A cerebral aneurysm can remain hidden in the brain for a lifetime or present itself in a sudden and violent way. Professor Giulio Maira, consultant neurosurgeon in Humanitas, spoke about this issue in an interview with Tg2 Medicine 33.
“An aneurysm is a progressive dilatation of an artery that carries blood to the brain, which for congenital reasons is more fragile and slowly yields under the pressure of the blood, until it forms a type of balloon”.
When the balloon ruptures the artery, blood invades the spaces surrounding the brain. “A subarachnoid hemorrhage, the minimum rupture of an aneurysm, is characterized by the appearance of a violent headache that patients define as the strongest headache of their life, followed by a sensation of neck stiffness; there may also be nausea and vomiting. If the hemorrhage is more significant, the damage is much greater and we can have up to 40% mortality and two thirds of the surviving people suffer permanent damage.
Risk factors
From 2 to 5% of the population have an aneurysm, but what are the risk factors?
“Smoking, high blood pressure, family history and being a woman are all risk factors for a brain aneurysm. It has also been observed that drug use (such as ecstasy or cocaine) significantly increases the risk of brain stroke and therefore of bleeding. If a boy carrying an aneurysm that might have never broken during his life, takes an ecstasy tablet, the aneurysm can break with very serious consequences”.
Treatment options
“Early diagnosis or correct interpretation of minimal expansions is very important because it makes it possible to treat aneurysms before an extremely serious prognosis is reached,” explains Professor Maira.
Depending on the case, the surgery can be performed with mini-invasive techniques, either by closing the aneurysm with metal clip, or endovascularly, by introducing a catheter into the arteries, with a stent or spirals to facilitate the formation of a thrombus and remove the aneurysm from the artery. It is essential to go to a center that offers both the possibility of endovascular intervention and microsurgery.
