Brain Aneurysm

A brain aneurysm is a widening or protrusion of a blood vessel in the brain due to weakening of the blood vessel wall. These protrusions will look like hanging berries. If the blood vessel is torn, the symptoms that arise can range from severe headaches to loss of consciousness.

A brain aneurysm that enlarges and ruptures is an emergency condition, because it can cause brain bleeding , brain damage, and even death. Although it can affect anyone, brain aneurysms are most common in women over 40 years of age.

Causes of a Brain Aneurysm

A brain aneurysm occurs when the walls of blood vessels in the brain weaken or become thin. The cause of the weakening of the walls of blood vessels in the brain is not certain. However, there are several factors that are thought to increase the risk of developing a brain aneurysm, namely:

Suffer from high blood pressure ( hypertension )
Over 40 years old
Female sex, especially those who have menopause
Have a history of head injury
Excessive consumption of alcoholic beverages
Using drugs, especially cocaine
Have a smoking habit
Having a family with a brain aneurysm

Apart from these factors, there are several diseases that can increase the risk of developing a brain aneurysm, namely:

Polycystic kidney disease
Aortic coarctation
Arterial-venous malformation
Ehlers-Danlos syndrome
Marfan's Syndrome

Brain Aneurysm Symptoms

Brain aneurysms that are still small and have not ruptured often do not cause symptoms. However, as the size of the aneurysm increases, sufferers can experience various complaints, such as:

Pain around the eyes
Numbness on one side of the face
Dizziness and headache
Difficulty speaking
Balance disorders
It's hard to concentrate
Memory decline
Impaired vision

Enlarged brain aneurysms can rupture and cause bleeding in the brain. Symptoms of a ruptured brain aneurysm can include:

Severe headache
Blurred vision or double vision
Nausea and vomiting
Weakness or paralysis on one side of the body or leg
It's hard to talk
Hard to walk
Drooping eyelid ( ptosis )
seizures
Loss of consciousness

When to see a doctor

Check with your doctor if you experience the symptoms mentioned above, especially if you have risk factors such as suffering from hypertension, have a family history of brain aneurysms, or have had a head injury.

You are advised to seek medical help immediately if you experience symptoms of a brain aneurysm rupture in the form of a sudden severe headache. The rupture of a brain aneurysm is an emergency condition that must be treated immediately.

Brain Aneurysm Diagnosis

As a first step, the doctor will ask about the complaints experienced, medical history and illness in the patient and his family, and history of drug use.

To confirm the diagnosis, the doctor will ask the patient to undergo several supporting examinations, such as:

Scanning

Several types of scans that can be done on brain aneurysm sufferers are:

MRI , to view and detect brain aneurysms that have not ruptured
CT scan , to see the condition of bleeding in the brain due to rupture or leakage of a brain aneurysm
Brain angiography with CT scan (CTA) or MRI (MRA), to look for abnormalities in the blood vessels of the brain, including detecting brain aneurysms

Cerebrospinal fluid examination

If a subarachnoid hemorrhage is suspected , the doctor will ask the patient to undergo an examination of the cerebrospinal fluid , which is the fluid that covers the brain and spinal cord. This examination aims to detect the presence or absence of bleeding in the brain.

Cerebrospinal fluid examination is usually done if the patient has symptoms of a brain aneurysm rupture, but the results of a CT scan do not show any bleeding in the brain.

Brain Aneurysm Treatment

Treatment aims to prevent brain aneurysm rupture and prevent complications if the brain aneurysm has ruptured. Here's an explanation.

Prevention of rupture of a brain aneurysm

Prevention of a brain aneurysm by a doctor will be carried out based on the age and medical condition of the patient, as well as the location and size of the aneurysm.

If the risk of a brain aneurysm rupturing is low, the doctor will make periodic observations. Patients will be given blood pressure-lowering drugs, and encouraged to adopt a healthy diet and lifestyle in several ways, such as:

Quit smoking
Exercise regularly, but avoid strenuous exercise
Limit consumption of caffeinated and alcoholic beverages
Avoid strenuous physical activity

The doctor will recommend surgery if the risk of a brain aneurysm rupturing is high enough. The surgical procedure aims to stop blood flow to the brain aneurysm.

Surgery can be done by clamping blood vessels ( neurosurgical clipping ) or placing a coil at the aneurysm site ( endovascular coiling ). This aims to stop blood flow to the blood vessels experiencing an aneurysm so they don't swell or burst.

Treatment of a ruptured brain aneurysm

If a brain aneurysm ruptures, emergency treatment needs to be done immediately. The doctor will give medication to relieve symptoms and prevent complications. The types of drugs given can be in the form of:

Calcium antagonist drugs ( calcium channel blockers )
Administration of calcium antagonist drugs aims to prevent stiffness of blood vessels ( vasospasm ) which is a complication of a brain aneurysm. The type of calcium antagonist drug that can be given is nimodipine.

Pain
relievers Pain relievers, such as paracetamol , can be given to relieve headaches experienced by people with brain aneurysms.

Vasopressor drugs Vasopressor
drugs function to prevent stroke due to lack of blood supply to the brain. The types of vasopressor drugs that can be given are epinephrine, norepinephrine , and dopamine.

Antiseizure
drugs These drugs aim to relieve seizures caused by a ruptured aneurysm. The anti-seizure drugs given can be in the form of levetiracetam, phenytoin , and valproic acid .

Apart from drugs, doctors can treat a ruptured brain aneurysm by installing a catheter tube and creating a bypass ( ventricular or lumbar draining catheters and shunt ). The goal is to drain fluid from the brain and spinal cord so that the pressure on the brain will be relieved.

After a ruptured brain aneurysm is treated, the patient needs to undergo physiotherapy to restore his condition.

Brain Aneurysm Complications

A ruptured brain aneurysm can cause bleeding in the brain, especially subarachnoid hemorrhage , and damage brain tissue. Other complications that can arise due to the rupture of a brain aneurysm are:

Hydrocephalus
Bleeding that occurs due to rupture of an aneurysm can block the flow of cerebrospinal fluid , causing hydrocephalus . This condition can increase pressure in the cavity of the head and damage brain tissue.

Vasospasm
When a brain aneurysm ruptures, the blood vessels automatically narrow to reduce bleeding. This narrowing will cause other parts of the brain to lack oxygen and nutrients.

Hyponatremia
A brain aneurysm that ruptures and causes bleeding in the brain can also disrupt the balance of sodium in the body, causing hyponatremia .

In addition to these complications, a ruptured brain aneurysm can cause recurrent bleeding. This condition can cause further damage to brain tissue, even death.

Brain Aneurysm Prevention

Brain aneurysms can be prevented by undergoing routine control if you suffer from a disease that increases the risk of developing a brain aneurysm, such as hypertension . In addition, there are several measures that can be taken to prevent brain aneurysms, such as: