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Neurosurgery


Cerebral Aneurysm


The word aneurysm comes from the Latin word aneurysma, which means dilatation. Aneurysm is an abnormal local dilatation in the wall of a blood vessel, usually an artery, due to a defect, disease, or injury.

Aneurysms can be true or false. A false aneurysm is a cavity lined by blood clot. The 3 major types of true intracranial aneurysms are saccular, fusiform, and dissecting.

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What is a cerebral aneurysm ?

A cerebral aneurysm (also known as an intracranial or intracerebral aneurysm) is a weak or thin spot on a blood vessel in the brain that balloons out and fills with blood. The bulging aneurysm can put pressure on a nerve or surrounding brain tissue. It may also leak or rupture, spilling blood into the surrounding tissue (called a hemorrhage). Some cerebral aneurysms, particularly those that are very small, do not bleed or cause other problems. Cerebral aneurysms can occur anywhere in the brain, but most are located along a loop of arteries that run between the underside of the brain and the base of the skull.

What is a brain aneurysm ? Like a steel cylindrical pipe, an artery is comprised of an inner space (the "lumen", filled with blood) enclosed by a wall ( you can go to the section on Brain Artery Structure by clicking here). The wall is made up of a number of layers, two of which are muscle tissue and elastic tissue. When a region of the blood vessel wall weakens, it can balloon out to form a sac-like structure. This structure is called an aneurysm (a word derived from the Greek, aneurysma - a widening), and the major problem associated with aneurysms is that they can rupture, an event which may be fatal.
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At the outset, it should be noted that there are different types of brain aneurysms. They are usually classified as being either "true" or "false" aneurysms.

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What causes a cerebral aneurysm ?

Cerebral aneurysms can be congenital, resulting from an inborn abnormality in an artery wall. Cerebral aneurysms are also more common in people with certain genetic diseases, such as connective tissue disorders and polycystic kidney disease, and certain circulatory disorders, such as arteriovenous malformations (snarled tangles of arteries and veins in the brain that disrupt blood flow).

Other causes include trauma or injury to the head, high blood pressure, infection, tumors, atherosclerosis (a blood vessel disease in which fats build up on the inside of artery walls) and other diseases of the vascular system, cigarette smoking, and drug abuse. Some investigators have speculated that oral contraceptives may increase the risk of developing aneurysms.


What are the symptoms of a brain aneurysm ?

Most brain aneurysms are silent, the person totally unaware of a problem till the time of rupture. This is the pattern of events in approximately 90% of all brain aneurysm patients. At this point,, the time of rupture, the person experiences one or more of the following: a sudden, extremely severe headache [which may be described as the worst headache in life, or as a "sledge-hammer headache which struck like a bolt of lightning", vomiting, neck stiffness, collapse, sudden loss of function in one or more parts of the body or a fit. In the remainder of patients,

The brain aneurysm is either found by chance during investigation for some other reason, or presents with symptoms due to its relatively large size or "mass" (where it may compress or irritates surrounding brain structures; seen in 7% of all brain aneurysm patients). In these instances of so-called "mass effect", the symptoms may be continuous morning headaches, nausea, loss of function in one or more of one of the nerve bundles in the brain or spinal Of course, these symptoms may also occur in conditions not related to brain aneurysms so careful evaluation by a physician is required.

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Diagnosis

We care Health Services specialists use CT scans, MRI, and cerebral arteriograms to determine an aneurysm's size, location and risk of rupture. Test results generally are available to the neurologist in Mayo's state-of-the-art electronic medical record within 24 hours.


Treatment Options

We care Health Services offers the full range brain aneurysm treatment options. Mayo physicians have special expertise in the use of minimally invasive techniques (such as aneurysm coiling) to treat cerebral aneurysms, including aneurysms in hard-to-reach or critical locations.

List of other Cerebral Aneurysm Surgery options offered in India







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