Aneurysm

An aneurysm is the condition that develops when a blood vessel’s wall is abnormally weakened, leading to a bulging or ballooning of the blood vessel. It is a serious condition that, if undetected or left untreated, can lead to the rupture of the blood vessel affected, which can lead to an internal bleeding, a stroke or even death.

Though an aneurysm can form in any kind of blood vessels, the arteries are the most frequent location of aneurysms. These are the blood vessels that deliver oxygen-rich blood from the heart to the rest of the body. Particularly vulnerable to aneurysm are the branching points of arteries, where the blood flow causes constant pressure.

There are more types of aneurysms. The location of the aneurysm determines its type. Therefore, these are the main types of aneurysms:

Brain or cerebral;
Thoracic aortic.
Abdominal aortic.

According to the Center for Disease Control and Prevention, during 2019, only the aneurysms in aorta were the cause of 9.904 deaths.

Aneurysm symptoms

An aneurysm can develop over years without causing any symptoms. It is usually when the aneurysm expands too quickly or when it ruptures that symptoms start to develop. Depending on the location of the aneurysm, the symptoms can widely differ.

Even so, as blood clots are getting formed, an aneurysm that has not ruptured, yet, could still block the circulation of blood to the tissues. An unruptured aneurysm can actually lead to thromboembolism, which can be the cause for ischemic stroke.

In case of thoracic aneurysms, the nerves and other blood vessels that are located close to it could also get affected. Moreover, it can cause breathing difficulties, swallowing or pain in jaw or in the chest, that could radiate towards the upper back.

If you are suffering of an unruptured aneurysm and you have symptoms, such as fever or weight loss, you should be informed that they are not caused by the aneurysm per se. The actual causes of these symptoms are the same conditions that caused the brain aneurysm. Therefore, it is very important to properly determine the main cause of the condition.

Brain aneurysm

The brain aneurysm - also called intracranial or cerebral aneurysm - occurs when the blood vessel that is weakened and consequently develops the abnormal bulge is located in or around the brain. The blood flow that will continue to pass through this blood vessel will cause the aneurysm to stretch even further, which in turn will see the wall of the blood vessel get thinner. The probability of the aneurysm leaking or rupturing will thus increase, as will the risk for damage caused by the bleeding in the brain.

Even if the exact causes of the brain aneurysm remain unknown, it is for sure that there are some external factors that could highly affect the strength of the blood vessels and stimulate the condition. These factors could be vices, injuries or other conditions, such as:

Smoking;
Use of drugs, as amphetamine or cocaine;
Brain injury;
Blood infection;
Buildups of fatty on the walls of the blood-vessels (atherosclerosis).

Brain aneurysm symptoms

Normally, there are no symptoms related to brain aneurysm until it ruptures, except if the size is considerably large and puts pressure on the tissues and nerves within the brain. Therefore, the symptoms that could be correlated to an unruptured brain aneurysm are:

Headache;
Loss of sight – it could be partial or total;
Pain around an eye;
Decreased mobility or even paralysis on one side of the face;
Reduced ability to speak;
No equilibrium;
Focusing problems;
Short-term memory loss.

In case the brain aneurysm has ruptured, the first symptom to occur is an agonizing headache, that is considered by most of the patients as the worst headache in a lifetime. The other symptoms of a ruptured brain aneurysm are:

Sickness;
Stiffness and pain in neck;
Sensibility to light;
Partial loss of sight;
Unconsciousness;
Seizures;
Weakness on one part of the body.

Brain aneurysm diagnosis

As the technology improves, there are more ways of detecting a brain aneurysm. The new technologies could provide with precise information that would be used to present the whole perspective, such as the actual situation and its roots.

For example, one way to look for a brain aneurysm is to perform a CT (computerized tomography). The CT is a specialized X-ray exam, which is used to obtain actual images of the brain, in order to determine if there are any bleeding in it or around it. When performing a CT scan, the specialist could also inject you a substance that will highlight the blood in the brain. Therefore, the obtained image of the brain will have the blood flows accentuated and it will be easier for the specialist to identify any unusual flows of blood. This is method of following the blood flows is called CT angiography.

Another test that is performed by specialists is called cerebrospinal fluid test. This test is made only if the CT scan has not provided information regarding a hemorrhage, but you have the symptoms associated to a ruptured aneurysm, as the cerebrospinal fluid test shows if there are any red blood cells around the brain and spine, as a cause of subarachnoid hemorrhage.

The MRI (magnetic resonance imaging) consists of a magnetic field and radio waves that recreate detailed 2D or 3D images of the brain. This test might detect a brain aneurysm.

The cerebral angiogram is another method of imaging the brain aneurysm. This procedure consists of inserting a catheter into a large artery, in the groin, normally, through which a special dye is injected, prior to a series of X-ray scans. The special dye substance will help in identifying the details of the arteries, during the X-ray scan, and will help determine the aneurysm. Usually, as this method of diagnosing is the most invasive one, it is used only when other methods are not effective.

Aneurysm brain treatment

Usually, a non-ruptured aneurysm is identified only when performing tests for other medical conditions.

In case that you have found that you have an unruptured aneurysm, your doctor might recommend to leave it as it is and not treat it, just if you have no symptoms related to it. But the doctor will also need to perform checks on it regularly, in order to determine if there are any changes in size. The first recommendations that your doctor will make you are to quit smoking (if you are a smoker) and to keep the blood pressure under control.

On the other hand, both the ruptured aneurysm and the unruptured aneurysm, but which has symptoms associated to it, require immediate medical attention. There are two types of treatment of the brain aneurysms:

Open surgical intervention;
Endovascular treatment.

The process of deciding which is the most suitable method of treatment depends on more risk factors for the patient, such as:

Age;
Location of the aneurysm and its characteristics;
The vascular anatomy;
Genetics.

The open surgical intervention consists of a tiny cut into the skull, in order for the surgeon to access the aneurysm. During this procedure, the surgeon will use very small sized instruments and will be guided by X-ray images. There, the surgeon will attach a tiny metal clip at the aneurysm’s base, in order to remove it. This method is very efficient, as the blood is blocked from flowing into the aneurysm and it could stop a brain hemorrhage or maintain an unruptured aneurysm from breaking open. Also, the procedure is considered to be very effective, as the recurrence rate after this surgery is very low.

The recovery period after undergoing this surgical intervention lasts about 2 to 4 weeks, in case of an unruptured aneurysm, while the recovery period for repairing a ruptured aneurysm could take up from weeks to months.

The endovascular treatment is different, as there is no need for an opening in the skull, as in the case of the open surgical intervention. The endovascular treatment consists of an insertion of a catheter into the blood vessel, in the groin or in the wrist. The catheter threads towards the brain, to the spot of the aneurysm.

The surgeon inserts in the aneurysm, a ball of platinum wires which determines blood clot formation both around and inside the aneurysm. This procedure could reduce significantly and even eliminate the risk of rupture, as the blood flow is deviated from the aneurysm.

Also, the surgeon could use another technique, which is referred to as the flow diversion. Using the same catheter, the doctor could place a mesh tube in the blood vessel that is affected by the aneurysm. The mesh deviates the blood flow from the aneurysm.

The recovery period for this procedure is pretty similar to the recovery period after open surgical intervention. Therefore, in case you are repairing an unruptured aneurysm, the recovery period takes could take up to a couple of weeks, while for a ruptured aneurysm, the recovery period could take up to a couple of months.

Based on your risk factors and the characteristics of the aneurysm, your surgeon will decide which is the best procedure for your condition.

Aneurysm in abdominal aorta

Aneurysm in abdominal aorta

An abdominal aortic aneurysm (AAA) is a condition that could become even deadly. As it is also referred to as the aneurysm in stomach, the condition consists of a swelling in the blood vessel that unfolds from the heart to the tummy. If it is not timely noticed and left untreated, the weak point of the aorta could break open and lead to a hemorrhage.

The abdominal aortic aneurysm is a condition identified by specialists in about 200.000 patients yearly, in the United States of America. The abdominal aortic aneurysm is classified as the 10th cause of death for men in over 55.

The aneurysm in stomach can be caused by other conditions that are weakening spots in the blood vessel walls, such as:

Peripheral artery disease;
Vasculitis;
Buildups of fat inside the arteries (Atherosclerosis);
Cardiovascular disease;
Traumatic injuries;
Smoking;
Genes, as the abdominal aortic aneurysm can be genetic.

Aneurysm in abdominal aorta symptoms

Normally, the aneurysm in the abdominal aorta is not associated to any ruptures, unless it is about to rupture, such as:

Back, leg or abdominal pain that does not disappear;

Palpitation within the belly, just like a heartbeat.

If the aneurysm in the abdominal aorta has ruptured, you might experience symptoms, such as:

Nausea;
Vomiting;
Dizziness;
Breathing problems;
Increased heartbeat;
Fainting;
Acute pain in the belly, lower back or in the legs.

Aneurysm in abdominal aorta diagnosis

As the abdominal aortic aneurysm is not associated with any symptoms, unless it ruptures, the patients do not seek medical attention for it. Therefore, the abdominal aortic aneurysm is usually identified during checks for other health conditions.

These are the checks that are made, in order to determine the abdominal aortic aneurysm:

The abdominal ultrasound is a very rapid and non-invasive method of identifying the aneurysm. This test is based on technology that is using the sound waves to recreate live images from the patient’s belly. During this test, it should be easy for the specialist to detect the abdominal aortic aneurysm.
CTA (Computed Tomography Angiography) consists of injecting a contrast dye before starting the computed tomography exam. The contrast solution highlights the blood and it will considerably help the specialist to determine the exact characteristics of the abdominal aortic aneurysm, such as the location, size and severity.

Aneurysm in abdominal aorta treatment

If the aneurysm you are suffering of is not ruptured and it has no symptoms associated to, the doctor will just check it regularly, to spot possible modifications of size.

If the aneurysm you are suffering of has symptoms associated to or it has ruptured, the medic will have to decide which is the best procedure, given your situation. In order to treat the abdominal aortic aneurysm, surgery is needed, but the kind of intervention is decided based on multiple factors. The main deciding factor is represented by the characteristics of the aneurysm. So, the size, location and severity will highly influence the repairing procedure type. Therefore, the doctor will have to decide between the open surgery and the endovascular aneurysm repair procedure.

The open surgery consists of a cut that is made across the belly, in order to obtain access to the abdominal aorta. The surgeon will change the affected part of the aorta with a tube that is made from a synthetic material. The graft, as the tube is referred to, has the purpose of reinforcing the aneurysm, in order to avoid a future rupture. The recovery period could take up to a couple of months.

The endovascular aneurysm repair method is a minimally invasive surgical procedure through which the surgeon inserts a catheter in the artery and with the guidance of X-ray images, he threads it to the location of the aneurysm. In the catheter, there is an expandable stent that is placed at the place of the aneurysm. Its purpose is to prevent a future rupture. The recovery period is shorter than for the open surgery. It usually lasts up to about a couple of weeks.

Aneurysm in thoracic aorta

The thoracic aortic aneurysm occurs in the chest and it and both men and women could be affected by it. The chances of occurrence increase while ageing.

The thoracic aortic aneurysm is typically resulted from high blood pressure. Also, a sudden injury could also stimulate its occurrence. In some cases, the genetics could play an important role in developing an aneurysm in the thoracic aorta. For example, those who inherit connective tissue disorders, such as Marfan syndrome or Ehlers-Danlos syndrome are more likely to suffer from a thoracic aorta aneurysm.

It is thought that around 13.000 U.S. patients die annually of thoracic aorta aneurysm. Moreover, this condition is ranked as the 18th most common cause of death among all individuals, in the United States of America. The incidence rate of thoracic aorta aneurysm is also increasing, as the diagnosing methods have considerably improved. The average age of the patient that is diagnosed with familial thoracic aorta aneurysm is at 56.8, while the average age for patients that suffer of thoracic aorta aneurysm due to other causes is 64.3. It is also considered that men are more prone to develop this condition, while women are more susceptible to develop worse clinical outcomes.

Aneurysm in thoracic aorta symptoms

Usually, the patients who suffer of a thoracic aorta aneurysm would not accuse any symptoms, until it ruptures.

The thoracic aorta aneurysm can be associated with symptoms, such as:

Acute and sudden pain in the chest that could radiate to the upper back;
Breathing problems;
Swallowing problems.

Aneurysm in thoracic aorta diagnosis

There are more ways in which the aneurysm in thoracic aorta could be identified.

The most common way of detecting a thoracic aortic aneurysm is the contrast-enhanced CT (Computed Tomography) scan, which can rapidly and easily identify the condition and assess the exact characteristics, such as location, size and severity. The CT scan can also show the images of calcifications or dissections.

The MRI (magnetic resonance imaging) offers a 2D or 3D image of the aorta, based on sound waves.

TEE (tranesophageal echocardiography) is a precise method of diagnosing aortic aneurysms. It can offer exact information of the aneurysm.

The ascending aortography is a method that can provide clear images of the aortic contour. Therefore, this method could identify the aneurysm, but it could not assess the exact size and severity.

PET scan is a diagnostic test that could help in identifying the metabolic activity depicting inflammation and it could signal an imminent rupture.

Chest X-ray is another method that is used to obtain an image of the aneurysm’s location. The X-ray scan provides clear and precise images of the organism. It is one of the main methods of diagnosing a thoracic aortic aneurysm.

In order to assess the thoracic aortic aneurysm, the specialists will also perform genetic tests. The exome and genome sequencing are very effective in determining the genes that are associated with thoracic aortic aneurysm. Therefore, the patients with high-risk genotypes could be efficiently diagnosed.

Aneurysm in thoracic aorta treatment

Aneurysm in thoracic aorta treatment

The treatment for thoracic aortic aneurysm could be made either by open surgery or endovascular repairing procedure, depending on several factors, such as the location of the aneurysm and its dimensions.

In case of an aneurysm of ascending aorta, open surgery is needed. The ascending aorta is the part of the aorta that threads toward the head. The open surgery consists of making an incision in the chest and cutting the part of the aorta that is affected by the aneurysm. That part of the aorta is replaced with a plastic tube or a fabric graft. It is a major surgery and it requires a heart lung-machine. The same procedure is made in patients that are suffering of an aneurysm of the descending aorta. The single difference is that the incision is made on the left side of the chest and it could reach the abdomen.

The endovascular repairing method is a minimally invasive surgical intervention. It consists of inserting a stent, using a catheter, into the affected area of the aorta. It will prevent the aneurysm from getting ruptured.

Aneurysm vs stroke

Even though the terms “stroke” and “aneurysm” are used interchangeably, these terms refer to serious medical conditions that include major differences.

A stroke is different from the aneurysm, as it appears only when a blood vessel gets broken within the brain or when the blood flow to the brain is obstructed.

An aneurysm is a medical condition that occurs due to a weakened artery wall. In opposition to the stroke, the aneurysm can occur anywhere in the body and it could affect as well the brain and the heart.

Conclusion

The aneurysm could represent a serious health condition that could occur while ageing. Today’s medical technology could help the specialist detect easier aneurysms in each patient, even if they were not susceptible of.

Even if the aneurysms could be life-threatening, the treatment procedures are effective and they could be repaired. Depending on the severity, in just a couple of months, you could be healed.

But it is best to stay healthy and to avoid the aneurysms. This could be made by choosing to live healthy. This means that in order to prevent the aneurysms, it is best to eat healthy, quit smoking and excessive drinking, and to exercise regularly.

Always take care of yourself and of your dear ones. Stay healthy!