The cerebral aneurysm are dilatation of the cerebral blood vessels of several etiology probably due to the different structure of cerebral vessels (less elasticity, less muscle, thinner adventitia) and the absence of little connective tissue around the artery.
There are four aspects in saccular aneurysm that have to be considered. The first, saccular aneurysms arise at a branching site on the parent artery; the second, they arise at a turn or curve in the artery (saccular aneurysms arise on the convex, not concave, side of the curve); the third, they point in the direction that the blood would have gone if the curve at the aneurysm site were not present.
The fourth rule is that there is a constantly occurring set of perforating arteries situated at each aneurysm site that need to be protected and preserved to achieve an optimal result. The aneurysm arising in a straight point of the artery are of dissecting type and they are called fusiform aneurysms.
The most frequent presentation of cerebral aneurysm is subarachnoid hemorrhage (SAH). The symptoms are: headache; meningismus; hypertension; focal neurological deficit; obtundation or coma; Terson syndrome.
Imaging studies used are: MRI; MR Angiography; CT scan; Cerebral Angiogram; CT Angiography. Treatment: endovascular treatment; surgical treatment. The surgical procedure is performed placing a metallic clip across the neck of the aneurysm. Complications: cerebral vasospasm; hyponatriemia; cardiac problems; rebleeding; hydrocephalus after SAH.
There are four aspects in saccular aneurysm that have to be considered. The first, saccular aneurysms arise at a branching site on the parent artery; the second, they arise at a turn or curve in the artery (saccular aneurysms arise on the convex, not concave, side of the curve); the third, they point in the direction that the blood would have gone if the curve at the aneurysm site were not present.
The fourth rule is that there is a constantly occurring set of perforating arteries situated at each aneurysm site that need to be protected and preserved to achieve an optimal result. The aneurysm arising in a straight point of the artery are of dissecting type and they are called fusiform aneurysms.
The most frequent presentation of cerebral aneurysm is subarachnoid hemorrhage (SAH). The symptoms are: headache; meningismus; hypertension; focal neurological deficit; obtundation or coma; Terson syndrome.
Imaging studies used are: MRI; MR Angiography; CT scan; Cerebral Angiogram; CT Angiography. Treatment: endovascular treatment; surgical treatment. The surgical procedure is performed placing a metallic clip across the neck of the aneurysm. Complications: cerebral vasospasm; hyponatriemia; cardiac problems; rebleeding; hydrocephalus after SAH.
References
- Handbook of Neurosurgery - fifth edition - Mark S. Greenberg - ed. Thieme 2001;
- Rhoton ALJ. Rhoton Cranial Anatomy and Surgical Approaches. Ed Lippincott, Williams & Wilkins, October 2003.
