Causes, treatment of aneurysms are hot topics for modern medicine due to the high risk of such a condition. The term is used to denote the processes of stretching of the arterial walls, leading to the protrusion of a separate area. As an independent pathology, aneurysms localized in the aorta, heart, brain and peripheral circulatory system are considered.
General information
Aneurysms forming in the brain are called cerebral, intracranial. These can cause damage to the cerebral arteries, which over time will lead to hemorrhage. An aortic aneurysm is a dissection of the tissues that form the vascular wall due to fluid leakage. If all layers of the vessel break through, there will be a large-scale hemorrhage, severe blood loss. High probability of death.
Aneurysm localized in the peripheral vascular system can affect any limb. Sometimes a lesion of the visceral artery or carotid artery is established. Cardiac appears more often inas a complication against the background of a heart attack, carditis, trauma. All cases of heart failure are divided into acute, subacute and chronic. The division into three groups is accepted: mushroom-, bag-shaped, expanding.
Where did the trouble come from?
The main cause of aneurysm is genetic prerequisites. There is a higher probability of a pathological condition if the blood flow system does not work properly, there are violations in the functioning of connective tissues or renal polycystic. A large percentage of cases are due to congenital abnormalities in the state of the blood vessels.
Possible causes of symptoms of an aneurysm of the vessels of the brain, heart, aorta, and other localization options are an injury, a neoplasm or a wound. There is a higher probability of encountering pathology in heavy smokers and chronic hypertensive patients. Provocative aspects include infectious diseases, atherosclerosis, cholesterol plaques on the vascular walls.
And more details?
Quite often the cause of an aortic aneurysm is hypertension. Pathology can be provoked by injuries, injuries, wounds localized in the abdominal cavity, chest. A congenital defect of this vessel, atherosclerosis, can play its role. There is a higher risk of aneurysm formation in patients with syphilis, as well as in people who are often forced to face increased loads of various kinds - affecting the physical condition, psyche.
A common cause of a heart aneurysm is a heart attack. This pathological condition causesformation of scars on the muscle tissues of the cardiosystem. The wall formed by such fibers becomes thinner, the contractility of the organ decreases. Since there is still blood pressure, the tissue is stretched and the segment protrudes outward. More often this type of disease is observed in the region of the septum between the ventricles or in the left part of their cavities.
The cause of an aneurysm of the vessels of the peripheral circulatory system in most cases is erosive changes in tissues and an injury received by the patient earlier. Chronic high blood pressure and congenital disorders, deviations in the structure and functioning of the circulatory system can play a role. The dangerous factor is atherosclerosis.
How to suspect?
Regardless of the cause of the aneurysm (brain, aorta, other area of localization), the first manifestation of the pathological condition will be tingling, a feeling of squeezing, disturbing exactly where the diseased vascular area is located. Discomfort is due to pressure on organic structures in the vicinity of the vessel. If the aneurysm ruptures, acute and severe pain occurs. In certain cases, there are no symptoms at all. It is not uncommon for a pathology to be detected quite by accident during a preventive examination, ultrasound, or when evaluating an x-ray, to which the patient was referred for another reason.
Case refinement
Patients with aneurysm-producing causes deserve special attention. Symptoms of this condition as indicatedabove, may be absent, so it is important for people at risk to regularly attend preventive examinations to rule out pathology. If an aortic aneurysm is suspected, an instrumental examination of the patient's body is necessary. They take an ECG, do an aortography, use equipment for ultrasound, x-rays, clarify the Wasserman reaction.
If a cerebral aneurysm is suspected, angiography of the vascular system of the organ is necessary. If there are reasons to suspect a cardiac aneurysm, the patient is shown an ECG, ultrasound examination, echocardiography. If the peripheral circulatory system is suspected as an area of localization, a person is referred for dopplerography using ultrasound, CT, angiography.
What to do?
If an aortic aneurysm, cerebral, cardiac or any other, has arisen (regardless of the cause), the patient is indicated for surgery. An untimely intervention or the absence of such a measure is associated with the risk of breaking the region. With the heart, as an area of localization, the patient is shown bed rest. At first, the stability of the state can be maintained with drugs for pressure and arrhythmias. With the progress of the case and the insufficiency of the heart, it is important to operate on the patient as soon as possible.
For aortic aneurysm, it is indicated to take drugs to stabilize pressure. In a difficult case, endovascular intervention or open surgery is performed. An aneurysm in the brain can only be treated with surgery. During the intervention, doctors localize the diseased area, exclude it from the system of communicating blood vessels.vessels.
Cerebral aneurysm: case features
You can suspect this form if you are worried about pain in the eye area, forehead, pupils increase, vision becomes worse, and double vision. Most cases do not attract the attention of patients, as the condition worsens gradually. Pathology can be suspected by numbness of the face, in severe cases - paralysis. Eyelids drop.
A sharp sudden pain, blurred vision, stiffness of the cervical muscle tissue, nausea, vomiting indicate a rupture of the area. Perhaps convulsive or unconscious state, photophobia. For some, the ability to speak coherently and articulately is impaired.
Even if there seemed to be no reason for the occurrence of a brain aneurysm, with sudden and sharp pain, accompanied by double vision, you need to see a doctor. If a person nearby falls unpredictably, convulsive movements are noticeable, you need to urgently call for qualified help.
Possible factors: nuances of localization in the brain
Perhaps the most relevant and significant cause of cerebral aneurysm is genetic prerequisites. An abnormal structure, incorrect bending of the elements of the system, as well as violations of the integrity and functionality of the connective tissue can play their role. The likelihood of an aneurysm as a complication is increased if a person suffers from Ehlers-Danlos pathology. An aneurysm can be suspected of a headache if a head injury has previously been suffered, a person has had an infectious disease, suffered a fungal infection, orsyphilis. Among the causes of cerebral aneurysm are cancerous neoplasms of this area of localization, as well as atherosclerosis.
The risk group for the described pathology includes overweight and smokers, as well as those who regularly use hormonal medications. The danger is higher if an abnormally high cholesterol content is detected in the circulatory system. One of the causes of cerebral aneurysms is high blood pressure. People who are damaged by stress factors are more at risk. Certain risks are associated with ionizing radiation, renal hypoplasia.
Minimize risks: is it possible?
Knowing the causes of a brain aneurysm, you can adjust your lifestyle so that the dangers are minimal. In particular, you will have to take control of nutrition, reduce the intake of cholesterol from food, introduce adequate physical activity into everyday life and get rid of excess weight. In addition, all bad habits, and especially addiction to smoking, should remain in the past.
Analyzing the causes of brain aneurysm, it is clear that you can minimize the risks if you control pressure, eat right, dilute the diet with fruits and vegetables. You will have to limit the use of hormonal compounds, and it is important to coordinate all medications taken with the doctor. To reduce dangers, one should reconsider the way and rhythm of life to minimize stress, and in case of any he alth problems, poorFeeling well, visit a doctor to determine the exact cause.
Clarification and treatment
If there are reasons to suspect an aneurysm, then you need to come to the reception. First, the doctor will examine the patient, collect complaints and send them for tests to clarify the functioning of the body. Basic information is obtained by examining the cerebrospinal fluid. To confirm the diagnosis or exclude it, a CT scan of the brain, MRI, angiography is prescribed.
Aneurysms are cause for concern, so treatment should be started as soon as the diagnosis is confirmed. With small dimensions of the pathology, it will be necessary to reconsider the lifestyle, control pressure and minimize the intake of cholesterol, and come for examinations with a given regularity. If an operation is required, an open one can be performed by performing a cranial trepanation. Using shunting technology, doctors will strengthen the vascular walls. The endovascular method involves the introduction of microscopic coils through the femoral artery, which block the diseased area.
Localization - aorta
This pathology is quite common, in the age group over 65 it occurs with a frequency of one case per twenty people. If the problem area ruptures, there is a high chance of death. The therapeutic approach is the removal of diseased tissues and their replacement with artificial ones.
Before considering the causes of an aneurysm, one should pay attention to the human anatomy. The aorta is the largest artery in the human body. Through it, the heart is supplied with blood, from where the liquid through the branchesarteries enter various tissues and organs. The aorta from the heart goes up in the form of an arc, descends through the chest, abdominal cavity.
Aortic aneurysm is formed if a separate section of this vessel expands, protrudes. The predominant percentage of cases falls on the localization of the area in the abdominal cavity, the thoracic part suffers somewhat less often. The aortic wall weakens, and blood pressure poses a serious threat to it. The likelihood of rupture largely depends on the size of the aneurysm. With a size of more than 5 cm in every fourth patient, the rupture occurs in the next nine years. With larger dimensions, the danger is higher. If the aneurysm is small, surgery may not be scheduled, but you will have to visit the clinic every six months to monitor progress.
Symptoms and development of pathology
With an aneurysm localized in the abdominal cavity on the aortic wall, a person is worried about pulsation, dull pain. Your back may hurt. As a rule, several years pass before the first pronounced manifestations from the moment the aneurysm appears.
If a rupture occurs, a sharp, severe pain appears in the abdomen, spreading to the back. Rupture is the cause of heavy bleeding. If you do not do urgent surgery, there is a high probability of death.
Causes and consequences
The most common cause of an abdominal aortic aneurysm is atherosclerotic plaques. With the disease, cholesterol accumulates on the vascular walls, calcium deposits are also localized here andfibrin. All this provokes protrusion and weakens the wall. The likelihood of developing atherosclerosis, and, consequently, aneurysms, is higher if a person smokes, suffers from high blood pressure and excess weight. The danger is greater if there is no physical activity. Hereditary predisposition, gender plays a role (for men, the danger is greater). Aneurysms are more common in people over 55.
Sometimes an aortic aneurysm is formed on the background of trauma (more often - due to an experienced road accident), infection (syphilis), congenital pathologies. The latter is the rarest case. For example, Marfan's syndrome is one of the factors that increase the likelihood of a thoracic aortic aneurysm.
To confirm or refute the diagnosis, you must consult a doctor. The doctor will examine the patient, prescribe a CT scan, ultrasound, x-ray with a contrast agent. When the diagnosis is confirmed, treatment is prescribed based on the symptoms of the case, the size of the diseased area. A rupture requires urgent surgery. The event is associated with a high risk, the risk of death is quite significant.
About breakups
Currently, it is not possible to pinpoint the cause of the ruptured aneurysm. It is only known that this can happen quite suddenly, without any prerequisites. From the statistics it follows that with a break, up to 60% of the victims die immediately, about a quarter receive a disability, and only about 15% of people can return to normal life, work activity.
Aneurysm has three stages: prehemorrhagic, hemorrhagic,posthemorrhagic. Before the rupture, there are often practically no symptoms. An atypical gap with an erased picture is possible, the formation of a small volume. In this case, the rupture of a cerebral aneurysm is similar to inflammatory processes in the meninges, a hypertensive crisis.
Brain aneurysm: course and rupture
May develop a giant aneurysm. Before the rupture, this is similar in manifestations to a brain neoplasm. The patient is worried about pain in the head, it is difficult to coordinate movements, vision deteriorates, and the head is spinning. At the time of rupture, the manifestations are similar to subarachnoid hemorrhage of a non-traumatic nature. A person complains of a headache, sensations are comparable to a strong blow, it becomes impossible to navigate in space. Symptoms resemble meningitis: the muscles at the back of the head are rigid, the light frightens, the patient feels sick, vomits. Gradually, signs of a stroke may appear: sensitivity weakens, pupils do not react to light, facial muscles are asymmetrical, the smile is spastic, twisted.
If the case is severe, symptoms of a malfunction of the nervous system of the brain are gradually observed. Nystagmus appears, on one side of the face the eyelid falls, the mouth dries, the ability to recognize odors disappears. The meninges are irritated by blood and its metabolites. One of the possible consequences is vasospasm. Such a complication usually develops several days after blood loss, due to the toxic effect on the vasomotor centers. In some cases, vasospasm persists until the crescent. It cannot be cured, and the consequence is an ischemic stroke. The nuances of symptoms depend on the area of localization.
Manifestations and clarification of the state
The rupture of the aneurysm is indicated by a deterioration in the patient's perception of speech. From the side, disturbances in motor reactions, difficulty in coordinating movements are visible. Noises in the ears, uncontrolled urination is possible. After the primary hemorrhage, recurrence is especially high over the next month.
To clarify the patient's condition, cerebral angiography by CT was indicated. As part of the study, the places of protrusion and areas where the vascular lumens are greatly expanded are determined. Based on the results of CT, bleeding is localized, the volume of the affected areas is assessed, and the presence and level of hydrocephalus are determined. At the pre-hemorrhagic step, maximum useful information can be obtained through MRI. Among the invasive ones, the most useful diagnostic method is cerebral angiography.
The patient can take urine and blood for examination. Both the general tests and the biochemistry study show no specific abnormalities.
Consequences and future
Rupture of a brain aneurysm causes stroke, vasospasm, hemorrhage. This condition can lead to severe dropsy. Perhaps a violation of the structures of the nervous system - they are irreversible. An aneurysm rupture can cause loss of vision, impaired ability to speak. Possible consequences - paresis, paralysis, inability to move, coordinate actions. It is known that in some cases, the rupture of the aneurysm became the cause of a tendency to epileptic seizures.
With the clinical picture of subarachnoidbleeding of a non-traumatic nature, it is necessary to urgently hospitalize a person in a hospital setting. Regardless of the location of the gap and its dimensions, an urgent operation is required. Vascular spasm significantly worsens the picture and prognosis, reduces the likelihood of a complete recovery. In evaluating the effectiveness of the chosen treatment, it is necessary to analyze the progress of symptom relief and the rate of return to normal of the main affected functions.
Features of treatment
Before surgery, conservative therapy is indicated. The main task pursued by doctors is to stabilize the patient's condition and prevent relapse, as well as vasospasm. If one has developed, medicines are chosen so as to alleviate the condition. With manifestations of ischemia, therapy is aimed at their relief. To reduce the likelihood of complications in the postoperative period, to simplify the intervention itself, lumbar drainage should be done. It is shown to remove about 20 ml of cerebrospinal fluid. To reduce the risk of dropsy, resort to external drainage. They prevent vascular spasm by removing blood clots, eliminating the hematoma, and then excluding the area of the aneurysm from the blood circulation system.
In some cases, the operation is impossible - for example, the patient's condition can be very serious, it is not possible to stabilize it. In such a situation, external decompression and removal of the hematoma are indicated without aneurysm exclusion. The patient is given a drain. With small dimensions of the pathological area, a wide neck of the aneurysm, with a giant protruding area that cannot beto operate, occlusion inside the vessels is shown. Use a stand or balloon remodeling.
If residual bleeding persists after endovascular surgery, the operation should be repeated using open technology. After clipping, a puncture or opening is shown, designed to exclude the diseased area from the system of communicating vessels.
