What is an aneurysm?

    An aneurysm is a medical condition characterized by a localized, abnormal bulge or swelling in the wall of a blood vessel, typically an artery. This bulge is caused by the weakening of the blood vessel wall, possibly due to factors such as high blood pressure, atherosclerosis, trauma, or genetic predisposition. The term "aneurysm" is derived from the Greek words "aneurysma," meaning "dilation," and "ana," meaning "up" or "through."

    Aneurysms can develop in any blood vessel in the body, but they are most commonly found in the arteries of the brain, the aorta (the largest artery in the body), and the arteries of the legs. They can vary in size and shape, ranging from small, spherical bulges to larger, more irregular formations.

Types of Aneurysms

    Aneurysms are categorized based on their specific location within the body. Among the most critical sites for aneurysm occurrence are the arteries of the brain and the heart.

    1. Aortic aneurysm

    The aorta, a major artery originating from the heart's left ventricle and extending through the chest and abdomen, typically measures 2 to 3 centimetres (cm) in diameter. However, this diameter can exceed 5 cm in cases of an aneurysm.

    The most prevalent form of aortic aneurysm is the abdominal aortic aneurysm (AAA), which occurs in the segment of the aorta passing through the abdominal region. For AAAs surpassing 6 cm in size, the yearly survival rate without surgical intervention is only 20 per cent.

    Although AAAs can swiftly become life-threatening, individuals who make it to a medical facility have a 50 per cent chance of overall survival.

    In contrast, thoracic aortic aneurysms (TAAs) are less common and affect the portion of the aorta within the chest. TAAs boast a survival rate of 56 per cent without treatment, rising to 85 per cent post-surgery. TAAs are rare, constituting only 25 per cent of all aortic aneurysms.

    One of the significant risks associated with aneurysms is the potential for rupture, which can lead to severe bleeding and life-threatening complications. Therefore, prompt diagnosis and appropriate medical intervention are essential for managing aneurysms and preventing complications.

Brain Aneurysms

    A brain aneurysm, also known as a cerebral or intracranial aneurysm, is a weak or bulging spot in a blood vessel in the brain. These aneurysms can develop anywhere in the brain's arteries but are commonly found at branching points. Due to their appearance, they are also known as “berry” aneurysms. If left untreated, a brain aneurysm can rupture, leading to a haemorrhagic stroke, brain damage, or even death.

    Symptoms of a brain aneurysm can vary depending on its size and location but may include headaches, vision changes, numbness or weakness in the face or limbs, seizures, and loss of consciousness. Early detection and treatment are crucial to prevent a rupture and its potentially severe consequences.

Peripheral aneurysm

    A peripheral aneurysm can develop in arteries outside of the brain and heart. Various types of peripheral aneurysms include:

    1. Popliteal aneurysm: Occurs behind the knee and is the most common type of peripheral aneurysm.

    2. Splenic artery aneurysm: Found near the spleen.

    3. Mesenteric artery aneurysm: Affects the artery supplying blood to the intestines.

    4. Femoral artery aneurysm: Located in the groin area.

    5. Carotid artery aneurysm: Develops in the neck.

    6. Visceral aneurysm: A bulge in arteries supplying blood to the bowel or kidneys.

    Compared to aortic aneurysms, peripheral aneurysms are less prone to rupture.

What are the causes of Aneurysms?

    An aneurysm can result from various factors contributing to the degradation of the structural proteins in the aortic wall, which provide crucial support and stability. While the exact cause remains unclear, atherosclerosis, characterized by the hardening of arteries due to plaque buildup, is believed to be a significant factor in the development of aneurysms. Common risk factors associated with atherosclerosis include:

  • Advanced age
  • Male gender
  • Family history of aneurysms
  • Genetic predisposition
  • Hyperlipidaemia (elevated blood fats and cholesterol levels)
  • Hypertension (high blood pressure)
  • Smoking
  • Diabetes
  • Obesity

    Other causes of aneurysms vary depending on their location in the body. Examples of aneurysms and their specific causes may include:

Abdominal Aortic Aneurysm (AAA)

  • Atherosclerosis, particularly in the segment of the abdominal aorta below the kidneys (known as an infrarenal aortic aneurysm)
  • Genetic disorders
  • Giant cell arteritis is characterized by inflammation of the temporal arteries and other arteries in the head and neck, resulting in narrowed arteries and reduced blood flow, potentially leading to persistent headaches and vision loss.
  • Infection

Cerebral Aneurysm

  • Congenital (present at birth)
  • High blood pressure
  • Atherosclerosis
  • Head trauma

Common Iliac Artery Aneurysm

  • Atherosclerosis
  • Pregnancy
  • Infection
  • Trauma following lumbar or hip surgery

Femoral and Popliteal Artery Aneurysm

  • Atherosclerosis
  • Trauma
  • Congenital disorders

Symptoms of Aneurysm

    In many cases, unruptured brain aneurysms do not present symptoms, mainly if they are small. Often, they are discovered incidentally during imaging tests conducted for unrelated medical reasons.

    However, a ruptured aneurysm is a critical medical emergency and typically manifests as a severe headache. Additionally, when an unruptured aneurysm exerts pressure on brain tissue or nerves, it can lead to discomfort and other associated symptoms.

Ruptured aneurysm

    A ruptured aneurysm typically presents with a sudden and intense headache, often described as the most severe headache an individual has ever had.

    Additional symptoms of a ruptured aneurysm may include:

  • Nausea and vomiting
  • Stiff neck
  • Blurred or double vision
  • Sensitivity to light
  • Seizures
  • Drooping eyelid
  • Loss of consciousness
  • Confusion

    'Leaking' Aneurysm

    An aneurysm might sometimes release a small amount of blood, signalling a potential impending rupture. Such leaks often precede a more severe rupture, which may occur days or weeks later.

    Symptoms of a leaking brain aneurysm may include:

  • Sudden and highly severe headache persisting for several days to two weeks.

Unruptured Aneurysm

    An unruptured brain aneurysm may not manifest symptoms, mainly if it is small. However, a giant unruptured aneurysm might exert pressure on brain tissues and nerves.

    Symptoms of an unruptured brain aneurysm may include:

  • Pain above and behind one eye.
  • Dilated pupil.
  • Change in vision or double vision.
  • Numbness on one side of the face.

When should I call the doctor?

    If you experience any of the following symptoms, it's crucial to seek immediate medical attention:

    1. Sudden, excruciating headache: If you or someone else complains of a sudden and severe headache, mainly if described as the worst headache, it could indicate a serious medical emergency.

    2. Loss of consciousness or seizure: If someone loses consciousness or experiences a seizure alongside a sudden severe headache, it's essential to call our emergency number immediately.

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