of muscles, therapeutic exercises.
To speed healing and eliminate the consequences of the aneurysm rupture will help the recipes of traditional medicine:
- The crushed root elderberry (20 g) pour water (250 milliliters) and bring to a boil. Infused for several hours. Drink 3 times a day 30 milliliters.
- Similarly prepare a decoction of fennel seeds.
- To strengthen the walls of blood vessels and prevent the development of recurrent aneurysms, it is recommended herbal teas brewed from the berries of hawthorn.
- To increase the elasticity of the arteries helps vitamin mixture. To prepare oranges (2 pieces) and lemons (2 pieces) mince, add honey (40 grams) and leave for a day. Eat the mixture daily for 40-50 grams.
- To give tone to the arteries will help the root of the peony. The root (20 grams) brewed with boiling water (250 milliliters). Take 20 milligrams 5 times a day.
- You can also use the pharmacy alcohol tincture of peony root. Use it 3 times a day 25 drops.
Specific methods of prevention of aneurysm no. But to prevent its development will help the observance of certain rules:
- active lifestyle;
- timely diagnosis and treatment of vascular diseases;
- limitation of hormonal drugs;
- control of blood pressure;
- avoidance of stress.
People diagnosed with an intracranial aneurysm, you must:
- monitor the pressure;
- to control cholesterol;
- to avoid physical and emotional fatigue, stress;
- to limit the consumption of fatty and fried foods;
- to increase the consumption of vegetables and fruits;
- take vitamins;
- to give up Smoking and alcohol.
You also need to consult with your doctor about taking aspirin and other medications, blood thinners, and oral contraceptives.
- X-rays of the vessels, in which the use of a contrast agent called