Signs of a cerebral artery aneurysm

The signs that an aneurysm can trigger in the brain are broadly diversified. The greatest difficulty is that a vascular aneurysm can often cause no discomfort or symptoms at all if a rupture has not yet occurred. This is the main reason why aneurysms are often only diagnosed after bleeding in or are seen as random findings during examinations.

In some cases, however, even aneurysms that have not ruptured cause discomfort and thus prompt an examination. Whether an aneurysm causes complaints or not depends to a large extent on the location in the brain where the aneurysm has formed. If the aneurysm is so large that it exerts pressure on neighboring structures, such as other vessels or nerves, it can cause corresponding complaints.

These include headaches whose frequency and painful nature are new and unusual for the person affected, and in some cases neurological deficits caused by pressure being applied to nerves passing the sacculated blood vessel. This can lead to visual or hearing disorders or to movement impairments of various extremities, such as arms or legs. Depending on the size of the irritated area, speech disorders may also occur.

The neurological abnormalities do not necessarily have to last very long, they can disappear and then reappear a short time later. Patients who have an aneurysm in the head may also report dizziness that has been recurring for some time. Rather rarely, all typical symptoms are reported at the same time. The majority of unruptured cerebrovascular aneurysms do not cause symptoms.The suspicion of an aneurysm is increased if one or more cases are reported in the family of the person affected. It has been proven that in approximately 8-10% of aneurysm patients, an aneurysm had already become symptomatic in the family.

When a brain aneurysm bursts

The greatest danger of an aneurysm in the brain is not the possible symptoms it can cause, but the life-threatening bleeding if the aneurysm ruptures. The risk of an aneurysm bursting is not as high as feared all these years, according to the latest studies. The risk of an existing aneurysm rupturing depends on various factors.

The most important factor is the diameter of the aneurysm. For example, sizes over 7 mm high are suspect and tend to burst much more often than smaller aneurysms. An aneurysm would be operated on from a size of 5 mm.

If the aneurysm ruptures, this is an absolute emergency. Because the high pressure in the arteries immediately causes large amounts of blood to pour into the space around the ruptured blood vessel. This can cause serious damage if not treated immediately.

A ruptured aneurysm of a cerebral vessel is usually associated with severe headaches, which are described as pain of destruction. Neurological failures often occur immediately and suddenly. In some cases, patients are found unconscious with a ruptured aneurysm.

In this case, the diagnosis is extremely difficult, as the patient is unable to give any information about the symptoms. In any case, immediate emergency doctor communication is urgent. The patient must be taken to an acute hospital (preferably a hospital with neurosurgery).

The vital diagnosis is always a CT of the head. On the one hand, this serves to distinguish between a vascular occlusion and a cerebral hemorrhage, since both can cause similar symptoms and the therapy in both cases is fundamentally different. In addition, the CT can be used to assess the extent of the bleeding.

The immediate measure to be taken if a ruptured cerebrovascular aneurysm is suspected is primarily a CT of the brain. The reason is that a CT is faster and provides an overview of whether the clinical picture is a hemorrhage or a vascular occlusion. However, an MRI has the advantage that vessels can be better visualized and thus the extent and spread of the blood can be better assessed.

It is therefore at the discretion of the practitioner and the availability of diagnostic equipment which of the two procedures is used. If one suspects that a vessel has already ruptured, the CT examination is the best diagnostic option due to time constraints. If the presence of an aneurysm is suspected, an MRI of the brain should be performed for an exact evaluation.

In magnetic resonance imaging, the patient is pushed into a tube. Before or during the examination, which can last 20-30 minutes, it may be necessary to inject the patient with a contrast medium. This is necessary if areas of the brain cannot be displayed differently.

In the case of the diagnosis of an aneurysm, a vascular imaging with a contrast medium is always necessary. The contrast medium is injected into the vein via a brown bulb and floods the entire body within a very short time. The blood vessels of the brain are reached within 1-2 seconds.

During this time, one should have taken appropriate images with the MRI device to enable the exact imaging of the vessels. The blood vessels are brightly colored, as is a sacculation. Already existing leaking vessel sections can also be displayed by contrast medium leakage. In order to be able to carefully plan the operation of an aneurysm, a previous MRI examination of the blood vessels is indispensable.