Disease: Aneurysm

What Is an Aneurysm?

Women from 30 to 60 years old are at highest risk of a brain aneurysm, while men over 65 are at highest risk of an aortic aneurysm.

An aneurysm is a bulging weak point in an artery.

Aneurysms most commonly occur in the arteries of the brain or in the body’s largest artery, the aorta.

An aortic aneurysm can be in the chest (a thoracic aortic aneurysm or TAA) or in the abdomen (an abdominal aortic aneurysm or AAA).

Most people with an aneurysm don’t even know they have one.

However, if the aneurysm grows large enough, the artery wall may become so thin that blood begins to leak into the wall of the blood vessel (called a dissection) or out into neighboring tissues or parts of the body.

An aneurysm can become so weak that it eventually bursts.

If a brain aneurysm leaks or ruptures, areas of the brain may not get sufficient blood circulation.

When the brain is deprived of blood (and therefore oxygen), a stroke results.

In other cases, an accumulation of blood from a leaking brain aneurysm may press on areas of the brain, causing brain damage.

When an aortic aneurysm leaks or ruptures, severe bleeding (called hemorrhage) may occur. This is a medical emergency that requires immediate attention.

Who Has Aneurysms?

In the United States, brain aneurysms occur in one out of every 50 people, though most of them will never have any symptoms or problems as a result.

About 27,000 people a year have a stroke caused by a burst brain aneurysm, and about 14,000 people die every year from aortic aneurysms — 75 percent of them from AAA.

Women between age 30 and 60 are most at risk for brain aneurysms, and men over the age of 65 are most at risk for aortic aneurysms.

Other groups who have a high risk of developing an aneurysm include people who:

  • Smoke
  • Have a family history of aneurysm
  • Have high blood pressure
  • Have atherosclerosis (blocked and weakened blood vessels)
  • Have Marfan syndrome (a connective tissue disorder)
  • Have untreated syphilis
  • Have infections
  • Have injuries

Signs of an Aneurysm

Sometimes a very large aneurysm may put pressure on neighboring nerves or tissues, causing pain, numbness, or other dysfunction.

However, most aneurysms cause no symptoms unless they begin to bleed or burst.

Symptoms of a dissecting or bleeding aneurysm depend on the aneurysm’s location.

Symptoms may include intense pain (such as severe headache, throbbing or sharp pain in abdomen, chest and/or back), sweating, nausea, vomiting, and loss of consciousness.

Diagnosing Aneurysms

Many aneurysms are diagnosed incidentally when a patient undergoes a test for another reason.

Tests to confirm a diagnosis of aneurysm may include x-ray, ultrasound, CT scan, MRI scan, and dye studies to view the arteries.

Treating Aneurysms

Smaller aneurysms might not need treatment, just regular monitoring to make sure they aren’t growing.

Some people can be treated with medicines that lower blood pressure and relax the arteries, decreasing the chance that the aneurysm will burst.

A brain aneurysm may be treated by sliding a tiny coil or clip into the area of the aneurysm, to prevent blood from reaching and enlarging it.

Larger aortic aneurysms or those that have already begun bleeding into the artery wall may need to be treated with an operation.

Surgery may be performed through an open incision or by sliding instruments through the blood vessels towards the aneurysm.

Sources:

  • Aortic Aneurysms; The Society of Thoracic Surgeons.
  • Cerebral Aneurysms; American Academy of Neurology.
  • Explore Aneurysm; National Heart, Lung, and Blood Institute.

Aneurysm Symptoms

Most people with aneurysms don’t have any symptoms, until they begin to grow, bleed, or burst.

A bulging, weak area of an artery is known as an aneurysm.

At first, an aneurysm doesn’t cause any noticeable symptoms, unless it grows and puts pressure on neighboring nerves and tissues.

This pressure can cause pain, numbness, or other dysfunction.

More severe (and even life-threatening) symptoms occur when an aneurysm leaks blood into the wall of the artery, into nearby tissues, or bursts.

Specific symptoms depend on the aneurysm’s location.

Most aneurysms occur in the brain, in the part of the aorta that runs through the chest (thoracic aortic aneurysm), or in the section of aorta in the abdomen (abdominal aortic aneurysm).

Symptoms of a Brain Aneurysm

The classic symptom of a brain aneurysm is “the worst headache ever,” which comes on suddenly, and is severe and unrelenting.

Other symptoms can include

  • Nausea, vomiting
  • Light sensitivity
  • Vision changes, including blurring or double vision
  • Stiff neck
  • Drooping of eyelid or one side of the face
  • Numbness, tingling, weakness, or paralysis in face or limbs
  • Difficulty swallowing and/or speaking
  • Seizures
  • Confusion
  • Unconsciousness

Signs and Symptoms of a Thoracic Aortic Aneurysm

Symptoms of a bleeding or burst aneurysm in the chest include:

  • Severe throbbing or sharp stabbing pain in chest and/or back), which may move into neck, jaw, arms
  • Hoarseness
  • Coughing
  • Trouble breathing, shortness of breath
  • Difficulty swallowing, speaking, or moving one side of the body
  • Drop in blood pressure
  • Unconsciousness

Signs and Symptoms of an Abdominal Aortic Aneurysm

Symptoms of a bleeding or burst aneurysm in the abdomen include:

  • Odd pulsing sensation in the abdomen
  • Sudden severe pain in abdomen or lower back, often described as stabbing or ripping in nature; may spread to groin, buttocks, legs
  • Cold, tingling, or numb arms, legs, hands, feet
  • Sweating
  • Dizziness
  • Fast heart beat
  • Palpitations
  • Nausea, vomiting
  • Light-headedness
  • Unconsciousness
  • Shock

Sources:

  • Aortic Aneurysms; The Society of Thoracic Surgeons.
  • Cerebral Aneurysms; American Academy of Neurology.
  • Explore Aneurysm; National Heart, Lung, and Blood Institute.
  • Thoracic Aortic Aneurysm; Vascular Web, Society for Vascular Surgery.

Aneurysm Treatment

Not all aneurysms require surgery or aggressive treatment.

Aneurysms that are small and not causing symptoms may not need treatment.

Larger or leaking aneurysms may need treatment to prevent further growth and weakening of the artery wall.

A burst aneurysm will need emergency surgery.

Watchful Waiting

Smaller, asymptomatic aneurysms might only require close and careful monitoring, with imaging studies (x-rays, ultrasound, CT, or MRI) performed periodically.

If the aneurysm grows significantly or begins to cause symptoms, then treatment may be needed.

Medications

Because high blood pressure may further weaken an aneurysm, increasing its risk of leaking or bursting, it’s important to take blood pressure medications as directed.

Some blood pressure medicines (especially calcium channel blockers and beta blockers) can help relax artery walls, cutting down on the risk of rupture.

Surgery for Brain Aneurysms

Brain aneurysms may be treated with a procedure to put a clip at the aneurysm’s base, blocking blood flow into the aneurysm and preventing its enlargement.

A platinum wire will be passed through the body’s arteries to coil up within the brain aneurysm, blocking blood flow and stopping the aneurysm’s growth.

Flow diverters are devices that guide blood flow through the artery, past the aneurysm, resulting in closure of the aneurysm.

If a brain aneurysm bursts, surgery will be needed to evacuate blood from the skull, or to drain excess fluid from the brain.

Surgery for Thoracic or Abdominal Aortic Aneurysms

The two main operations to repair a large, leaking, or ruptured aortic aneurysm include:

Open repair: A large incision is made, and the aneurysm and a piece of the aorta are removed and replaced with a length of fabric tubing called a graft.

Endovascular stenting: A collapsed stent/graft is passed through the body’s arteries to reach the area with the aneurysm, where the stent/graft is expanded to fit snugly within the aorta.

Blood then flows through this stent/graft, no longer entering into the aneurysm.

Sources:

  • Aortic Aneurysms; The Society of Thoracic Surgeons.
  • Cerebral Aneurysms; American Academy of Neurology.
  • Explore Aneurysm; National Heart, Lung, and Blood Institute.
  • Thoracic Aortic Aneurysm; Vascular Web, Society for Vascular Surgery.

Source: http://www.everydayhealth.com

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