Aneurysm: Causes, Types, Symptoms, Complications, Diagnosis, Treatment, Survival Rate and Prevention

It is caused by the weakening of the walls of the arteries.

Aneurysms can occur in any blood vessel in the brain, in the aorta, intestines, spleen, kidney, and vessels in the legs.

An aneurysm occurs when an abnormal widening or ballooning occurs in a portion of an artery caused by weakness of the blood vessel wall.

The aneurysm weakens the blood vessel. It begins as a weak point in the wall of the blood vessels, which deflates over time from the force of the blood pump.

Aneurysms usually develop at the point where a blood vessel branches, because the “fork” is structurally more vulnerable.

Aneurysms can occur anywhere in the circulatory system, but most often they develop along the aorta (the main artery in the body that runs along the trunk from the heart) and in the blood vessels of the brain.

Aneurysms are potentially fatal if they rupture.

An individual develops an aneurysm when the walls of the artery become weak resulting in the formation of an abnormally large lump.

The aneurysm can be so large that when it ruptures it can cause significant internal bleeding.

A ruptured aneurysm is quite dangerous and the individual can die in just minutes.

Causes

The exact etiology of why an aneurysm occurs is not yet clear, but there are certain factors that tend to contribute to the development of the aneurysm.

Damaged tissue in the artery can play an important role in the development of an aneurysm.

Fatty deposits that block arteries can also cause an aneurysm to form, as these blockages require the heart to pump harder than normal in order for blood to pass through these blocked arteries and this can damage the arteries. in a significative way.

There are also certain medical conditions that can cause an aneurysm. These conditions are:

Aneurysm caused by an atherosclerotic disease

An atherosclerotic disease (buildup of cholesterol in the arteries) is a condition in which plaque builds up, damaging the arteries and can lead to the formation of an aneurysm.

High cholesterol levels and smoking can increase the risk of aneurysms.

Hypertension

Persistent and untreated hypertension tends to weaken the vessels and arteries, and thus can lead to the formation of an aneurysm over time.

High blood pressure is believed to play a role in abdominal aortic aneurysms.

The pregnancy

Pregnancy is often associated with the formation and rupture of aneurysms located in the splenic artery.

Other causes are the presence of injuries or infections and the weakness of the blood vessels caused by hereditary factors.

Types of aneurysms

The different types of aneurysms include brain aneurysms, thoracic aortic aneurysms, and abdominal aortic aneurysms.

Brain aneurysm

The cerebral aneurysm is the most dangerous of all the aneurysms.

The size of a cerebral aneurysm is usually very variable, they are basically asymptomatic.

Often the site of occurrence is in blood vessels deep in the brain.

A person may not even know if they have a brain aneurysm, they are usually discovered in diagnoses of underlying diseases.

A brain aneurysm occurs in a blood vessel in the brain.

An aneurysm in the brain is unrelated to other aneurysms in the body, but in a small number of people, there is a family history.

These aneurysms are more common after age 60.

Splenic aneurysm

A splenic artery aneurysm is the third most common abdominal aneurysm.

It is diagnosed when an aneurysm forms in the spleen, with a diameter greater than 1 cm.

Aortic aneurysm

An aortic aneurysm forms in the aorta, which is the largest blood vessel in the body.

This begins in the left ventricle of the heart and runs to the abdomen where it forks into both legs.

Due to its large size, it is a fairly common site for aneurysm to occur.

Thoracic aortic aneurysm

If an aneurysm develops in the chest cavity, then it is called a thoracic aortic aneurysm.

A thoracic aortic aneurysm affects the aorta in the chest.

Symptoms of a thoracic aortic aneurysm rupture include chest, back and neck pain, cough, dyspnea, swallowing difficulties, hoarseness of the voice, swelling of the arms and a constricted pupil and drooping of the eyelid affecting one eye .

However, in many cases, a thoracic aortic aneurysm does not cause any symptoms and is discovered by accident during medical examinations for an unrelated condition.

Abdominal aortic aneurysm

An abdominal aortic aneurysm affects the aorta in the abdomen.

Symptoms include lower back pain, abdominal bloating, nausea, vomiting, rapid heart rate (tachycardia), sweating, and the feeling of a pulse in the abdomen.

These aneurysms are the most common type.

The aneurysm may appear as a small blood-filled grape attached to the blood vessel by a stem.

This is known as a saccular or berry aneurysm.

Sometimes aneurysms can form in groups.

Symptoms

Symptoms will depend on where the aneurysm is located.

Aneurysms often do not cause symptoms.

Most aneurysms do not have any signs or symptoms until they become very large or rupture.

If an aneurysm ruptures, there may be pain, low blood pressure, fast heart rate, and dizziness.

There may also be loss of consciousness, sensitivity to light, and nausea and vomiting.

Immediate medical attention should be sought if these symptoms are experienced.

The risk of death after the rupture occurs is very high.

Symptoms often resemble other conditions or medical problems.

The symptoms that can occur will depend on the different types of aneurysms.

  • Abdominal aortic aneurysm: Constant pain in the abdomen, chest, lower back, or groin area.
  • Brain aneurysm: sudden and severe headache, nausea, vomiting, visual disturbances, or loss of consciousness.
  • Common iliac aneurysm: pain in the lower abdomen, back, or groin.
  • Femoral and popliteal artery aneurysm: Pulsation of the artery that is easily felt in the groin area (femoral artery) or in the back of the knee (popliteal artery).

Complications with aneurysms

Depending on the location of the aneurysm, some of the possible complications of an untreated aneurysm include:

  • Blood clots inside the aneurysm.
  • Compression of nearby nerves, if the aneurysm is large enough.
  • Blood leaking from the aneurysm into the walls of the artery (aneurysm dissection).
  • Disturbance of blood circulation beyond the point of the aneurysm.
  • Bleeding into the layers of tissue that surround the brain (subarachnoid hemorrhage).
  • Fluid in the brain (hydrocephalus).
  • Epilepsy.
  • Paralysis.
  • Congestive heart failure
  • Heart attack.
  • Renal insufficiency.
  • Sudden death.

Diagnosis of aneurysms

An aneurysm is usually discovered during an X-ray, CT scan, or MRI.

They are often found when doing one of these tests for other conditions.

For patients who have been diagnosed with an aneurysm or show symptoms of having one, one or a combination of the following diagnostic procedures may be ordered, in addition to a complete medical history and physical exam:

  • Arteriogram: An X-ray image of the blood vessels is used to evaluate various conditions, such as aneurysms, stenosis (narrowing of the blood vessels), or blockages. Contrast liquid is passed through the artery with the help of a thin, flexible tube. This dye will make the blood vessels visible on X-rays.
  • Cerebrospinal fluid test: In this procedure for brain aneurysms, a specialist uses a needle to remove cerebrospinal fluid from the back to detect red blood cells (also known as a lumbar puncture).
  • CT angiography: Combining a CT scan with an injection of a special dye, this scan produces images of the blood vessels.
  • Echocardiogram: This procedure is used to evaluate the structure and function of the heart using sound waves, which create a moving image of the heart and the heart valves.
  • MRI scan : This test produces detailed images of organs and structures in the body.
  • Ultrasound – An ultrasound is used to view internal organs as they function and assess blood flow through various vessels.

Treatment

Treatment options for an aneurysm may include one or more of the following:

Control risk factors

Control or modify risk factors, such as quitting smoking, controlling blood sugar (in patients with diabetes), and losing weight (if you are overweight or obese).

Diet

Limiting fat intake in the diet can help control aneurysm progression.

Medicines

Taking medications to control factors such as hyperlipidemia (high blood cholesterol levels) or high blood pressure to treat these conditions.

Surgery

The patient may undergo surgery, including minimally invasive approaches to prevent ruptures.

If the aortic aneurysm is less than two inches wide, it is usually left untreated, but rather closely monitored (if it becomes large).

If it is larger than 5 cm, the aneurysm is surgically repaired.

In most cases, the aneurysm is cut and the hole is plugged with an artificial graft.

Treating a ruptured brain aneurysm is an urgent treatment, aneurysm trimming and endovascular coiling procedures are now more commonly performed.

Depending on the location of a brain aneurysm, it will be treated surgically with clipping or by using fine platinum coils inserted into the aneurysm via angiogram.

Which is a radiological procedure used, in this case, to close the aneurysm and preserve normal blood flow in the brain.

Aneurysm cutout

In this procedure, neurosurgeons remove a section of the skull, navigate through the brain tissue to the aneurysm, and then place a small metal clip to stop the flow of blood to the aneurysm.

This can prevent the aneurysm from bursting or it can prevent rebleeding from an aneurysm that has recently ruptured.

Endovascular coiling

Until recently, brain aneurysms were most often treated by the surgical cutting procedure.

Now, in some cases, interventional neurologists, using angiography, can repair the rupture within the vessel without open surgery and incisions.

During this procedure, small wires or coils are inserted into the aneurysm, causing a clot to seal it off.

Studies show that this non-invasive treatment is safer with fewer complications and shortens hospital stay and recovery time.

Survival rate for aneurysm

An individual with an aneurysm has no associated symptoms as long as it does not rupture.

The consequence of a ruptured aneurysm is catastrophic, especially if the aneurysm is in the brain and can be fatal.

A ruptured aneurysm in the brain can lead to severe brain damage, paralysis, or even death.

The prognosis for an individual with a ruptured aneurysm depends on several factors such as:

  • Age of the individual.
  • The location and extent of the aneurysm.
  • The general health of the individual.
  • The neurological status after the rupture of the aneurysm.

While some patients cannot survive a ruptured aneurysm, there are cases where people have made a full recovery.

Prevention of an aneurysm

Practicing a healthy lifestyle and following a balanced diet is the key to avoiding the formation of any type of aneurysm.

A diet low in fat and cholesterol is also beneficial.

You should exercise regularly or at least walk for 30 minutes a day and stay in shape so that there is healthy blood circulation and the chances of developing plaques become less and less.

Avoid smoking and consuming alcoholic beverages as much as possible.