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| Brain Aneurysm, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications |
A brain aneurysm is a widening or protrusion of a brain blood vessel due to a weakening of the blood vessel wall. These protrusions will look like hanging berries. When the blood vessels are torn, symptoms that arise can range from severe headaches to loss of consciousness.
A brain aneurysm that enlarges and ruptures is an emergency condition, because it can cause brain bleeding, brain damage, and even death. Although it can affect anyone, brain aneurysms are most common in women over the age of 40.
Causes of Brain Aneurysm
A brain aneurysm occurs when the walls of blood vessels in the brain weaken or thin. The cause of the weakening of the walls of blood vessels in the brain is not yet certain. However, there are several factors that are thought to increase the risk of a brain aneurysm, namely:
- Suffering from high blood pressure (hypertension)
- Over 40 years old
- Female, especially those who have gone through menopause
- Have a history of head injury
- Excessive consumption of alcoholic beverages
- Using drugs, especially cocaine
- Have a smoking habit
- Having a family with a brain aneurysm
In addition to these factors, there are several diseases that can increase the risk of a brain aneurysm, namely:
- Polycystic kidney disease
- Coarctation of the aorta
- Arterial-venous malformations
- Ehlers-Danlos Sindrom syndrome
- Marfan Sindrom syndrome
Symptoms of Brain Aneurysm
Brain aneurysms that are small and have not ruptured often do not cause symptoms. However, as the size of the aneurysm enlarges, sufferers can experience various complaints, such as:
- Pain around the eyes
- Numbness on one side of the face
- Dizziness and headache
- Difficulty speaking
- Balance disorders
- Difficult to concentrate
- Memory loss
- Visual impairment
A brain aneurysm that gets bigger can rupture and cause bleeding in the brain. Symptoms of a ruptured brain aneurysm can include:
- Severe headache
- Blurred vision or double vision
- Nausea and vomiting
- Weakness or paralysis on one side of the body or leg
- Difficulty speaking
- Difficulty walking
- drooping eyelids (ptosis)
- Seizures
- Loss of consciousness
When to go to the doctor
Check with your doctor if you experience the symptoms mentioned above, especially if you have risk factors such as suffering from hypertension, having a family history of brain aneurysm, or having experienced a blow to the head.
You are advised to seek medical attention immediately if you experience symptoms of a ruptured brain aneurysm in the form of a sudden, severe headache. A ruptured brain aneurysm is an emergency condition that must be treated immediately.
Brain Aneurysm Diagnosis
As a first step, the doctor will ask about the complaints experienced, the medical and disease history of the patient and his family, as well as the history of using drugs.
To confirm the diagnosis, the doctor will ask the patient to undergo several supporting examinations, such as:
Scan
Several types of scans that can be performed on people with brain aneurysms are:
- MRI, to view and detect unruptured brain aneurysms
- CT scan, to see the condition of bleeding in the brain due to rupture or leaking of a brain aneurysm
- Brain angiography with CT scan (CTA) or MRI (MRA), to see abnormalities in the blood vessels of the brain, including detecting brain aneurysms
Cerebrospinal fluid examination
If a subarachnoid hemorrhage is suspected, the doctor will ask the patient to undergo a cerebrospinal fluid examination, which is the fluid that surrounds the brain and spinal cord. This examination aims to detect the presence or absence of bleeding in the brain.
Cerebrospinal fluid examination is usually done if the patient has symptoms of a ruptured brain aneurysm, but the CT scan results do not show any bleeding in the brain.
Brain Aneurysm Treatment
Treatment aims to prevent the rupture of the brain aneurysm and the prevention of complications when the brain aneurysm has ruptured. Here's the explanation.
Prevention of brain aneurysm rupture
Prevention of brain aneurysm rupture by the doctor will be based on the age and medical condition of the patient, as well as the location and size of the aneurysm.
If the risk of rupture of a brain aneurysm is low, the doctor will conduct regular observations. Patients will be given blood pressure-lowering drugs, and are advised to live a healthy diet and lifestyle in several ways, such as:
- Quit smoking
- Exercise regularly, but avoid strenuous exercise
- Limit consumption of caffeinated and alcoholic beverages
- Avoid strenuous physical activity
Doctors will recommend surgery if the risk of rupture of a brain aneurysm is high enough. The surgical procedure aims to stop blood flow to the brain aneurysm.
Surgery can be performed by clamping blood vessels (neurosurgical clipping) or placing coils at the site of the aneurysm (endovascular coiling). This aims to stop blood flow to the aneurysm so it doesn't swell or burst.
Treatment of a ruptured brain aneurysm
If a brain aneurysm ruptures, emergency treatment needs to be done immediately. The doctor will give medication to relieve symptoms and prevent complications. The types of drugs given can be:
• Calcium antagonist drugs (calcium channel blockers)
Giving calcium antagonist drugs aims to prevent blood vessel stiffness (vasospasm) which is a complication of brain aneurysms. The type of calcium antagonist that can be given is nimodipine.
• Pain relievers
Pain relievers, such as paracetamol, can be given to relieve headaches experienced by people with brain aneurysms.
• Vasopressor drugs
Vasopressor drugs serve to prevent stroke due to lack of blood supply to the brain. Types of vasopressor drugs that can be given are epinephrine, norepinephrine, and dopamine.
• Antiseizure drugs
This drug aims to relieve spasms caused by a ruptured aneurysm. Antiseizure drugs given can be levetiracetam, phenytoin, and valproic acid.
In addition to medication, doctors can treat a ruptured brain aneurysm by inserting a catheter and creating a ventricular or lumbar draining catheter and shunt. The goal is to remove fluid from the brain and spinal cord so that the pressure on the brain will be reduced.
After the ruptured brain aneurysm is treated, the patient will need to undergo physiotherapy to restore his condition.
Complications of Brain Aneurysm
A ruptured brain aneurysm can cause bleeding in the brain, especially a subarachnoid hemorrhage, and damage brain tissue. Other complications that can arise from a ruptured brain aneurysm are:
• Hydrocephalus
Bleeding that occurs due to aneurysm rupture can block the flow of cerebrospinal fluid, causing hydrocephalus. This condition can increase the pressure in the cavity of the head and damage brain tissue.
• Vasospasm
When a brain aneurysm ruptures, the blood vessels will automatically narrow to reduce bleeding. This narrowing will cause other parts of the brain to lack oxygen and nutrients.
• Hyponatremia
A brain aneurysm that ruptures and causes bleeding in the brain can also disrupt the sodium balance in the body, causing hyponatremia.
In addition to these complications, a ruptured brain aneurysm can cause recurrent bleeding. This condition can cause worsening of brain tissue damage, even death.
Brain Aneurysm Prevention
Brain aneurysms can be prevented by undergoing regular check-ups if you have a disease that increases your risk of developing a brain aneurysm, such as hypertension. In addition, there are several efforts that can be made to prevent brain aneurysms, such as:
- Quit smoking
- Not using drugs
- Reduce consumption of alcoholic beverages
- Eat a balanced nutritious diet
- Exercise regularly
- Maintain ideal body weight
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