Treatment and surgery to remove cerebral aneurysms: risks and consequences. The most common form of cerebral artery aneurysms is saccular

A brain aneurysm, the symptoms of which will be described below, can occur at any age. However, more pathology is typical for adults than for children. Next, we will find out what an aneurysm is, how it manifests itself and what methods are used today to identify and eliminate it.

General information

What is an aneurysm? This is a small formation inside the skull. It appears on the blood vessel of the brain. Education is growing rapidly. Its convex part can put pressure on surrounding tissues or on a nerve. The greatest danger to life is the rupture of an aneurysm of the brain. In this case, blood penetrates into the surrounding tissues. This condition is called hemorrhage. The formation of small sizes does not lead to complications. An aneurysm can appear in any area of ​​the brain. However, as practice shows, most often it is located in the area where the branches of the artery originate. This place is located between the cranial base and the lower region of the brain. As for the structure, there is a neck in the aneurysm. It retains the three-layer structure of the artery, which makes it the most durable part of the formation. There is a body in the aneurysm. The elastic membrane in it is broken; muscle layer also missing. The thinnest point is the dome. It consists only of the vascular intima. This is where the break occurs.

Causes of pathology

The appearance of education can provoke various diseases of the vessels of the brain. The cause of the pathology may be a genetic disorder. In particular, it may be polycystic kidney disease or connective tissue lesions. Contribute to the formation and disease of cerebral vessels associated with circulatory disorders. This is, in particular, a congenital arteriovenous defect. Provoking factors should also include injuries and other head injuries, infections, blood, tumors. The cause of an aneurysm can be atherosclerosis - a vascular pathology complicated by the deposition of cholesterol on the walls. make things worse bad habits: smoking, alcohol abuse, drugs. According to some researchers, when taking oral contraceptives, the risk of aneurysm increases. Formations that appear as a result of infection are called mycotic. Aneurysms that accompany cancer pathologies are often associated with metastatic or primary tumors of the neck and head. When using drugs, blood circulation is disturbed. In particular, with frequent use of cocaine, vascular lesions develop, as a result of which aneurysm may occur.

Classification

Treatment is carried out in accordance with the type of pathology and the severity of its course. As for the formations under consideration, there are three types of them in total. The first type is saccular aneurysm. It looks like a round sac with blood. It is attached by the neck or base to the branch of the vessels or to the artery itself. The saccular type is considered the most common type of pathology. It is also called "berry" because of the resemblance to a berry hanging from the stem. Typically, such an aneurysm appears in the arteries at the base of the brain. The saccular type of formation is most often detected in adults. The second type is considered to be a lateral aneurysm. It is like a tumor on one of the walls. The third category includes spindle-shaped formation. It is formed due to the expansion of the vascular wall in one of the areas. There is also a classification of formations by size. Small ones are those whose diameter is less than 11 mm. Medium-sized aneurysms include formations of 11-25 mm, giant - more than 25 mm.

At-risk groups

Absolutely with all types of aneurysms, there is a possibility of their rupture and hemorrhage. People with certain congenital pathologies are at increased risk. It has been established that aneurysm is detected more often in women than in men. About 10 aneurysm ruptures are registered annually for every 10 thousand people.

What is the danger of pathology?

As mentioned above, the rupture of the aneurysm entails a hemorrhage in the brain. This, in turn, causes quite serious, life-threatening complications. In particular, CNS damage, hemorrhagic stroke or death. The first break may be followed by a second. In this case, hemorrhage will occur again. In addition, new aneurysms may form. As a rule, during a rupture, blood enters the cavity between the brain and the cranial bone. In this case, we talk about subarachnoid hemorrhage. Its rather dangerous consequence is hydrocephalus. This condition is characterized by increased accumulation of cerebrospinal fluid in cerebral ventricles that expand and press on the brain tissue. There may be another, no less dangerous complication - vasospasm. In this case, we are talking about the narrowing of blood vessels, as a result of which blood flow to the most important areas of the brain is limited. The lack of blood supply leads to tissue damage or stroke.

Brain aneurysm: symptoms

Very often, the pathology does not manifest itself. Signs of a brain aneurysm begin to appear when it reaches a large size or bursts, which, in turn, can happen against a background of perfect well-being, just after physical or emotional stress. Small, non-increasing formations may not be accompanied by any manifestations throughout a person's life. At the same time, a constantly growing brain aneurysm, the symptoms of which are quite easily confused with other pathologies, puts constant pressure on tissues and nerves. Average age patients in whom pathology is detected - 30-50 years. Many live for quite a long time despite the fact that they have a brain aneurysm. Symptoms of the pathology are as follows: pain in the eye area, paralysis, numbness or weakness of the muscles of one side of the face. There is also blurred vision, dilated pupils.

Signs of an aneurysm in the posterior artery - distortion of the outline of objects, loss or narrowing of the visual fields. With a lesion in the anterior, transient weakness is noted lower extremities. Aneurysm of vessels in the back is accompanied by peripheral paresis of the facial nerve, hearing loss (one-sided). There is also a strong blowing noise in the ear. When an aortic aneurysm of the brain bursts, a person feels a sudden and very severe pain. Vomiting or nausea also begins, stiff neck muscles occur. Possibly even loss of consciousness. As patients themselves say, describing this condition, this is the most terrible headache that can happen in life. The condition is characterized by intensity and severity. In some cases, before the aneurysm ruptures, a person develops warning pains in the head. They can last several days or even weeks after the attack occurs. Other symptoms of pathology include a drooping eyelid, changes in mental state, increased anxiety, and the appearance of sensitivity to light. IN rare cases the patient may go into a coma. With the localization of pain in the fronto-orbital region, damage is likely in the anterior connective and anterior cerebral, in the temple and occiput - in the back, in half of the skull - in the basilar artery. If there are periodic paroxysmal pain, combined with other symptoms mentioned above, you should immediately visit a doctor.

Diagnosis of cerebral vessels: general information

In some cases, pathology is detected quite by accident, during examinations associated with other conditions. Differential Diagnosis carried out with tumor diseases of the brain. The risk of hemorrhage from the detected formation is quite high. The probability is higher, the larger the size of the lesion. Also, the risk will depend on the somatic status (general), the location of the aneurysm. Subsequent hemorrhages increase the likelihood of death and are much more severe than the previous ones. Most often, an aneurysm of the brain, the treatment of which should be carried out exclusively in a specialized department, is detected in the process of rupture. The patient may lose consciousness, have convulsions, an epileptic seizure, anisocoria, and fever are likely. It must be remembered that the treatment of cerebral vessels should only be carried out by a doctor. With the appearance of these manifestations, the patient must be urgently hospitalized. With an aneurysm, a vasospasm is likely with an increase in the area of ​​ischemia, a breakthrough of blood into the ventricular system, and the appearance of an intracerebral hematoma.

Research methods

Diagnosis of cerebral vessels allows you to obtain the necessary information about the lesion. And then, based on it, prescribe adequate therapy. As a rule, studies are carried out after a subarachnoid hemorrhage. There are the following diagnostic methods:

Therapeutic measures: general information

It must be said that education does not always burst. As mentioned above, a person can live all his life with an aneurysm that will not manifest itself in any way. Such patients need constant monitoring of the dynamics of the development of education. Blood pressure levels should be constantly monitored, appropriate therapy should be elevated level cholesterol, as well as treat (if any) the consequences of traumatic brain injuries and infectious diseases. It is also necessary to note new manifestations that may accompany cerebral aneurysm. Treatment in this case will be prescribed as soon as possible. The results of research and observations allow you to choose the most effective tactics. It should be noted that each defeat is unique in its own way. Treatment of cerebral vessels should be carried out taking into account the location, type and size of damage. Equally important is the age of the patient, heredity, medical history, general health. The risk of aneurysm rupture is also taken into account.

Surgical intervention

Treatment of cerebral vessels in this case can be carried out in two ways. The first method is the so-called clipping. Any brain surgery comes with risks. These interventions pose the greatest danger to patients. The operation of an aneurysm of the cerebral vessels by the clipping method is a "shutdown" of the damaged area and the preservation of blood circulation through the main channel. A clip is put on the formation, the outflow of blood is eliminated. Exists alternative method used to remove the aneurysm. Endovascular embolization surgery may be performed several times during a patient's life. During the intervention, special agents are introduced. They fill the aneurysm of the brain. The operation is carried out using the latest drugs or microcoils gluing the damage. This technique is currently considered the most progressive.

Is it possible to prevent the development of pathology?

At present, measures have not yet been developed by which it is possible to prevent the appearance and increase in the size of education. Patients at risk should carefully monitor their health, observe the daily routine, control pressure, do not smoke or take drugs (cocaine and others). In addition, you should consult with your doctor about taking drugs such as Aspirin and other drugs that help thin the blood. Women should consult with a specialist regarding the use of oral contraceptives. These are the main activities for people who have a predisposition or already have a brain aneurysm. The operation is considered necessary with an intensive growth of education and an increase in the risk to the patient's life.

Consequences and prognosis

An unruptured aneurysm in the brain can remain undetected for a long period, and in some cases for a lifetime. In other situations, a burst formation can cause death, hemorrhagic stroke, or vasospasm. The last complication is the main factor provoking disability or death due to aneurysm rupture. A burst formation can provoke a coma, hydrocephalus. Irreversible or temporary brain damage is also likely. The prognosis after a hemorrhage will depend on the age of the patient, the characteristics of his body, and other associated neurological conditions. What matters is the location of the formation, its size, the degree of bleeding, and also whether it is repeated or primary. When assessing the consequences, one should also take into account the period between the provision of assistance and the hemorrhage itself.

Patients who have been treated for an unruptured mass require less time to recover than those who have had an aneurysm burst. Recovery period in the latter case, it can be several weeks or months. Rehabilitation after a particular operation should take place under the supervision of a doctor. Medicinal herbs can be used as maintenance therapy.

General preventive measures

Many vascular pathologies are quite preventable. First of all, you should pay attention to your lifestyle. In the conditions of a fairly high rhythm of modern life, it is necessary to find time for proper rest. In this case, we are talking about active sports, preferably outdoors. Experts recommend to everyone possible methods fight hypothermia. The emotional background of a person is also of great importance. If possible, it is necessary to eliminate stressful situations, mental overstrain. All this has an extremely negative effect on the state of the vessels. All drugs prescribed by a doctor should be taken exclusively in accordance with the scheme of application, do not exceed the dosage. Experts strongly recommend listening to your body, not ignoring the signals it gives. If you experience regular headaches, you should visit a doctor and undergo an examination. In no case is it recommended to self-administer any drugs. With pathologies of the vessels of the brain, self-treatment can lead to serious consequences that are life-threatening. The sooner a visit to the doctor takes place, the easier it is to identify the cause of a particular condition, prescribe adequate therapy or surgical intervention. It must be remembered that in the body all systems are interconnected with each other. Vascular pathologies are not isolated from other conditions that act as a consequence or cause of disturbances in the blood supply and nutrition of the brain. Timely access to a doctor in many cases avoids disability or death.

Cerebral aneurysm - features of the disease

Aneurysm is a very dangerous disease associated with a violation cerebral circulation. When it occurs, a protrusion of a section of the artery. This can happen for a variety of reasons and develops at any age, although it is very rare in children. Statistics show that the disease is more common in women. For unknown reasons, a large percentage of patients with aneurysms are registered in Japan and Finland.

The danger of the disease lies in the fact that it is difficult to diagnose. Often it is asymptomatic and is detected only when the aneurysm ruptures. Without timely treatment, this condition can lead to lethal outcome because it causes intracranial bleeding or hemorrhage. Currently, there are no effective methods for preventing aneurysm, you can only try to reduce the likelihood of its rupture. The disease is treated mainly with the help of surgery. It is very important to be attentive to your condition and consult a doctor if disturbing symptoms appear.

Description of the disease

According to the ICD, cerebral aneurysm belongs to the group of diseases of the circulatory system. During its formation, damage to the vessel wall occurs. Part of it protrudes, forming a sac filled with blood. It can put pressure on neighboring vessels and nerves, causing various neurological disorders.

But in most cases, the aneurysm does not cause any inconvenience to the patient. The danger lies in the fact that the wall of the vessel at the site of the protrusion becomes thinner, and under certain conditions it may rupture. In more than half of the cases, this condition leads to the death of the patient.

Aneurysms can form in almost any vessel. But most often the protrusion occurs near the base of the skull. Similar arterial aneurysms of cerebral vessels occur due to the fact that the blood pressure here is higher than in other vessels. And if there is a slight damage to one of the layers of the artery wall, part of it protrudes under the pressure of blood.

Types of cerebral aneurysms

In order to describe the disease in more detail and prescribe the correct treatment, doctors distinguish many types of aneurysms. They are classified according to their place of origin, form, and even age of occurrence.

Sometimes there is a congenital aneurysm of the cerebral vessels, but mostly it is an acquired disease. Vessel wall protrusions can be small, medium, or large. It is also very important to determine where the aneurysm develops.

Several types of the disease are distinguished according to the form; saccular aneurysm most often develops on the cerebral vessels. It occurs due to a local lesion of the vessel wall, in the region of which a sac filled with blood is formed. It can grow and break at any moment.

When diagnosing and choosing proper treatment it is important to know how many aneurysms a patient has formed on vessels. Most often, single defects occur. But there are also multiple aneurysms of cerebral vessels, due to which the blood supply to individual areas can be disrupted.

Cerebral aneurysm: causes

Why does damage to the walls of blood vessels occur? It can be caused by many factors. The main cause of an aneurysm is high blood pressure. With hypertension, a protrusion of the vessel wall in a weak spot can occur at any time. Why is there such a defect?

After closed injury head often observed stratification of the vessel wall. An aneurysm may form at this site. Defects in the walls of blood vessels can form after inflammation of the meninges caused by infection.

The development of aneurysms is also provoked by various diseases: cancerous tumors, polycystic kidney disease, atherosclerosis, and others. Vascular damage can be caused by a systemic infection that spreads through the blood. This, for example, syphilis or endocarditis.

Various congenital genetic or autoimmune diseases cause weakening of the connective tissue. This also creates the prerequisites for the occurrence of an aneurysm. The use of drugs and alcohol, as well as smoking, disrupt blood circulation and weaken the walls of blood vessels, causing protrusion of their areas.

Sometimes the disease develops already at birth. Although the number of such cases is very small, it can be said that there is a predisposition to its occurrence. But most often, cerebral aneurysm is inherited not by itself, but in the form of genetic anomalies and connective tissue defects.

The manifestation of the disease

Often aneurysms in the brain are small and do not cause any negative consequences. The patient can live for a long time without noticing this defect. But in some cases, the symptoms of an aneurysm are very pronounced. This happens when:

• the size of the aneurysm is large;
• the patient has pathologies in the work of the heart vascular system;
• the aneurysm is localized in an important area of ​​the brain;
• the patient does not comply with preventive measures.

Sequelae of a cerebral aneurysm

The protrusion of a part of the vascular wall leads to various disorders in the patient's state of health. And the more aneurysms in the brain, the worse it is. What does the formation of a sac on the vessel wall lead to?

Because of it, blood flow slows down, and the tissues behind the aneurysm are less supplied with oxygen and nutrients. Due to turbulence in the movement of blood, the risk of blood clots increases. As an aneurysm grows, it compresses surrounding tissues, blood vessels, and nerves. The most dangerous consequences are observed at break.

Rupture of a cerebral aneurysm

When the vessel wall ruptures, hemorrhage occurs, which causes severe damage to the nervous system, hemorrhagic stroke, and even death. Therefore, in the presence of this disease, it is very important to follow the measures recommended by the doctor to prevent such an outcome.

If you see a doctor in time, you can prevent hemorrhage. To do this, you need to follow all the recommendations: take prescribed medications, eat right, do not overexert yourself and undergo regular examinations.

Surgical removal of the aneurysm

After examining and determining the type of disease, the doctor decides which operation to apply for treatment. The aneurysm is clipped to prevent rupture. With the help of a metal clip, the leg of the protruding portion of the vessel is clamped. Thus, cerebral aneurysms are often treated. In most cases, the patient is subsequently given a disability. After such treatment, many restrictions must be observed, but still this does not prevent the appearance of new aneurysms.

In difficult cases, when there are many deformations, clipping will not help. Then endovascular occlusion of cerebral aneurysms is done. A special metal stent is inserted into the formed cavity and protects the vessel wall from rupture. Recovery after surgery can take several days. But after that, the patient must change his lifestyle.

Sequelae of cerebral aneurysm surgery

Such treatment almost completely returns the patient to a normal lifestyle. With proper rehabilitation after surgery, performance is fully restored. If the treatment is carried out on time, then the recurrence of the disease can be avoided. For control, it is necessary to undergo regular examinations with a doctor.

Sometimes surgery can cause complications. More often this happens in elderly and debilitated patients with concomitant chronic diseases. Perhaps the development of vascular obstruction, their frequent spasms. All this leads to oxygen starvation.

Pregnancy with cerebral aneurysm

An aneurysm rupture is the most dangerous for the patient's life. And during pregnancy, the likelihood of such an outcome increases. After all, all the changes that occur in a woman's body are reflected in the vessels. Moreover, the volume of blood at this time increases, which can lead to an increase in the aneurysm and to its rupture.

The danger lies in the fact that often a woman finds out about the presence of an aneurysm closer to the middle of pregnancy, and surgery cannot be done at this time. Therefore, a woman should always be under the supervision of a doctor.

The key importance in this disease is the timeliness of contacting a doctor. It is impossible to ignore the symptoms of an aneurysm, as this can lead to fatal consequences.

Symptoms

Symptoms of a cerebral aneurysm

Doctors identify the following symptoms of cerebral aneurysm:

Bouts of nausea;

• A sharp deterioration in vision;

  Photophobia;

  Split vision;

  Numbness of body parts, mainly on one side;

  Headache;

  hearing problems;

  Speech disorder.

Headache in cerebral aneurysm is most often paroxysmal, similar to migraine. The pain is localized in different places, but most of all manifests itself in the back of the head. One of the signs is the noise in the head of a pulsating character. As blood flow accelerates, the noise increases.

Signs of an aneurysm of cerebral vessels, which are not considered basic, but which you should still pay attention to:

Strabismus;

Harsh noises in the ears;

Strong pupil dilation;

omission of the upper eyelid;

Hearing loss on one side;

Vision problems such as distortion of objects, cloudy veil;

Sudden onset of weakness in the legs.

When an aneurysm ruptures, there is unbearable sharp pain.

Very often, aneurysm occurs in children, mainly in boys under two years of age. It is located in the posterior cranial fossa and is quite large. The symptoms are similar to those in adults.

The main reasons due to which an aneurysm of cerebral vessels may occur:

Traumatic brain injury;

Head wound;

High arterial pressure;

Various kinds of infections;

Atherosclerosis (problems with blood vessels, which are accompanied by the fact that cholesterol begins to be deposited on the walls of blood vessels);

Other diseases that have a detrimental effect on blood vessels;

Drugs and cigarettes.

What to do if you have found one of the symptoms of a cerebral aneurysm

If you have found one of the symptoms of a cerebral aneurysm, you should consult a doctor who will prescribe a list of tests and conduct a series of examinations to diagnose the disease and prescribe effective treatment.

Diagnosis of an aneurysm is a rather complicated process, since before the rupture, the formation does not manifest itself in any way. Diagnosis is carried out using X-ray studies of blood vessels. Studies reveal the destruction or narrowing of the vessels of the brain and parts of the head. Diagnostics is also carried out through computed tomography head and magnetic resonance imaging (MRI). MRI provides the clearest view of the blood vessels and shows the size and shape of the aneurysm.

Diagnostics

This diagnosis is made by a neuropathologist during the initial examination. Also, the diagnosis of cerebral aneurysm occurs through an x-ray examination of the cranium, examination of the spinal cord fluid, using a tomographic examination. An MRI examination allows you to identify signs of a brain aneurysm much faster.

Symptomatic signs of cerebral aneurysm.

Very often, signs of an aneurysm of cerebral vessels are not expressed in any way until such time as it becomes especially large or breaks through.

If the symptoms of the disease take place, then, as a rule, they are expressed in the following manifestations:

• ache in the eyes;
• paralytic syndrome;
• weakening of the facial muscles;
• blurred vision;
• enlarged pupils.

Symptoms of a burst aneurysm of the cerebral vessels are expressed in intense and piercing pain in the head, vomiting, nausea reflex, occipital rigidity (increased tone of the muscles of the neck), in some episodes - fainting. Sometimes the symptoms of the disease in a patient are expressed in migraine, which can be prolonged. Less commonly, signs of a cerebral aneurysm can be expressed in:

• omission of the eyelid;
• increased susceptibility to bright light;
• violation of the stability of the psyche;
• increased anxiety;
• convulsions.

All these symptoms are an "alarm bell", in which case you should urgently apply for medical care. It must be remembered that only a specialist can make a diagnostic conclusion; all these signs of an aneurysm of cerebral vessels do not 100% determine the presence this disease. Any conclusions can only be made by a neuropathologist, based on the examination and the results of the examination.

Diagnosis of signs of cerebral aneurysm

Signs of cerebral aneurysm need a medical examination, only a doctor can confirm or deny the presence of a disease in a patient.

The examination is very important, since the risk that a hemorrhage will occur from the detected pathology is very high. The probability of this negative prognosis is influenced by many factors: the magnitude of the pathology, its location, the condition of the vessels, and also the general history. Recurrence of hemorrhage takes place in more than complex form and increases the risk of death. That is why the signs of a cerebral aneurysm are a serious reason to seek medical help. If the symptoms are getting brighter, then when the patient contacts specialists, the following types of examinations are possible:

• When examining a patient, a neurologist makes appropriate conclusions. A doctor's examination helps to identify meningeal (symptoms of irritation of the meninges) and focal (deficiencies starting due to local damage to the brain) symptomatic signs. According to them, a specialist can confirm that the observed problems are signs of an aneurysm of cerebral vessels.
• Signs of a cerebral aneurysm are confirmed or refuted by an x-ray of the cranium. The procedure "shows" clots in the vessels, as well as a violation of the integrity of the bones of the base of the cranium, which helps to identify the disease.
• CT makes it possible to conduct a quick scan of the brain structure and its structure. Diagnosis of signs of cerebral aneurysm by this method allows you to fix the slightest abnormal changes in the brain and determine the disease. CT immediately "sees" signs of cerebral aneurysm, MRI also helps to cope with this task.
• Also, MRI helps to identify signs of cerebral aneurysm in the early stages. The procedure makes it possible to "examine" the structure of the organ (brain), "see" abnormal formations. Signs of cerebral aneurysm MRI detects, as a rule, from the first procedure, except in cases where the pathology is negligible. Then the diagnosis of signs of cerebral aneurysm is carried out using CT. However, with the primary signs of cerebral aneurysm, MRI is most often prescribed by specialists.
• Signs of an aneurysm of the cerebral vessels are the basis for the doctor to prescribe an examination of the cerebrospinal fluid. Diagnosis of signs of cerebral aneurysm by the presented method is carried out using laboratory research. Experts check how transparent the liquid is.
• With signs of cerebral aneurysm, angiographic examination of the vessels is also prescribed. It determines where the pathology develops, determines its shape and dimensions, scans the veins of the brain.

• signs of cerebral aneurysm are not expressed for a long time;
• the diagnosis helps to study the signs of cerebral aneurysm only when examining the patient with special equipment;
• if signs of cerebral aneurysm appear, then the disease has acquired a serious form;
• signs of cerebral aneurysm indicated on the site do not determine the presence of the disease, only a specialist can determine the diagnosis. Only a doctor can diagnose a cerebral aneurysm.

In addition to all these methods, the collection of information on anamnesis is of great importance in the diagnosis of the disease. A neurologist, before prescribing any examinations, asks the patient or his relatives and the following important factors:

• symptoms that worry you the most this moment;
• the first manifestations of the disease;
• concomitant chronic or acquired diseases;
• previous treatment, whether it was performed at all;
• injuries;
• allergies;
• hereditary diseases.

Sometimes this disease can be detected completely by accident, when the patient is being examined in connection with complaints about other circumstances. Similar diagnostic examinations carried out and with suspicion of tumor formation in the brain. Even more often, this disease, unfortunately, is detected only after the rupture of the aneurysm, in which case the patient is urgently hospitalized.

Treatment

Treatment of cerebral aneurysm

Treatment of a brain aneurysm is of several types:

Blocking of blood supply by emboli of one body structure. This leads to a decrease in the size of the aneurysm.

Surgical intervention. If the aneurysm has not yet ruptured, then the following operations are performed:

• clipping operation. The bottom line is that compressive clips are applied, which ultimately remove the aneurysm from the bloodstream.

  transcranial removal.

In 14 percent of cases, the rupture of the neoplasm leads to an outpouring of blood into the ventricles. In this case, the hematoma is removed.

Hemorrhage into the ventricles is also possible, then the doctor performs ventricular drainage.

It is not excluded the use of folk remedies in the treatment of aneurysms. Infusions of hawthorn, dill, elderberry and jaundice will help.

The prognosis for the treatment of this disease depends on many factors. It all depends on the location and size of the aneurysm.

With a rupture of the neoplasm, the forecasts are not comforting. The probability of disability: 25-37%, and the possibility of death is even higher: 35-52%.

A cerebral aneurysm (in other words, an intracranial aneurysm) is considered to be a small tumor in the human brain that instantly begins to grow and bleed. However, some types of aneurysms, namely the smallest aneurysms, do not cause hemorrhage, and removal entails little to no consequences. The aneurysm is often located where all the arteries are, namely along the lower part of the brain and the cranial base, and it is believed that treatment without surgery is quite likely.

According to some experts, the operation of a cerebral aneurysm is undesirable, since the consequences can be the most unpredictable, the results are always individual.

Operations for cerebral aneurysms

Endovascular surgery for an aneurysm of the cerebral vessels is carried out only under the careful supervision of doctors, who will continue to observe the process of recovery of the body for a long time to come. Rehabilitation after surgery for cerebral aneurysm takes place in medical treatment facilities. Clipping of a brain aneurysm is performed under general anesthesia.

There are about ten officially registered aneurysm ruptures per year for every hundred thousand people, and this is about twenty-seven thousand people a year in America. The fact that an aneurysm develops can also be influenced by factors such as: hypertension, frequent use of alcohol, drugs of a nature (especially cocaine) and cigarettes.

In addition, the development of the disease, the risk of rupture and the effectiveness of aneurysm treatment directly depend on its size.

In any case, you should immediately contact a specialist, and he will prescribe you the appropriate treatment.

Medications

If a strange and severe headache occurs, a person must immediately contact the nearest medical institution for qualified help. The disease is not treated with medication, but there is prevention and rehabilitation after surgery.

Surgical intervention is currently the only and most promising method of aneurysm treatment. Treatment with special drugs is used only to stabilize the patient or in a situation where surgery is contraindicated or impossible at all.

Chemical drugs are not able to eliminate the aneurysm, they only reduce the likelihood of rupture of the vessel by eliminating critical factors. Part medicines included in the complex general therapy, which is aimed primarily at alleviating the symptoms of the initial pathology in patients. What vitamins and drugs are taken for cerebral aneurysm?

Calcium channel blockers

The main representative of the nimodipine group. The chemical drug reliably blocks calcium channels in the muscle cells of the vascular walls. Vessels expand. Blood circulation in the cerebral arteries improves significantly. These drugs are simply irreplaceable in the prevention of dangerous spasms of the arteries.

Antacids

The principle of action is based on the blocking of H2 histamine receptors in the stomach. As a result, its acidity decreases and the secretion of gastric juice is significantly reduced. This group includes Ranitidine.

Anticonvulsants

To date, Fosphenytoin is the main representative of this group. The drugs cause reliable stabilization of membranes in nerve cells. Pathological nerve impulses noticeably slow down and do not spread.

Antiemetics

Prochlorperazine is mainly used. The gag reflex decreases due to the blocking of postsynaptic dopamine receptors in the mesolimbic compartment of the brain.

Painkillers

Morphine is very effective for pain relief. The level of pain is reduced as a result of exposure to specific opioid receptors.

Antihypertensive drugs

Recently, three main drugs have been used: labetalol, captopril, hydralazine. Due to the effect on enzymes and receptors, the overall tone of the arteries decreases, and rupture is prevented.

Folk remedies

Cerebral aneurysm. Are folk remedies used?

Cerebral aneurysm refers to those physiological disorders for which one drug treatment won't be enough. The same can be said about folk remedies. However, drugs used in traditional medicine can affect the blood flow inside the cerebral arteries. In many cases, this will be enough to reduce the risks associated with hemorrhagic stroke and aneurysm rupture.

The main condition for the use of folk methods

Folk methods are applicable only when they are approved by a doctor. Cerebral aneurysms folk remedies are treated only after an examination and determination of the degree of development of a dangerous disease.

Before starting an aneurysm treatment traditional medicine, you need to decide what effect the drugs used have on the body, whether they cause allergic reactions.

Bearing in mind the high risk of complications, experts recommend giving preference to medications. Treatment of an aneurysm of cerebral vessels with folk remedies is permissible only when the doctor has given the go-ahead for the use of alternative medicine.

5 recipes that can reduce risks

The first thing that should give treatment folk remedies is a decrease blood pressure. The proposed 5 recipes have been tested not only by time, but also by laboratory. It has been proven that they have a positive effect on the cardiovascular system and at the same time strengthen the body, saturating it with the necessary substances, which allows curbing the disease and making it less dangerous.

To the most effective methods include:

• Decoction of blackcurrant. For the preparation of this remedy, dry berries are used. Take 100 grams and pour a liter of hot boiled water. A quiet fire is made, on which the berries languish for 10 minutes. Strained and cooled means is taken 50 gr. three times during the day.
• Beetroot juice mixed with honey in equal proportions. Taken three times a day, 3 tablespoons.
• A decoction of potato skins. Potatoes are boiled unpeeled, and then the expressed liquid is drunk. It is also useful to eat boiled potatoes unpeeled.
• Jaundice levkoy is poured with boiling water and infused. Take 2 tablespoons per glass of water. Taken 4 or 5 times a day, one tablespoon.
• Corn flour. A tablespoon of flour is mixed with a glass of boiling water and left overnight. In the morning on an empty stomach, you need to drink the expressed liquid.

There are other noteworthy methods. The choice must be made by a specialist. Without his approval, one should not resort to folk remedies.

The information is for reference only and is not a guide to action. Do not self-medicate. At the first symptoms of the disease, consult a doctor.

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Among diseases of the cerebral vessels, aneurysm can be attributed to the most dangerous. Due to a change in the structure of the vessel, it loses its elasticity, as a result of which a rupture may occur with hemorrhage in the subarachnoid region or brain substance. Cerebral aneurysm leads to serious violations circulation, death. The neoplasm in the vessel gradually fills with blood, increases in size. In addition to rupture of the aneurysm, the very fact of deformation of the vessel also poses a danger. A convex area can put pressure on brain tissue, nerves.

An aneurysm has a peculiar structure, which determines the high risk of its rupture. The natural three-layer structure of the artery is preserved only in the neck of the formation; this area is the most durable. In the walls of the formation body, the elastic membrane is already broken, there is a lack of a muscular layer. The thinnest part of the aneurysm is the dome formed by the intima of the vessel. Here it ruptures, causing a hemorrhage.

Brain aneurysm: types

Brain aneurysms differ in shape, size, type. Formations can be spindle-shaped, saccular, lateral, consist of several chambers and one. Fusiform aneurysm is formed after the expansion of a certain section of the vessel wall. A lateral aneurysm is characterized by its formation on the vessel wall.

Giant formations are usually located in the area of ​​bifurcation, in the carotid artery passing through the cavernous sinus, reach 25 mm. A small formation has a size of up to 3 mm. The risk of hemorrhage increases dramatically with the size of the aneurysm.

It is customary to distinguish two main types of formations in the vessels of the brain: arterial and arteriovenous.

arterial aneurysm

When the walls of the arterial vessels protrude like a sphere or sac, this is an arterial aneurysm. Most often, the location of these formations becomes in the region of the base of the skull. This is where the arteries branch the most. There are multiple, single, giant, small formations.

Arteriovenous aneurysm

When the venous vessels of the brain are dilated and form a tangle, the formation is an arteriovenous aneurysm. With the communication of venous and arterial vessels, this type of aneurysm can develop. There is less blood pressure in the veins than in the arteries. arterial blood is thrown out under high pressure into the veins, due to which the walls expand, deform, aneurysms occur. Nervous tissue is subjected to compression, there is a violation of the blood supply to the brain.

Aneurysm of the vein of Galen

An aneurysm of the vein of Galen is rare. However, one third of young children and newborns account for this anomaly. It is twice as common in boys. Forecasts for this disease are unfavorable - death occurs in 90% of cases in infancy, the neonatal period. With embolization, high mortality remains - up to 78%. Symptoms are absent in half of the affected children. Symptoms may appear, hydrocephalus develops.

saccular aneurysm

A round blood sac visually resembles a saccular aneurysm. It is attached to the site of a branch of blood vessels, the main artery, with its neck. This type of aneurysm is the most common. It develops most often in the base of the brain. It usually occurs in adults. A typical formation is small in size, less than 1 cm. Structurally, the bottom, body and neck are distinguished in it.

Symptoms of the disease

The symptomatology of an aneurysm depends largely on the area of ​​the vessel where it is located. Aneurysm symptoms:

• Weakness;
• Nausea;
• visual impairment;
• Photophobia;
• Dizziness;
• Speech disorder;
• hearing problems;
• Numbness on one side of the body, face;
• Headaches;
• Double vision.

It is easier to identify the formation at the stage of its rupture, when the signs are more obvious.

paroxysmal headache

Local pain in the head of varying intensity, which is repeated in one area, is characteristic of an aneurysm of cerebral vessels. With damage to the basilar artery, pain occurs in one half of the head, when the formation is located in the posterior cerebral artery, pain appears in the temple, occipital region. For aneurysms of the anterior connective and anterior cerebral arteries, severe pain in the fronto-orbital area is common.

Other signs of an aneurysm

Other signs of a brain aneurysm are also known. The following symptoms are possible:

1. A sharp whistling noise in the ear;
2. There is strabismus;
3. Hearing loss is unilateral;
4. The upper eyelid drops (the phenomenon of ptosis);
5. The pupil expands;
6. Double vision appears;
7. Sudden weakness in the legs;
8. Vision is disturbed: everything becomes cloudy, objects are distorted;
9. Paresis of the facial nerve of the peripheral type;
10. Fields of vision are distorted or drop out.

In general, the symptoms of an aneurysm may resemble signs of a stroke, circulatory disorders.

Attention! If even individual symptoms of an aneurysm are observed, it is necessary to immediately consult a doctor. When the condition is severe, it is important to immediately call ambulance. Timely treatment, surgery can cope with the disease.

Causes of brain aneurysms

At the moment, a complete theory of the occurrence of aneurysms is under development. However, the factors that contribute to the development of formations have been studied in sufficient detail.

The most serious cause of aneurysm development is birth defects present in the muscular layer of the cerebral arteries. They often appear in areas of strong bends of the arteries, their connection. There is a lack of collagen, which provokes abnormal formations. This factor is hereditary.

Cause the development of aneurysms and hemodynamic disorders: uneven blood flow, high blood pressure. With the greatest force, this manifests itself in areas where the arteries branch. The blood flow is disturbed, it puts pressure on the already deformed vessel wall, which leads to its thinning, rupture.

A genetic disorder that causes vascular damage is a pathological phenomenon when the veins and arteries of the brain are intertwined, disrupting blood circulation. Accompanying aneurysms and malignant neoplasms, when tumors of the neck and head metastasize. Some other causes of aneurysms should be noted:

• Smoking;
• Drug use, in particular cocaine;
• Various diseases of the vascular system in general;
• infections;
• Wound, head injury.

All these factors jeopardize the circulatory system, blood vessels, contribute to the development of aneurysms.

Aneurysm rupture and its consequences

Rupture of an aneurysm at its thinnest point results in either an intracerebral hematoma. Blood can enter the ventricles of the brain, brain tissue. In 100% of cases it develops. Probably acute occlusion when closing the cerebrospinal fluid pathways with blood accumulated in the ventricles, cerebral edema. The brain tissue reacts to the products of blood decay, necrosis is characteristic, the cessation of the work of individual brain areas.

When an aneurysm ruptures, partial paralysis, severe nausea, headache, and vomiting occur. Consciousness is confused, the patient may fall into a coma. Convulsions appear, ptosis and various visual impairments are characteristic.

Complications after aneurysm rupture

Due to the hemorrhage provoked by the rupture of the aneurysm, a number of complications are observed. There is a cerebral angiospasm, a repeated rupture of the aneurysm is likely. Development is possible, which leads to death in 17% of cases. Complications are similar to those in ischemic, hemorrhagic stroke. In some cases, after a rupture of the formation, a convulsive syndrome develops. The following complications are likely.

1. Pain syndrome. After a stroke, pain attacks of varying intensity and duration can develop. Pulsating and shooting pain, a feeling of heat is hardly removed by painkillers.
2. Cognitive impairment. Patients lose the ability to process external information, perceive it. The logic and clarity of thinking, memory are disturbed, the ability to plan, learn, and make decisions is lost.
3. Psychological disorders. Depressive states, abrupt mood swings, increased irritability, insomnia, and a sense of anxiety are characteristic.
4. Difficulty in defecation and urination. Patients have difficulty with bladder, intestines, their emptying.
5. Visual disturbances. characterized by a decrease in visual acuity, loss of visual fields, double vision.
6. Difficulty or impaired swallowing. This complication can lead to food entering the trachea and bronchi, and not the esophagus. Dehydration and constipation are likely.
7. Behavioral disorders. Characterized by emotional lability, slow reaction, aggression or fearfulness.
8. Perceptual disturbances. The patient is not able to pick up an object, does not understand what he sees in front of him.
9. Problems with speech. Difficulty understanding and reproducing speech. Patients have difficulty counting, writing, reading. This complication is typical for damage to the left hemisphere of the brain (in right-handers).
10. Movement disorders. There is paralysis, weakness, patients move and walk with difficulty, coordination is disturbed. Sometimes there is hemiplegia - impaired movement of one side of the body.

After an aneurysm rupture, it is important to start treatment in a timely manner, to properly organize the subsequent rehabilitation of the patient.

Surgery

In most cases, the most effective tool for the treatment of aneurysm is considered. They make clipping, strengthen the walls of blood vessels, disrupt the patency of blood vessels at the site of the lesion with special microscopic spirals.

clipping

clipping of the aneurysm

It is carried out with direct surgical intervention. The operation is open, intracranial. The aneurysm is switched off from the general blood flow, while maintaining the patency of the carrier and surrounding vessels. It is mandatory to remove blood in the entire subarachnoid space or drain an intracerebral hematoma.

This operation is recognized in neurosurgery as one of the most difficult. The neck of the aneurysm should be blocked immediately. The optimal surgical approach is selected, modern microsurgical equipment and an operating microscope are used.

Strengthening the walls of the vessel

Sometimes they resort to the method of strengthening the walls of the aneurysm. The affected area is wrapped with surgical gauze, which provokes the formation of a special capsule from the connective tissue. The disadvantage of the method is the high probability of bleeding in the postoperative period.

Endovascular operations

Now the method of purposeful violation of the patency of the aneurysm is popular. The desired part of the vessel is artificially blocked with the help of special microcoils. The patency of neighboring vessels is carefully examined, the operation is controlled thanks to. This method is minimally invasive and is widely used in Germany. The operation does not require opening the skull, it is less traumatic.

Aneurysm BEFORE and AFTER endovasal surgery

Postoperative complications

Often there are postoperative complications. Usually they are associated with the development of cerebral hypoxia, vasospasm, especially when the intervention was carried out in the acute period of cerebral hemorrhage. Complications are also observed when the walls of aneurysms are damaged. In some cases, the microspiral pierces the wall.

Oxygen starvation is characteristic of complete or partial obstruction of the vessel that carries the aneurysm. Now, thanks to modern techniques, the space of the vessel can be expanded and strengthened artificially in order to provide the necessary blood flow in strictly defined areas.

A fatal outcome is likely if the aneurysm is gigantic and is at a difficult stage of development. It is important to start treatment on time, to carry out surgery without starting the disease. Mortality is minimal, if the disease has not had time to go to the stage of exacerbation, the operation is direct. Individual deaths are likely due to the individual characteristics of the body, not directly related to the disease, the operation.

Non-surgical treatments

Although the main and radical method to combat the disease - surgery, conservative treatment is also carried out. First of all, you must constantly be under the supervision of a doctor. Each patient needs an individual approach, it is necessary to take into account his condition as a whole, all the features of the organism. This approach is also important when choosing surgical treatment. Are used various drugs to prevent aneurysm rupture, to improve the general condition.

• Antiemetics and painkillers. They are necessary to alleviate the patient's condition.
• Preparations for stabilization blood pressure. The most important thing is to provide a certain fixed threshold, above which the pressure will not rise. An increase in blood pressure can lead to rupture of the aneurysm, hemorrhage.
• Anticonvulsants. These drugs are also commonly prescribed because seizures are likely to occur.
• . The drugs prevent cerebral spasm, stabilize blood vessels. It is necessary to use medications so that blood access to those parts of the brain that have suffered due to the development of an aneurysm is not cut off.

The optimal combination of conservative and surgical treatment, since a brain aneurysm needs surgical intervention to reduce the risk of its rupture and prevent death.

Prevention of cerebral aneurysms

First of all, it is necessary to pay attention to the factor of hereditary transmission of the disease, predisposition to it. Prevention of cerebral aneurysm is based on the timely diagnosis of the disease, the identification of symptoms, the passage of an examination, after which appropriate treatment is immediately prescribed. Sufficiently reliable results are obtained by magnetic resonance imaging,. Angiography is also performed.

A person who already suspects the presence of this disease should maintain himself in a special state, not only physically, but also emotionally. It is important not to overexert yourself, to avoid overwork. It is necessary to make efforts to constantly stabilize the emotional background and not get overexcited. We must forget about stress, worries, vain insults and doubts, we must live in the present and enjoy every day.

It is important to minimize the risk of damage to blood vessels, head injuries. It is necessary to constantly monitor blood pressure. Timely detection of primary warning bleeding plays an important role. It is impossible to ignore the symptoms of a brain aneurysm - you should immediately contact a specialist.

Video: cerebral aneurysm in the program “Live healthy!”

These are pathological local protrusions of the walls of the arterial vessels of the brain. In a tumor-like course, an aneurysm of the cerebral vessels imitates the clinic of volumetric education with damage to the optic, trigeminal and oculomotor nerves. In apoplexy, an aneurysm of the cerebral vessels is manifested by symptoms of subarachnoid or intracerebral hemorrhage, which suddenly arise as a result of its rupture. Cerebral aneurysm is diagnosed on the basis of anamnesis data, neurological examination, x-ray of the skull, research cerebrospinal fluid, CT, MRI and MRA of the brain. If indicated, cerebral aneurysm is subject to surgical treatment: endovascular occlusion or clipping.

General information

According to some data, 5% of the population has cerebral aneurysms. However, it is often asymptomatic. An increase in aneurysmal expansion is accompanied by thinning of its walls and can lead to aneurysm rupture and hemorrhagic stroke. The aneurysm has a neck, a body, and a dome. The neck, like the wall of the vessel, is characterized by a three-layer structure. The dome consists only of the intima and is the weakest point in which a cerebral aneurysm can rupture. The most common gap is observed in patients aged 30-50 years. According to statistics, it is a ruptured aneurysm that causes up to 85% of non-traumatic subarachnoid hemorrhages (SAH).

Causes of an aneurysm

Congenital protrusion of the cerebral vessels is the result of developmental anomalies that lead to disruption of the normal anatomical structure their walls. It is often combined with other congenital pathologies: polycystic kidney disease, aortic coarctation, connective tissue dysplasia, arteriovenous malformation of the brain, etc.

Acquired cerebral aneurysm can develop as a result of changes occurring in the vessel wall after a traumatic brain injury, against the background of hypertension, with atherosclerosis and hyalinosis of the vessels. In some cases, it is caused by the introduction of infectious emboli into the cerebral arteries. Such an aneurysm in modern neurology is called mycotic. The formation of pathology is facilitated by such hemodynamic factors as uneven blood flow and arterial hypertension.

Pathogenesis

Cerebral aneurysm is a consequence of a change in the structure of the vascular wall, which normally has 3 layers: the inner one - the intima, the muscular layer, and the outer one - the adventitia. Degenerative changes, underdevelopment or damage to one or more layers of the vascular wall lead to thinning and loss of elasticity of the affected area of ​​the vascular wall. As a result, in a weakened place under the pressure of blood flow, a protrusion of the vascular wall occurs, an aneurysm is formed. Most often, the protrusion is localized at the branching of the arteries, since there the pressure exerted on the vessel wall is highest.

Classification

In its form, the aneurysm of the cerebral vessels is saccular and fusiform. Moreover, the former are much more common, in a ratio of approximately 50:1. In turn, the saccular form can be single or multi-chamber. By localization, an aneurysm of the anterior cerebral artery, middle cerebral artery, internal carotid artery and vertebrobasilar system is distinguished. In 13% of cases, there are multiple aneurysms located on several arteries. There is also a classification by size. According to her, aneurysms are distinguished:

• miliary - up to 3 mm in size
• small - up to 10 mm
• medium - 11-15 mm
• large - 16-25 mm
• giant - more than 25 mm.

Symptoms of a cerebral aneurysm

According to its clinical manifestations, the pathology may have a tumor-like or apoplexy course. With a tumor-like variant, the aneurysm of the cerebral vessels progressively increases and, reaching a significant size, begins to compress the anatomical formations of the brain located next to it, which leads to the appearance of the corresponding clinical symptoms. The tumor-like form is characterized clinical picture intracranial tumor. It is most often detected in the region of the optic chiasm (chiasm) and in the cavernous sinus.

The anomaly of the vessels of the chiasmal region is accompanied by impaired visual acuity and visual fields; with prolonged existence, it can lead to optic nerve atrophy. Cerebral aneurysm, located in the cavernous sinus, may be accompanied by one of three cavernous sinus syndromes, which are a combination of paresis of III, IV and VI pairs of cranial insufficiency with lesions of various branches trigeminal nerve. Paresis of III, IV and VI pairs is clinically manifested by oculomotor disorders (weakening or impossibility of convergence, development of strabismus); defeat of the trigeminal nerve - symptoms of trigeminal neuralgia. Long-term may be accompanied by destruction of the bones of the skull, detected during radiography.

Often the disease has an apoplectic course with the sudden onset of clinical symptoms as a result of an aneurysm rupture. Only rarely is aneurysm rupture preceded by headaches in the fronto-orbital region.

Aneurysm rupture

The first symptom of a rupture is a sudden, very intense headache. Initially, it may be local in nature, corresponding to the location of the aneurysm, then it becomes diffuse. Headache is accompanied by nausea and repeated vomiting. There are meningeal symptoms: hyperesthesia, stiff neck, symptoms of Brudzinsky and Kernig. Then there is a loss of consciousness, which can last a different period of time. There may be epileptiform seizures and mental disorders from slight confusion to psychosis. Subarachnoid hemorrhage, which occurs when an aneurysmal expansion ruptures, is accompanied by a prolonged spasm of the arteries located near the aneurysm. In about 65% of cases, this vascular spasm leads to damage to the substance of the brain according to the type of ischemic stroke.

In addition to subarachnoid hemorrhage, a ruptured cerebral aneurysm can cause hemorrhage into the substance or ventricles of the brain. Intracerebral hematoma is observed in 22% of cases of rupture. In addition to cerebral symptoms, it is manifested by increasing focal symptoms, depending on the location of the hematoma. In 14% of cases, a ruptured aneurysm causes hemorrhage into the ventricles. This is the most severe variant of the development of the disease, often leading to death.

The focal symptomatology that occurs during rupture can be of a diverse nature and depends on the location of the aneurysm. When located in the bifurcation of the carotid artery, disorders occur visual function. The defeat of the anterior cerebral artery is accompanied by paresis of the lower extremities and mental disorders, the middle cerebral artery is accompanied by hemiparesis on the opposite side and speech disorders. An aneurysm localized in the vertebrobasilar system upon rupture is characterized by dysphagia, dysarthria, nystagmus, ataxia, alternating syndromes, central paresis of the facial nerve, and lesions of the trigeminal nerve. The protrusion of the vessels of the brain, located in the cavernous sinus, is located outside the dura mater and therefore its rupture is not accompanied by hemorrhage into the cranial cavity.

Diagnostics

Quite often, the disease is characterized by an asymptomatic course and can be detected randomly when examining a patient in connection with a completely different pathology. With the development of clinical symptoms, the diagnosis is carried out by a neurologist based on the history, neurological examination of the patient, X-ray and tomographic examinations, and examination of the cerebrospinal fluid.

A neurological examination reveals meningeal and focal symptoms, on the basis of which a topical diagnosis can be made, i.e., to determine the location of the pathological process. Instrumental diagnostics includes:

• radiography. X-ray of the skull helps to detect petrified aneurysms and destruction of the bones of the base of the skull. A more accurate diagnosis is provided by CT and MRI of the brain.
• Angiography. Cerebral angiography allows you to determine the location, shape and size of the aneurysm. Unlike X-ray angiography, magnetic resonance angiography (MRA) does not require the introduction of contrast agents and can be performed even in the acute period of rupture of a cerebral aneurysm. It gives a two-dimensional image of the cross section of vessels or their three-dimensional image.

• Lumbar puncture. In the absence of more informative diagnostic methods, a ruptured cerebral aneurysm can be diagnosed by performing a lumbar puncture. The detection of blood in the obtained cerebrospinal fluid indicates the presence of subarachnoid or intracerebral hemorrhage.

In the course of diagnosis, a tumor-like aneurysm of cerebral vessels must be differentiated from a tumor, cyst, and brain abscess. Apoplexy aneurysm of cerebral vessels requires differentiation from an epileptic seizure, transient ischemic attack, ischemic stroke, meningitis.

Treatment of cerebral aneurysm

Patients with small cerebral aneurysms should be constantly monitored by a neurologist or an operating neurosurgeon, since such an aneurysm is not an indication for surgical treatment, but needs to be controlled for its size and course. Conservative therapeutic measures in this case are aimed at preventing an increase in the size of the aneurysm. These may include normalization of blood pressure or heart rate, correction of blood cholesterol levels, treatment of the effects of TBI or existing infectious diseases.

Surgical treatment is aimed at preventing the rupture of the aneurysm. His main methods are aneurysm neck clipping and endovascular occlusion. Stereotactic electrocoagulation and artificial thrombosis of the aneurysm with the help of coagulants can be used. In relation to vascular malformations, radiosurgical or transcranial removal of the AVM is performed.

A ruptured cerebral aneurysm is emergency and requires conservative treatment similar to the treatment of hemorrhagic stroke. According to indications, surgical treatment is carried out: removal of a hematoma, its endoscopic evacuation or stereotaxic aspiration. If an aneurysm of cerebral vessels is accompanied by hemorrhage into the ventricles, ventricular drainage is performed.

Forecast

The prognosis of the disease depends on the place where the vascular protrusion is located, on its size, as well as on the presence of pathology leading to degenerative changes in the vascular wall or hemodynamic disorders. A cerebral aneurysm that does not increase in size can exist throughout the patient's life without causing any clinical changes. In the event of a rupture, 30-50% of patients die, 25-35% have persistent disabling consequences. Re-hemorrhage is observed in 20-25% of patients, mortality after it reaches 70%.

For full-fledged work, the human brain needs a certain amount of blood rich in oxygen and a number of useful elements. Two groups of vessels are responsible for the implementation of this process - paired carotid arteries and paired vertebral arteries. The basilar artery (BA) is formed at the confluence of two spinal canals.

Among other blood vessels supplying the brain, which are formed from the branches of the vertebral arteries, the anterior artery of the spinal cord and the inferior posterior artery of the cerebellum are distinguished. The front departs already from the BA.

Anatomical features of AD

The basilar artery forms under the lower part of the medulla oblongata. This vessel releases its 2 most important branches - the midbrain. They branch off in the region of the upper edge of the pons, after a long and rectilinear rise of the BA upward along the cavity located between the pons and the base of the skull. Before the formation of these two branches, BA gives off one more branch - the superior cerebellar. At the confluence of 2 vertebrates, the main artery of the brain is formed.

A whole network of posteromedial arteries departs from the midbrain branches, which deliver blood to the midbrain tegmentum. The second network branches off from the midbrain trunk. They reach the roof of the midbrain, passing over its surface and giving off many branches along the way.

BA supplies blood to important structures such as the medulla oblongata, peduncles, occipital region, and basal temporal lobe. And also to the cerebellum, mastoid bodies, the upper plate of the roof and the roof of the 3rd ventricle, the visual tubercle, the labyrinth of the inner ear, the roller corpus callosum, cranked bodies.

Vessels supplying blood to the brainstem are divided into 3 types:

1. paramedial - delivering blood to the area near the BA;
2. branches of one basilar and two vertebral arteries - part of the trunk cover;
3. posterior cerebral - some parts of the midbrain.

There is no doubt that if all these structures are not adequately supplied, there will be serious consequences. Any disturbances in the basin of the basilar vessel lead to the development of dangerous diseases accompanied by unpleasant symptoms.

Pathologies can develop not in the BA itself, but in the vertebrobasilar basin. Since BA is a place of intercourse of two vertebrates, keeping their way through a canal constructed by holes in the transverse processes of the cervical vertebrae and up to a hole in the skull.

The region of the vertebrae is subject to numerous diseases - from osteochondrosis to pathological tortuosity. And any of them can affect the blood flow of BA and its branches. If for some reason the lumen is narrowed in one of the vertebral arteries, the blood flow through the common BA will decrease significantly, and the brain will begin to starve. What pathologies can develop and for what reasons?

Vertebrobasilar insufficiency

With the development of pathological processes in the arteries of the vertebrobasilar basin, a person develops vertebrobasilar insufficiency. This is a syndrome accompanied by a whole group of symptoms and processes that occur against the background of insufficient blood supply to the brain. The result of the syndrome is often a stroke.

In simple words, vertebrobasilar insufficiency is a violation of the brain due to some pathologies in the spine. "Vertebro" - everything that is connected with the spine. "Basilar" - localization of the problem in the brain. Vertebrobasilar syndrome is not selective - even children can suffer from it.

Causes

Reasons for the development of the syndrome:

• osteochondrosis;
• excess cholesterol, provoking the development of atherosclerosis;
• congenital anomalies associated with arteries - non-vertebrogenic syndrome of vertebral arteries;
• anomalies in the region of the cervical vertebrae - vertebrogenic syndrome of the vertebral arteries;
• inflammatory processes in the arteries;
• hypertension;
• diabetes;
• cervical intervertebral hernia;
• thrombosis of any arteries of the vertebrobasilar basin;
• neck compression and effective vasoconstriction;

Symptoms

Whatever the cause of the development of vertebrobasilar syndrome, the general symptoms will be similar. The first attacks due to oxygen starvation of the brain occur unexpectedly (sudden attack) or slowly (permanent attack). The first is the so-called ischemic attacks. The patient experiences weakness, loses the ability to control his own limbs, does not feel them - numbness, cannot move, loses balance, feels dizzy, pain in the neck, inability to swallow and speak, feels nausea. Vomiting may not relieve nausea.

An ischemic attack can last from several minutes to several hours. And often leads to stroke and death.

Permanent seizures, which are chronic in nature, are characterized as giving a person constant discomfort. Suddenly, at any moment in time, a person begins to feel severe pain, starting from the back of the head and moving to the temporal region. May lose consciousness, suffer from forgetfulness, get tired quickly, feel constant physical weakness, experience irritability. Also characteristic are deterioration in hearing, vision, tinnitus, mood swings, depression, sweating, loss of balance.

It is not necessary that all of the above appear at once. Headaches or a few other symptoms alone are enough to go to the doctor. Let's take a closer look at some of the pathologies.

Atherosclerosis

This is the formation of cholesterol formations (plaques) in the vessel. Against the background of atherosclerosis of BA, a fusiform or saccular aneurysm develops. This occurs at the point where 2 parallel vertebral arteries merge. Or in the area of ​​​​brain separation from BA. With the development of pathology, the BA lumen narrows significantly, and local hemorrhages begin to occur in the brain. Often, with this course of the disease, the patient's eye functions are disturbed.

Atherosclerotic pathology develops along the entire length of the BA, but its embolism occurs only in the bifurcation zone.

Tortuosity of the vertebrobasilar arteries

Pathological tortuosity of the vertebral arteries is another reason for the reduction in blood flow through the basilar artery and, subsequently, branches that supply the brain from it. This pathology increases the risk ischemic strokes by 30%.

As a rule, pathology develops due to hereditary factors. Namely, if the tissues that make up the blood vessels are dominated by elastic fibers instead of collagen ones. As a result, the walls of the arteries wear out quickly, decrease in diameter and deform (twist). An additional factor for the development of tortuosity is atherosclerosis.

Tortuous arteries do not bother the patient for a long time, since the disease is asymptomatic. In addition, if any symptoms appear, the patient quickly gets used to them. But as soon as noticeable circulatory disorders in the brain begin, a microstroke occurs.

Most often, pathology occurs in the region of the 1st or 2nd vertebra of the neck, here loops, spurs of the artery walls, kinks and aneurysms can form - other anomalies of the arteries.

Osteochondrosis of the cervical region

Cervical osteochondrosis is more common than in any other department. This is a progressive degenerative-dystrophic lesion of the discs located between the vertebrae. With such a pathology, the growth of the cervical vertebrae and the possible resulting muscle spasm put pressure on the vertebral artery. As a result, blood flow in one or two (rarely) channels is reduced, and the brain does not receive enough blood to perform its functions.

The person himself is to blame for the development of osteochondrosis. The main reason for the appearance of pathology is an incorrect lifestyle - a violation of posture, limited mobility, long sitting at the computer without warming up the neck ... Osteochondrosis is one of the vertebrogenic causes of vertebrobasilar insufficiency.

Among others affecting the arteries from the outside, the most common are tumors, bone growths, congenital and acquired anomalies (rare), intervertebral hernia and thrombosis.

Thrombosis of the arteries of the vertebrobasilar basin

Arterial thrombosis is the formation of a blood clot in a vessel. Thrombosis of BA is considered the most dangerous of all possible. Since the branches of the basilar artery are arteries that deliver 70% of all the blood it needs to the brain. With untimely treatment, the disease leads to cerebral edema. It is characterized by all the symptoms of vertebrobasilar insufficiency, as well as paralysis of half of the human body, pain in the face and its distortion.

Depending on which of the arteries extending from the basilar, thrombosis attacked, more pronounced symptoms develop. If the ophthalmic artery - there will be loss of vision, and then blindness. If the artery directed to the labyrinth of the inner ear - hearing loss, and then deafness.

The result of thrombosis in the region of the vertebrobasilar basin is a stroke. And often fatal.

Aneurysm in the vertebrobasilar system

One of the most dangerous diseases that cause pathological processes in the vertebrobasilar basin is an aneurysm. Therefore, it is worth considering in more detail.

Arterial aneurysm - expansion of the lumen and protrusion of part of the wall of the artery. In about 40% of cases, such a pathology is found in the anterior cerebral and communicating arteries. Among 30%, an aneurysm of the carotid artery, or rather its internal branch, is ascertained. And the middle brain. In the vertebrobasilar system, pathology is found in 15% of cases.

An ordinary saccular aneurysm has a small diameter, only up to 1 cm, but there are also giant species whose diameter exceeds 2.5 cm. Unlike a small one that has a clearly marked neck, bottom and body, giant ones do not have a neck at all.

Symptoms

It is impossible to identify an aneurysm on your own. According to their symptoms, aneurysms are similar to all major pathologies associated with insufficient blood supply to the brain. But the symptoms alone should be enough to call your doctor for help. And undergo an examination using magnetic resonance or computed tomography for the timely appointment of treatment - before the rupture of the pathological formation.

Aneurysm symptoms:

1. constant feeling of fatigue and muscle weakness;
2. feeling of nausea;
3. loss of vision, photophobia is possible;
4. dizziness;
5. unrelated speech;
6. poor hearing;
7. unilateral numbness of any part of the body or the whole body;
8. double vision, ripples in the eyes;
9. headaches.

If the disease is not detected in time, the signs of its presence will become more pronounced. The main thing clinical manifestation aneurysms are hemorrhages due to rupture of their walls that occur inside the skull. Hemorrhages can occur several times (recurrent) and often lead to death - in 60% of cases immediately after the first.

Fortunately, ruptured aneurysms occur infrequently - 7-10 cases out of 100,000 per year. They are detected at the earliest stages of development, but, as a rule, due to examinations for other diseases. These are the so-called "accidental" aneurysms.

Most often, pathological education develops in adulthood, starting from 30 years. This part of the population, which has undergone pathology, occupies 60%. Elderly people over the age of 50 suffer from the disease in 8% of cases. And children are even less - in only 3% of cases.

Treatment

The only valid and possible way treatment of arterial aneurysms is a surgical intervention. Its main purpose is to protect aneurysms from the general blood flow, carried out to prevent the first or repeated hemorrhage. After the operation, the treatment does not end, the person has to undergo a long course of therapy.

Methods for excluding aneurysms from the general circulation are different - direct and endovasal. Which ones are suitable for a particular patient depends on the anatomical features of the pathology, including its size, as well as the state of blood flow, the time elapsed since the last rupture, and the general condition of the patient.

Treatment of vertebrobasilar insufficiency

All patients who have undergone this syndrome need urgent hospitalization and treatment under the supervision of a doctor. With the exception of chronic and vertebrogenic forms. They can be treated on an outpatient basis.

Basic treatment consists of the following activities:

• support for the work of the entire cardiovascular system;
• fight against cerebral edema;
• normalization of water and electrolyte metabolism;
• symptomatic remedies;

As soon as the cause of the development of the syndrome is established, a narrower treatment is prescribed. Individual for each patient, since the course of development of the pathology may be different.

After stabilization of the normal state of the patient, physiotherapy exercises are prescribed in all cases, for each individually. Manual therapy, physiotherapy and acupuncture are also available.

The arteries of the vertebrobasilar basin supply the most important part of the human body- brain. Therefore, you should not ignore the causelessly arising pains in the neck, neck and head. And ignore any other symptoms. Visit the doctor on time and be healthy!