Information on Cerebral Aneurysm

A cerebral aneurysm (also known as an intracranial orMost cerebral aneurysms result from an inborn
intracerebral aneurysm) is a weak or thin spot on aabnormality in an artery wall. Cerebral aneurysms are
blood vessel in the brain that balloons out and fills withalso more common in people with certain genetic
blood. The bulging aneurysm can put pressure on adiseases, such as connective tissue disorders and
nerve or surrounding brain tissue. It may also leak orpolycystic kidney disease, and certain circulatory
rupture, spilling blood into the surrounding tissue (called adisorders, such as arteriovenous malformations -
hemorrhage). Some cerebral aneurysms, particularlycongenital malformations in which a snarled tangle of
those that are very small, do not bleed or cause otherarteries and veins in the brain disrupts blood flow.
problems. Cerebral aneurysms can occur anywhere inThe signs and symptoms of an unruptured cerebral
the brain, but most are located along a loop of arteriesaneurysm will partly depend on its size and rate of
that run between the underside of the brain and thegrowth. For example, a small, unchanging aneurysm will
base of the skull.generally produce no symptoms, whereas a larger
Cerebral aneurysms are pathologic focal dilatations ofaneurysm that is steadily growing may produce
the cerebrovasculature that are prone to rupture.symptoms such as loss of feeling in the face or
These vascular abnormalities are classified byproblems with the eyes. Immediately before an
presumed pathogenesis. Saccular, berry, or congenitalaneurysm ruptures, an individual may experience such
aneurysms constitute 90% of all cerebral aneurysmssymptoms as a sudden and unusually severe
and are located at the major branch points of largeheadache, nausea, vision impairment, vomiting, and loss
arteries. Dolichoectatic, fusiform, or arterioscleroticof consciousness.
aneurysms are elongated outpouchings of proximalMost aneurysms go unnoticed until they rupture. In
arteries that account for 7% of all cerebral aneurysms.about 10 to 15 percent of cases, however, there are
Infectious or mycotic aneurysms are situatedsymptoms. Common warning signs include an enlarged
peripherally and comprise 0.5% of all cerebralpupil in one eye, a drooping eyelid, or pain above or
aneurysms. Other peripheral lesions include neoplasticbehind the eye. Other symptoms include a headache in
aneurysms, rare sequelae of embolized tumorone specific part of the head, difficulty in walking,
fragments, and traumatic aneurysms.double vision, or numbness in the face.
A common location of cerebral aneurysms is on theDiagnosis of a ruptured cerebral aneurysm is
arteries at the base of the brain, known as the Circlecommonly made by finding signs of subarachnoid
of Willis. Approximately 85% of cerebral aneurysmshemorrhage on a CT scan (Computerized
develop in the anterior part of the Circle of Willis, andTomography, sometimes called a CAT scan). The CT
involve the internal carotid arteries and their majorscan is a computerized test that rapidly X-rays the
branches that supply the anterior and middle sectionsbody in cross-sections, or slices, as the body is moved
of the brain. The most common sites include thethrough a large, circular machine. If the CT scan is
anterior communicating artery (30-35%), the bifurcationnegative but a ruptured aneurysm is still suspected, a
of the internal carotid and posterior communicatinglumbar puncture is performed to detect blood in the
artery (30-35%), the bifurcation of the middle cerebralcerebrospinal fluid (CSF) that surrounds the brain and
artery (20%), the bifurcation of the basilar artery, andspinal cord.
the remaining posterior circulation arteries (5%).