Cerebral aneurysm is a dilatation of the cerebral blood vessels of various 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 to be considered:1. saccular aneurysms arise at a branching site on the parent artery; 2. they arise at a turn or curve in the artery (on the convex, not concave, side of the curve); 3. they point in the direction that the blood would have gone if the curve at the aneurysm site were not presen;4. there is a constantly occurring set of perforating arteries situated at each aneurysm site that need to be protected and preserved in order to achieve an optimal result. Aneurysms arising in a straight point of the artery are of a dissecting type and described as fusiform. The most frequent presentation of cerebral aneurysm is subarachnoid haemorraging (SAH).
Symptoms: headache; meningismus; hypertension; focal neurological deficit; obtundation or coma; Terson syndrome.
Imaging studies: MRI; MR Angiography; CT scan; Cerebral Angiogram; CT Angiography.
Treatment: endovascular; surgical. 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.
Symptoms: headache; meningismus; hypertension; focal neurological deficit; obtundation or coma; Terson syndrome.
Imaging studies: MRI; MR Angiography; CT scan; Cerebral Angiogram; CT Angiography.
Treatment: endovascular; surgical. 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.
