It is popularly known as the ballooning of the vein. Aneurysms of brain vessels are enlargements of blood vessels (arteries) that carry clean blood in general. Aneurysms can occur in very large vessels such as the aorta, as well as in small and medium-sized vessels.

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Aneurysms are of two types. Ballooning can be in the form of budding, or it can be in the form of enlargement of the vessel as a whole, which will not be discussed here, and weakening of the vessel wall in this enlarged place. Aneurysms, which are in the form of buds and cover most of the aneurysms, are formed at the points where the vessel wall is congenitally weak, usually at the points where the vessel divides into smaller branches. The bubble wall bursts as soon as it cannot withstand the pressure. The explosion either occurs spontaneously or occurs with the activation of the body, which requires excessive effort such as coughing, straining, sexual intercourse  and causing increased intracranial pressure.

 

Who gets an aneurysm?

– Deficiencies in the vessel wall (congenital)
– Arteriosclerotic or hypertensive changes in the vessel wall
– Traumatic (hit or accidental head injuries)
– May be due to infection

 

What are the Risk Factors?

– hypertension
– Smoking
– Oral contraceptives (Birth control drugs)
– Alcohol (Suspicious)
– cocaine

 

Where does an aneurysm form in the brain?

The vessels feeding the brain unite at the base of the brain to form a vascular network called the Polygon of Willis. Aneurysms usually form in this willis polygon.
Most people with aneurysms have no complaints. However, sometimes there may be migraine-like or non-specific headaches. In addition, in cases where the aneurysm is large, due to the mass effect, it can compress the structures in the adjacent areas of the brain and related symptoms can be seen.

 

How does an aneurysm occur?

– If the aneurysm reaches a significant size, it is incidentally found in the tomography or MRI examination taken for other reasons.
– By giving symptoms of the cranial nerves (for example, paralysis of the optic nerve ...)
– It is the most common condition that occurs as a result of bleeding. It occurs after the rupture of the aneurysm and can be fatal. Bleeding may occur between the membranes of the brain (subarachnoid hemorrhage) in the form of leakage, or it may occur into the brain tissue.

 

Bleeding due to rupture of the aneurysm begins as a sudden onset of severe headache. Patients often describe this situation as "lightning flashes in my head". After the headache, it may present with neck pain and stiffness, vomiting, impaired consciousness depending on the type and weight of the bleeding, and sometimes low back pain.

 

How is aneurysm diagnosed?

– Patients who do not have any complaints are not screened for aneurysm.

– If there is a complaint, the first thing to do is to apply to a neurologist or neurosurgeon.

– Patients often apply to the emergency room in cases of bleeding that occurs when the aneurysm ruptures.
– The first brain tomography taken without medication in aneurysms gives sufficient information about whether there is bleeding or not.
– In the second stage, angiography with computed tomography, MR angiography or digital catheter angiography must be performed.

– The incidence rate of aneurysms has been found between 6-10 per hundred thousand according to the statistical data in the USA.
 

Treatment of aneurysms

Today, aneurysms can be treated in two ways. One of them is the surgical method that involves clipping the aneurysm from the neck, and the other is endovascular embolization, which is called endovascular embolization, filling the aneurysm with a substance by entering the vein with a catheter, thus preventing the entry of blood into the aneurysm. Both methods have advantages and risks. The neurosurgeon specialist and the physician who will perform the endovascular intervention should decide together which method to choose. Not all aneurysms may be suitable for surgery, nor may they be suitable for endovascular treatment. Although both treatments are successful in bleeding aneurysms, a condition called vasospasm, in which the nutrition of the brain is impaired by the contraction of the vessels, may also occur. This may cause permanent and temporary neurological symptoms.