Surely many people have come across such a thing as saccular aneurysm. This is the name of the protrusion of the walls of the artery, which occurs due to changes occurring in its structure. A little less often veins, aortas, whole organs are affected.
What causes an aneurysm to form? What are the predisposing factors? Are there any symptoms that indicate its occurrence? And, most importantly, how to treat this pathology? The answers to these and many other questions related to the topic can be found in the article.
Briefly about pathology
So, a saccular aneurysm is a protrusion of a weak spot in a blood vessel resulting from damage to its walls.
Why such a name? Because visually, this neoplasm looks like a sac. Very often it does not manifest itself in any way, and therefore, before the examinationremains unnoticed. But sometimes the bag can break. As a result, blood will be released into the skull, which will provoke unpleasant symptoms. There may be serious consequences (stroke).
Saccular aneurysm of the brain is also called saccular. This is a common education. Among all intracranial aneurysms, about 80-90% fall on it. As a rule, "bags" are formed on the branches of large arteries, as well as on their bifurcations.
Statistics and classification
It's worth talking a little about percentage chance of occurrence. Saccular aneurysms form in the following locations:
- Internal carotid artery (36%).
- Middle cerebral (33%) and anterior (15%).
- Basic artery, also called the basilar artery (6%).
- Posterior medulla (5%).
- External carotid (2%).
Depending on the location, education data is divided into several types. There is such a small classification:
- Cerebral artery aneurysm. Visually similar to a small ball or bulge right in the vessel. Looks like it's "hanging" on a stem.
- Aneurysm of the anterior communicating artery. Dangerous neoplasm. It doesn't let you know about itself at all. If it is not found during the examination, then the patient will learn about it only after its rupture. And this is fraught with dysfunction of the hypothalamus or even a memory disorder.
- Aneurysm of the internal carotid artery. In this case, a separate section protrudes. itprovokes a weak area of the vessel.
Most often these "bags" are true, that is, the inner wall protrudes outward. What are they made of? From dense hardening fiber. As an aneurysm grows, it often changes shape, and blood clots form inside it. In this case, the notorious break occurs.
What about the size? These pouches can be small (up to 5mm), medium (6-15mm), large (16-25mm) and giant (over 25mm).
Reasons
Scientists around the world have been working on their clarification for a long time. But to date, only predisposing factors are known, due to which a saccular aneurysm of the left or right artery can form. They can be identified in the following list:
- Nicotine abuse.
- Drug addiction.
- Vascular injury.
- Meningitis.
- Hereditary predisposition. Manifested in the weak walls of blood vessels from birth.
- Past tuberculosis.
- Polycystic kidney disease.
- Gastrointestinal disorders.
- Syphilis in advanced stage.
- Diseases of the cardiovascular system.
- Hypertension.
- Atherosclerosis.
Sometimes there are cases in which the formation of aneurysms was preceded by infectious processes. Often, cysts and tumors lead to this pathology.
It can develop in people of any age and gender. But the risk group, as a rule, includes men over the age of 50.
Symptoms
Often a saccular aneurysm of the brain develops without any special signs indicating it. But it is not uncommon for there to be symptoms. They can be identified in the following list:
- Headaches. They differ in duration, but more often they make themselves felt in the form of seizures. Often occurs as a result of high blood pressure. Pain is localized in different places - it all depends on where exactly the saccular aneurysm was formed. If it is deep, then uncomfortable sensations will not bother a person much, because the brain does not have pain receptors. But superficial aneurysms compress the membranes - they can cause severe discomfort. Often, patients even suffer from migraines, which disappear after surgery.
- Disturbed sleep. If a saccular aneurysm occurs in the area that controls sleep, the person may experience drowsiness or insomnia.
- Nausea and vomiting. These symptoms appear if the meninges are irritated. And such a reaction is caused by superficial aneurysms. Large "bags" cause increased intracranial pressure, and it is also fraught with nausea that occurs due to dizziness. And it does not go away even after taking the medication. In this case, there is reason to believe that there is a problem in a specific center of the brain.
- Meningeal symptoms. Their cause is superficial or large aneurysms. The most common manifestation is tension in the neck muscles, the inability to bend the legs at the knee or hip joint.
- Convulsions. They arisedue to compressed superficial parts of the brain. This symptom indicates large aneurysms. He is serious, as the convulsions may even lead to respiratory arrest.
- Impaired sensitivity. Often, saccular aneurysms of cerebral vessels compress the structures that are responsible for this. Often even tactile sensitivity is lost in certain areas, hearing and vision disorders occur. The presence of an aneurysm can also affect the coordination of movements.
Even more serious symptoms are impaired movement and cranial nerve function. In general, it can be said that all patients with a saccular aneurysm of a cerebral artery have individual symptoms. This greatly complicates the diagnosis.
Saccular aneurysm of the carotid artery
This pathology deserves special attention. It never goes away without a trace, and its symptoms vary.
Large aneurysms can even be seen with the naked eye. They are small pulsating tumors on the neck. A saccular aneurysm of the carotid artery can feel tensely elastic (if filled with liquid blood) or dense (if there are only clots inside).
The following alarming symptoms are distinguished:
- Dizziness.
- Insomnia.
- Chronic fatigue.
- Tinnitus.
- Headaches for no reason.
- Discomfort in the region of the heart.
- Deterioration of vision.
- Shortness of breath.
- Dilated pupils and eye pain.
- Hoarse voice.
- Feeling like blood vessels are pulsing.
- Pain in the shoulder, back of the head, neck.
If the saccular aneurysm of the internal carotid artery is large, then it presses on the trachea, throat, even the esophagus. Because of this, there are various functional disorders. They can be indicated by causeless nosebleeds, dyspnea (shortness of breath), dysphonia, hoarseness.
As it develops, the tumor progresses, spreads deeper, compresses neighboring nerve trunks. Because of this, acute pain appears, paresis, paralysis develops.
It is necessary to make a reservation that the saccular aneurysm of the right artery is characterized by common symptoms. These are fainting, headaches, impaired consciousness, dyspepsia, convulsions, psychomotor agitation. If the neoplasm has arisen on the left vessel, then epileptiform seizures, motor aphasia, hemianopsia, paresthesia are possible.
Saccular aortic aneurysm
Another case requiring further consideration. Because of this formation, an irreversible expansion of the lumen of the arterial trunk occurs. They occur in the abdominal part (37%), in the ascending and descending thoracic regions (23% and 19.5%) and in the arches (19%). Very often, this neoplasm is combined with coarctation and aortic insufficiency.
Symptoms differ depending on where exactly the "pouch" appeared. Pain is usually the leading symptom. It is caused by stretching or damage to the aortic wall, or the so-called compressionsyndrome.
If, for example, the abdominal aorta is affected, the patient is faced with the following manifestations:
- Spilled pains.
- Heaviness in the epigastrium.
- Burp.
- Discomfort in the abdomen.
- Nausea and vomiting.
- Feeling full in stomach.
- Dramatic weight loss.
- Intestinal dysfunction.
- Increased pulsation in the abdomen.
In the case when an aneurysm is formed in the ascending aorta, retrosternal pain, dizziness, tachycardia, shortness of breath appear. You may experience superior vena cava syndrome, swelling of the face or even the upper body.
When "sacs" form on the aortic arch, there is compression of the esophagus, dry cough, hoarseness, bradycardia and drooling. There may be stridor breathing, shortness of breath. And with an aneurysm of the descending aorta, pain appears in the scapula, left arm. If the intercostal artery is also involved, there is a risk of developing spinal cord ischemia.
Diagnosis
As a rule, the examination is carried out according to the same principle - it does not matter whether it is a suspicion of a saccular aneurysm of the superior vena cava or one that has formed in the carotid artery.
First, the doctor conducts a general examination, clarifies complaints, collects an anamnesis, studies the clinical picture. Then instrumental methods of examination are assigned. Based on their results, specialists make an accurate diagnosis, prescribing competent treatment. Here are the most informative methods:
- Ultrasound. Able to give accurate information about the structure of the vascular wall, as well as the speed of blood flow and the state of the lumen.
- Doppler examination. Helps determine if a patient has vascular disease.
- Angiography. It involves the intravenous administration of a contrast agent for the subsequent creation of x-rays. They are accurate, clear, demonstrate the state of the vessels and all the changes in them.
- Duplex scanning. It helps to assess in a two-dimensional projection the state of the vessels. Triplex, respectively, in three-dimensional.
- MRI. Using this method, you can establish a diagnosis, as well as determine the form and stage of the disease. In the future - to determine the treatment tactics. But more often, MRI is preferred to CT - computed tomography is more accurate.
If the doctor considers it necessary, then electroencephalography is prescribed. This method allows you to determine the presence of other vascular problems in the brain.
Operation
Surgery is indicated if the unruptured aneurysm is larger than 7mm.
Before the appointment of the operation, general clinical studies are mandatory. Among them:
- General analysis of urine and blood.
- Coagulogram.
- Blood chemistry.
- ECG.
- Chest X-ray.
- Blood test for the presence or absence of viral hepatitis, RW, HIV.
If there is evidence, it is carried outconsultation of a therapist, neurologist and other specialists. MRI, CT and digital subtraction angiography are also mandatory. This is necessary in order to choose the most optimal method of intervention.
How are saccular aneurysms removed? The operation can be open or endovascular. The first type is much more difficult, as it involves craniotomy. In the second case, only a puncture is made.
Rehab
After the operation, the person is under the supervision of medical staff in the intensive care unit. Approximately in 24-48 hours he is transferred to the neurological. There, doctors continue monitoring and treatment for 7-14 days.
Could there be complications? Yes, but they are extremely rare. This may be an adverse reaction to anesthesia, damage to the vascular wall. In the conditions of modern medicine, this almost never happens, but a person must be aware of possible complications. Among them:
- Clot formation.
- Stroke.
- Cerebral edema.
- Difficulty speaking.
- Infection.
- Deterioration of memory or vision.
- Problems with coordination and balance.
But removing the aneurysm minimizes the possibility of severe complications. The operation and the difficulties of the rehabilitation period are incomparable with the consequences that may arise due to the rupture of the "pouch". In addition, many complications are eliminated during the intervention or on postoperative days.
Bwithin two weeks, the patient will be disturbed by headaches, anxiety and fatigue. If an open intervention was performed, then the discomfort will drag on a little.
It takes about two months to fully recover. You may need to undergo physiotherapy procedures, the help of a psychologist, work with a speech therapist, exercise therapy, massage sessions. Be sure to take painkillers and drugs prescribed by a neurologist, as well as maintain a calm lifestyle. It is strictly forbidden to lift something weighing more than 2-2.5 kg.
Aneurysm rupture
If it occurs, then the prognosis is usually unfavorable. About 30% of patients die, and that is why alarming symptoms cannot be ignored. Surgery could save a life.
If a rupture occurs, the person is hospitalized and undergoes surgery. This is the only sure way to treat a saccular aneurysm. Then the person is obliged to observe strict bed rest and take medications. As a rule, the doctor prescribes one of the following:
- Sedatives: Persen, Bellaspon, Valocordin.
- Painkillers: Brustan, Ibuklin, Ketonal.
- Vasodilators: Cinnarizine, Pentoxifylline, Papaverine.
- Means that improve the properties of blood: "Trental", "Complamin", as well as nicotinic acid.
- Antihypoxants: Actovegin.
- Antiaggregants: Cardiomagnyl, Curantil, Aspirin.
- Vitamins: Neuromultivit.
Goaldrug treatment - to stabilize the healing process and strengthen the vascular walls. Some people still practice folk remedies, but this is possible only if the attending physician has approved. Propolis, dill or hawthorn tincture, wild rose decoction, chokeberry infusion work well.
But besides this, it will also be necessary to normalize the way of life. It is strictly forbidden to smoke and drink alcohol, eat red meat and junk food. The diet should be diversified with fresh fruits and vegetables, be sure to monitor the level of cholesterol in the blood.
And then, when the rehabilitation period is over, you need to start leading a more or less active lifestyle. Walk outdoors more often, go to the pool a couple of times a week. And, of course, regular check-ups. Aneurysm is a dangerous disease, but it is not a sentence. With timely treatment and the patient's responsible attitude to his he alth, the prognosis is favorable.
