Aneurysm of cerebral vessels: symptoms, treatment, causes

What is it - among vascular diseases, cerebral vascular aneurysms occupy a dominant position because of the danger of a threat of vascular rupture.

is characterized by irreversible extensions of individual aortic sites and pathologies in its branches.

Vascular rupture, invariably leads to internal bleeding. A rupture of large aneurysms does not rarely lead to death.

Characteristics of the disease

Localization and development of pathology occurs in the arterial circle at the base of the brain, in the zone of bifurcation of large and middle cerebral arteries, as well as in intracerebral vessels. Brain aneurysm manifestations can be manifested by single forms and multiple, single-chamber and multi-chamber protrusions.

The rupture of such formations is the most likely cause of strokes. A quarter of patients, after such breaks, die within an incomplete first month, and 50% of patients who survived an aneurysm rupture die from a recurrence of hemorrhage in the first half of the year.

Aortic aneurysms and extensions in its branches are true and false.

1. True aneurysm is characterized by a pathology in which all layers of the vessel wall protrude.
   
2. Pseudoaneurysm - false aneurysm differs by protrusion of the upper layer of the vascular wall, as a result of dilatation of the vessel, which led to rupture of the intima and stratification of the middle endothelial layer.

The clinical picture of the disease is expressed:

• asymptomatic aneurysm - revealed by accident;
  
• with an unexploded aneurysm - symptoms are manifested as a result of compression of the intracranial nerves;
  
• ruptured aneurysms - are caused by signs of intracranial hemorrhage.

Classification of

formations Aneurysms are classified into certain types and forms of manifestation - diffuse and saccular appearance.

The diffuse form includes a spindle-shaped, serpentiform and branching type of pathology, in which the cylindrical or funnel-like expansion of a certain segment of arteries occurs along the entire perimeter, due to the strong pulse pressure. Under the action:

• adipose tissue degeneration;
  
• micronecrosis;
  
• mucoidization and reduction;
  
• tears and splittings of the elastic structure.

The intravascular state changes. In many areas, destruction of the endothelium is noted, the surface of the inner walls is covered with multiple thrombi, becoming rough. With this form of disease, there is a high risk of vascular rupture due to severe pressure, which usually leads to rapid death of the patient.

Sirloin type - characterized by protrusion, in the form of a "bag", only a certain part of the segment of the artery. This pathology is caused by damage to the muscular membrane and destructive changes in the average vascular layer:

1. 1) In the large sections of the vessel wall, there is no internal elastic membrane, the main value of which is to ensure its strength;
   
2. 2) Retained elastic fibers are placed in fragments, with signs of splitting and thickening;
   
3. 3) Destructive changes in muscle fibers are noted, the tissue layers break and dislodge;
   
4. 4) Atheromatous, calcific and ulcerative manifestations.

The saccate type of protrusion contributes to the deposition of blood clots in them, which seal the vascular walls, like a shell. The layering of such a shell threatens to detach, from a thrombus of variously large clots, and blockage of vascular sites, causing them to clog. The pathology of protrusion is expressed by various manifestations:

• with navicular form;
  
• in the form of a ring;
  
• with funnel-shaped and spherical forms.

The saccate appearance of the disease is characterized by multiple or single, single chamber or multi-chambered formation. Different sizes, from the smallest ones to the huge protrusion.

Mycotic species - at the end of the eighteenth century, the Canadian physician William Osler first described the mushroom-shaped aneurysmal change in infective endocarditis. This form was called mycotic, as a consequence of bacteremia, and rarely, fungal infections. With this form, vascular pathologies are marked:

• by the presence of leukocyte and cell-cell infiltrates;
  
• colonies of microbes and microabscesses;
  
• scar tissue with a large amount of hyaline cartilage;
  
• with calcareous deposits;
  
• severe deformation of the residual elements of the vascular wall.

The exfoliating form - characterized by blood flowing into the gap between two layers of the vascular wall - the inner layer and the middle. Pathology can develop both independently and as a consequence of aneurysmal manifestations of the true species. The flow of blood between the layers of the endothelium is due to the detachment of the intima and the breakthrough of the vessel is inevitable, which always ends in death.

Herniated appearance - pathology, one of the types of true aneurysm, is formed as a result of defects in the endothelium. The reason lies in the erosion or traumatic lesion of the vessel.

Aneurysm miliary - this type of disease is characterized by:

• impaired permeability - plasmorrhagia;
  
• by necrosis and delamination;
  
• with thromboses and closure of the lumen of the vessel;
  
• are marked by characteristic sacrificial protrusion of various sizes. These pathologies cause brain aneurysms.
  
  

  Causes of

  
  The cause of cerebral aneurysmal manifestations can be multiple vascular abnormalities in the arterial and vascular walls: immunocomplex lesions of the vascular walls:
  
  
  
  • of various kinds of hypertrophy media of the layer of arteries;
    
  • fragmentation and cleavage of the elastic membrane;
    
  • the presence of richly vascularized scar tissue;
    
  • reductivity and decreased intima of the arterial wall;
    
  • destruction and lack of collagen
  With the development of the disease, protrusions increase in size, which leads to their rupture and cerebral hemorrhages. The trigger mechanism for the development of such pathologies are:
  
  
  
  • congenital arterial and vascular anomalies;
    
  • deforming processes associated with age-related changes;
    
  • suffered intracranial injuries;
    
  • intracranial surgeries.
  Read also how to treat atherosclerosis of cerebral vessels.
  
  

  Symptoms of cerebral aneurysms

  
  Symptoms of intracerebral aneurysms are often not shown by any signs until the formations grow to large sizes, or their rupture occurs.
  
  Only with large dimensions of cerebral aneurysms, when there is excessive pressure on the surrounding nerve and tissue fibers, there are characteristic signs:
  
  
  
  • pain in the eye area;
    
  • general weakness and numbness;
    
  • manifestations of unilateral facial cuts;
    
  • clouding of vision and eyelid droop;
    
  • headaches and signs of intoxication;
    
  • mental changes;
    
  • cramps and loss of consciousness, possible coma.

  Diagnostics

  
  
  1. 1) The method of scintigraphy is a radioisotope study that allows assessing the general cerebral blood flow, determining an aneurysm or places of rupture.
     
  2. 2) CT examination, which allows to determine the presence of pathology, possible rupture, and the place of hemorrhage.
     
  3. 3) Angiography-CT - gives a more accurate and clear image of vascular structures;
     
  4. 4) MRI study with three or two-dimensional image, giving more complete information;
     
  5. 5) Investigation of cerebrospinal fluid in case of suspected rupture.

  Treatment of cerebral aneurysm

  
  Treatment, in the absence of damages of the vascular walls, is possibly conservative and radical, depending on the indications of the diagnostic examination.
  
  
  
  • is assigned a gentle( bed) mode;
    
  • is controlled by blood pressure;
    
  • is prescribed analgesic and sedative medication;
    
  • vasodilating and blood circulation improving drugs.
  Surgical intervention, the only radical way to exclude the formation of aneurysms from the circulatory system. Applied:
  
  Endovascular method with the use of special catheters, delivering a balloon to the cavity of formation. Having reached the goal, the can is filled with polymer material and separated from the catheter. Clogged the entrance to the aneurysm, thereby neutralizing it. It is also possible to tampon the cavity with platinum thin wire, which provides thrombosis of the cavity.
  
  With aneurysmal ruptures, open-type operations are used-the aneurysmal bases are pinched by special clips, the brain space is carefully inspected, blood clots are removed. In the presence of ventricular cerebral hemorrhage, drainage is established. At the same time, possible hematomas are removed.
  
  If an aneurysm rupture does not have a massive hemorrhage character, in people of very advanced age it is advisable to use the operation of intravascular operative access. The quality of the patient's future life depends on the timeliness of the recovery process and competent adequate rehabilitation.
  
  

  
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