Intracranial aneurysm - "brain" time bomb"

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Intracranial aneurysm is a kind of cerebral vascular disease with subarachnoid hemorrhage. Its incidence is much higher than people think. I


Intracranial aneurysm is a kind of cerebral vascular disease with subarachnoid hemorrhage. Its incidence is much higher than people think. Intracranial aneurysms are the third only to cerebral thrombosis and hypertensive intracerebral hemorrhage in cerebral vascular disease. The tumor is not intracranial aneurysm, intracranial vascular wall but local swelling uplift, like a rubber pipe expanding, the equivalent of intracranial "time bomb", once broken, high morbidity or death. Nearly half of the patients died of the first rupture. Even if survived, the risk of aneurysm rupture again. If not timely for aneurysm treatment, most patients will die within a few years, is worthy of the name "cold-blooded killer". But it is a kind of disease that can be cured. With the development of science and technology, most patients can recover after treatment.

Clinically, aneurysmal rupture is often characterized by severe headache, which is described as a split or an explosion. All of the intracranial hemorrhage in the eyes of ordinary people are considered as cerebral hemorrhage, cerebral hemorrhage is a kind of popular name, there are many, should say subarachnoid hemorrhage bleeding aneurysm is the bleeding site in the brain surface. The brain is covered with several layers of film, which has a layer called arachnoid, arachnoid and cerebral pial surface (a layer) between full liquid (cerebrospinal fluid), the main role is to protect, to avoid the impact on brain tissue. The most important thing is the subarachnoid space of cerebral blood vessels, and probably because of cerebral vascular hypertension, atherosclerosis and other factors outside the local swelling, have formed vesicles, aneurysms (also known as popular hemangioma). Aneurysms are usually asymptomatic until they are broken, and once they break down, they can develop a severe headache, nausea, vomiting, and even coma. Aneurysm rupture after bleeding is very dangerous, a simple description is: 1/3 death, 1/3 disability, 1/3 rehabilitation. Because about 15% of the patients died at the hospital.

Aneurysms were found in middle-aged (30-60 years old), slightly higher in women than men (1.34: 1). The main causes of congenital vascular defects, vascular inflammation, arteriosclerosis, atherosclerosis, hypertension, etc.. The most common site was the internal carotid artery, followed by anterior communicating artery, middle cerebral artery aneurysm, anterior cerebral artery aneurysm, and vertebral basilar artery aneurysm. According to the size of aneurysm diameter: small aneurysms (diameter < 5mm); general aneurysms (5mm = diameter < 15mm); large aneurysms (15mm = diameter < 25mm); giant aneurysm (diameter = 25mm). According to the clinical pathological features, cystic aneurysm; fusiform aneurysm; dissecting aneurysm; pseudoaneurysm.

As Zhao Benshan recovered from the Shanghai Huashan Hospital, the etiology and treatment process of the star gradually as we know, Zhao Benshan is due to subarachnoid hemorrhage after rupture of intracranial aneurysm, embolization of the aneurysm to rehabilitation. In fact, from this event we can have a general understanding of intracranial aneurysms, 1) occult, many cases of aneurysm and cannot obtain the diagnosis of aneurysm, unless the compression of the adjacent nerve had obvious symptoms, thereby indirectly suggest the presence of an aneurysm. As the star Zhao Benshan believes there are many ordinary people difficult to match the Medicare advantage, but still not in the rupture of the aneurysm was confirmed before, 2) the dangerous condition, a ruptured cerebral aneurysm can cause fatal bleeding and brain damage, people with 1/3 may be too late to the hospital after treatment, 1/3 treatment has left the disabled, only 1/3 patients can be recovered from this sense, it should be said that Zhao Benshan was lucky.

How to find and deal with cerebral aneurysms?

If the aneurysm ruptured, there will be obvious symptoms, the most typical manifestations of headache, nausea and vomiting, and even coma. The headache is very intense, often described as this life has never experienced the most severe pain, the majority of patients with coma is short, usually a few minutes to several hours, coma longer, often poorer prognosis. To the hospital will head CT examination confirmed subarachnoid hemorrhage, the doctor will use the cerebral angiography (DSA, performed by catheter in the thigh artery puncture, or CT angiography (CTA), does not require intubation, intravenous contrast agent) to diagnose aneurysm. But most people are no aneurysm rupture, when there is no rupture, only a few people have symptoms, the most common symptom is headache, ptosis (drooping eyelids side), these symptoms are often signs before aneurysm rupture. Most of the aneurysm patients have no symptoms, if you want to check whether you have an aneurysm, the safest way is not enhanced magnetic resonance angiography (MRA), if the magnetic resonance machine is high enough (3.0T, 3 Tesla), check the quality is very high. The enhanced magnetic resonance angiography and CTA are required by intravenous contrast agent, DSA is the most accurate examination.

The main treatment of aneurysm surgery (open cranial cavity, found aneurysm clamp) and interventional therapy (via endovascular approach with coil embolization, special tube inserted in the thigh), the purpose is to put the vesicles and intravascular blood isolation.

The most important problem is that the rupture of aneurysms after treatment, many patients may still have death and disability. The incidence in about 10% and 20% respectively, therefore, the best is to find and treat the aneurysm before rupture, there have been no invasive means, namely CT angiography (CTA) and magnetic resonance angiography (MRA).

Of course, the aneurysm discovered whether requires immediate treatment is a controversial issue, but if there is any of the following circumstances, i.e. aneurysm increases or irregular aneurysm during follow-up, aortic aneurysm located in the brain, the necessary medical intervention can greatly reduce the risk of aneurysm rupture. The ideal way is to deal with aneurysm and normal blood isolates, methods of dealing with surgical clipping and endovascular treatment, these two methods have advantages and disadvantages, according to the specific shape and patients with aneurysms depends on the conditions, the aneurysm can be timely and properly before the rupture or rupture most of the results are satisfactory. Because the brain aneurysm is a benign lesion in the brain.

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