Symptoms of a Ruptured Aneurysm
As a general rule, aneurysms are asymptomatic, which means there is no way of detecting their presence. In fact, they are often diagnosed by chance during an X-ray for an entirely different problem.
In rare cases, some people complain of localized headaches or vision issues. However, in principle, until the aneurysm has progressed to a complete rupture of the artery, there is nothing to alert you to its presence. Over time, the affected arterial wall nevertheless tends to gradually dilate, therefore becoming ever thinner and more fragile.
When a brain aneurysm ruptures* A rupture in the arterial wall where an aneurysm has developed. This rupture may lead to severe bleeding and death, so it is a serious emergency., bleeding occurs within the brain that can vary in terms of size. If the bleed is small, neck stiffness, or torticollis, may be the only symptom. However, cases of serious bleeding produce symptoms that should be treated as a medical emergency:
- a sudden and violent headache (a “thunderclap” headache),
- extreme sensitivity to light,
- nausea or vomiting,
- confusion or disorientation with potential hearing, balance, and/or speech issues, among others.
Causes of an Aneurysm
Aneurysms develop for many reasons. Weakness in vascular tissue is of course the most direct cause. However, a more general hardening and thickening of the arteries (arteriosclerosis*A medical issue characterized by hardening, thickening, and a lack of elasticity in the walls of the arteries.) and/or high blood pressure*A disease that occurs when the pressure exerted by the blood against the artery walls is too high. are the most common causes. Heredity and genetic predispositions could also explain around 10% of all aneurysms. Other possible triggering factors include:
- head trauma,
- certain diseases and infections,
- excessive alcohol consumption,
- taking oral contraceptives.
Aneurysms become more frequent with age. Smoking, or having smoked a lot, also increases the risk considerably.
In addition, the hereditary component of aneurysms means that people who have a family history of the condition should be screened from the age of 50. We talk about a family history of aneurysms when a close relative (father, mother, brother, or sister) has already suffered an aneurysm.
Treatment consists of surgically isolating the aneurysm from the blood flow. In the case of a brain aneurysm, one option is to place a metal clip at the base of the aneurysm. It can also be closed using a small metal spiral. In this case, it is not necessary to perform open surgery. The affected vessel can in fact be accessed using a catheter, most commonly via the femoral artery.
The aim is to prevent a bleed if the aneurysm has not yet ruptured, or to limit the complications of the rupture and prevent it re-occurring if it has.
Progression and Possible Complications
La rupture d’anévrisme, soit l’éclatement de la poche de sang formée par la dilatation d’une artère, entraîne une hémorragie interne et représente une urgence vitale.
The formation of a blood clot caused by the slowed blood flow during an aneurysm is an additional risk of complications. If a blood clot forms it can enter the blood flow and risk blocking a vessel, which is referred to as an embolism*The obstruction of the blood flow by a clot, which can cause a stroke.. It is life threatening.
There is no specific preventative treatment for aneurysms and aneurysm ruptures. However, as it is a disease of the arterial walls, it is reasonable to think that he measures you can take to prevent cardiovascular risks also apply in this case. They essentially entail living a healthy lifestyle by:
- eating a healthy diet,
- doing a reasonable amount of exercise,
- keeping an eye on your weight,
- limiting alcohol consumption,
- not taking up smoking, or stopping if you already smoke,
- avoiding stressful situations as much as possible.
If the aneurysm remains small, the risk of rupture is considered to be low and medical monitoring is sufficient. However, if it grows to the point that the pocket of blood becomes larger than 5.5 cm in men and 5 cm in women, surgery may be required, particularly if the patient has several risk factors at once (for example age and a family history of aneurysms).
After the operation, the patient must be monitored with regular checks using medical imaging (ultrasound*A medical imaging technique that uses ultrasound to “see” the inside of the body. or tomography*A medical imaging technique used to reconstruct an object using a series of images.).
When Should You Contact the Doctor?
The signs that signal an aneurysm rupture are well known. For example, they include stiffness in the neck, a sudden and violent headache sometimes followed by loss of consciousness, nausea and/or vomiting, extreme sensitivity or intolerance of light, vision problems, and confusion.
In certain cases, the patient complains of having a headache several hours or days before the aneurysm rupture. These are called sentinel headaches. An aneurysm rupture is always a medical emergency.
Care at Hôpital de La Tour
Brain aneurysms can be diagnosed in different ways, mainly using medical imaging methods that can sometimes be combined thanks to new technologies:
- computed tomography*A medical imaging technique used to obtain a 3D reconstruction of the different organs of the body. (CT-scan),
- brain angiography*An X-ray examination used to observe the veins and arteries of the brain.,
- magnetic resonance imaging*A medical imaging technique used to obtain 2D or 3D images of the inside of the body.,
Once diagnosed, an aneurysm must be monitored regularly. The possibility of surgery warrants discussion with the doctor. The size of the aneurysm, the patient's age, health, and any risk factors must be considered to determine which type of intervention would be best suited.