What is aneurysm?

An aneurysm is a condition that can affect any artery in the body. It appears as a balloon-like bulge in an artery due to a weakening of the arterial walls, which are pushed outward by blood pressure.

What Is an Aneurysm?

Depending on the level of dilation, an aneurysm can rupture and cause a potentially fatal hemorrhage.

Aneurysms often occur in the brain, causing a stroke that can lead to death, and in the aorta, either at the thoracic or abdominal level, with a risk of fatal cardiovascular consequences.

In the case of cerebral aneurysms, they generally appear between the brain and the tissue that covers it. When they rupture, they cause a subarachnoid hemorrhage, leading to a hemorrhagic stroke, which is a medical emergency that requires immediate attention.

Many times, cerebral aneurysms don’t rupture and have no symptoms or complications, so they are often detected by accident during studies performed for other reasons. Once detected, treatment focuses on preventing a possible rupture later on.

The direct causes of their appearance have not yet been determined, but it is known that they affect adult women more and that a number of potential risk factors have been identified as possible triggers:

• Head injuries.
• Infections.
• Alcoholism.
• Smoking.
• Drug use.
• High blood pressure.

In the case of congenital factors, these are associated with the presence of various conditions such as:

• Arterial malformations.
• Having family members who have had an aneurysm.
• Aortic narrowing.
• Ehlers-Danlos syndrome.
• Polycystic kidney disease.

Depending on the size, location, and whether it is a ruptured or unruptured aneurysm, it can manifest with various clinical signs that can put the patient’s life at risk. Given this, it is crucial to be aware of the possible symptoms to achieve early detection and timely treatment.

Ruptured Aneurysm

When an aneurysm ruptures, symptoms appear suddenly and are generally intense. In the case of a ruptured cerebral aneurysm, the most characteristic sign is a sudden, unbearable headache, which is often described as “the worst headache of my life.”

This pain can be accompanied by other symptoms such as nausea, vomiting, neck stiffness, loss of consciousness, and, in some cases, seizures.

Beyond the pain, a ruptured aneurysm can also cause severe neurological changes such as double vision, light sensitivity, difficulty speaking, paralysis on one side of the body, or disorientation.

These types of symptoms reflect brain damage from a subarachnoid hemorrhage, a medical emergency that requires immediate medical attention. If there is no urgent treatment, the consequences can be devastating, including permanent brain damage or death.

Unruptured Aneurysm

An unruptured aneurysm is often a silent condition, which is detected incidentally during studies performed for another reason. However, some people may experience symptoms if the aneurysm is putting pressure on nearby structures. For example, in the case of a cerebral aneurysm, symptoms can include blurred vision or vision loss in one eye. There can also be facial or cranial pain, as well as weakening of the facial muscles.

If the aneurysm is in other locations, such as an abdominal aortic aneurysm, symptoms may be absent. But there may be a pulsating sensation in the abdomen, persistent pain in the back or abdomen, as well as discomfort that worsens when standing or straining. All of these can be a sign that the aneurysm is growing.

The diagnosis of an aneurysm begins with clinical suspicion, especially in people who already have risk factors such as hypertension, a family history, or smoking.

To reach a confirmatory diagnosis, imaging studies are used, which vary depending on the location of the aneurysm. In the case of cerebral aneurysms, a CT scan or an MRI can be performed to reveal the presence of a vascular malformation.

If a rupture is suspected, an emergency CT scan and, if necessary, a lumbar puncture are performed.

For aortic aneurysms, the most commonly used studies are abdominal ultrasound, CT scan, and angiography to evaluate the size, location, and risk of rupture.

All of these tools are also useful for planning surgical treatment and for monitoring patients with small aneurysms who don’t yet require intervention.

The treatment for aneurysms will depend on the location, size, symptoms, and risk of rupture. Sometimes, especially if the aneurysm is small and asymptomatic, medical monitoring with periodic check-ups is chosen. But if there is a risk of rupture or significant symptoms, surgical intervention is initiated.

There are two main approaches to treating an aneurysm:

• Open surgery: An incision is made to directly access the aneurysm and repair it with grafts or clips.
• Endovascular repair: This is a less invasive procedure that involves inserting a catheter through the femoral artery to the aneurysm, where a stent or coil is placed to reinforce the arterial wall.

The choice of treatment type should be based on the patient’s general condition, the aneurysm’s anatomy, and the available resources.

At the Neurological Center and the Cardiovascular Center of Centro Médico ABC, we can provide you with specialized care. Contact us!

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