Brain aneurysms

An aneurysm is an abnormal, localized dilation of the wall of a blood vessel, usually an artery, due to a defect, disease, or injury. Over time, pressure within the aneurysm can cause it to widen or even rupture. There are two types of true intracranial aneurysms: saccular and fusiform.
Common causes of intracranial aneurysms include hemodynamically induced or degenerative vascular injury, atherosclerosis (usually resulting in fusiform aneurysms), and underlying vasculopathy (eg, fibromuscular dysplasia). Rare causes include trauma and infection.

Congenital abnormalities of the intracranial vessels, such as vertebrobasilar junction fenestration or persistent trigeminal artery, are associated with an increased incidence of saccular aneurysms. Vasculopathies such as fibromuscular dysplasia, connective tissue diseases and spontaneous arterial dissection are also associated with an increased risk of aneurysm formation.

Diseases that increase the risk of cerebral aneurysms:
  • Polycystic kidney disease
  • Coarctation of the aorta
  • Abnormal vessels
  • Fibromuscular dysplasia
  • Connective tissue diseases (Marfan syndrome, Ehlers-Danlos syndrome)
  • Presence of vascular malformations and fistulas in other organs
  • Clinical presentation of ruptured cerebral aneurysm.
Hemorrhage occurs suddenly, there is a sharp headache, a "blow to the head", nausea, repeated vomiting, weakness, loss of consciousness, rarely a seizure. Meningeal symptoms appear somewhat later. Focal symptoms are determined by the localization of the aneurysm and include damage to the oculomotor nerves, hemiparesis or hemiplegia, speech disorders, and possible mental disorders with damage to the frontal lobe.

Course options:

  • apoplectic - acute onset with severe headaches, frequent loss of consciousness, and the development of meningeal syndrome, the development of focal symptoms;
  • pseudotumorous with the gradual appearance of the indicated clinical picture.