All About Aneurysm

Dr.Madhukar Bhardwaj, 4 mins read

An aneurysm is a medical condition where a part of an artery weakens and swells like a balloon. It usually doesn’t cause any symptoms unless they burst or rupture. If this happens, it can be dangerous or fatal.

Thus, it is crucial to consider periodic health checkups for early diagnosis. An early diagnosis will help you initiate the treatment process urgently and prevent any complications.

This condition can occur in any part of the body, including blood vessels of the brain, aorta, neck, intestines, kidney, spleen and legs. Its common risk factors include genetic conditions, injury, artery disease or infection.

Symptoms:

Usually, aneurysms show no symptoms unless they burst. Sometimes, they may show symptoms such as confusion or dizziness, difficulty in swallowing, fatigue, headache, nausea or vomiting, pain in the abdomen and vision problems.

A ruptured aneurysm is an emergency situation and needs immediate medical attention. A burst aneurysm shows the following signs:

• Sudden and severe pain in the head, chest, belly or back
• Fast heartbeat
• Feeling of fainting
• Loss of consciousness following a severe headache

If you suspect any sign of a ruptured aneurysm given above, call an ambulance right away.

Causes

The exact causes of aneurysms are still unknown. The possible causes may include narrowing of the arteries (atherosclerosis), high blood pressure and injury to the aorta. Having a family history of aneurysms can also increase your likelihood of developing this condition.

Types of Aneurysms:

Depending on the location, there are different types of aneurysm:-

• Abdominal Aortic Aneurysm (AAA): It can be formed in the main artery of the belly.
• Cerebral (brain) Aneurysm: It occurs in brain arteries, which often appear as a small berry attached to the artery.
• Thoracic Aortic Aneurysm: This is formed in the upper part of the aorta, near your chest.
• Carotid Aneurysm: It is formed in the carotid arteries that carry blood to the brain, neck and face.
• Popliteal Aneurysm: It occurs in the artery that runs behind the kidney.
• Mesenteric Aneurysm: It develops in the artery that supplies blood to the intestine.
• Splenic Aneurysm: This type is formed in the artery which carries blood to the spleen.

On the basis of size and development, aneurysm can be classified as:

• Fusiform aneurysm: It bulges out on all sides of your artery.
• Saccular aneurysm: It causes just one side of your artery to bulge.
• Mycotic aneurysm: It develops after an infection (typically in your heart valves)
• Pseudoaneurysm or false aneurysm: It occurs when the outer layer of the artery wall expands.

Diagnosis

To detect an aneurysm, doctors will first conduct a complete medical history and perform a physical examination. If the doctor suspects any abnormality, they may recommend one or more diagnostic tests such as:

• Arteriogram (angiogram): An X-ray of the blood vessels can be taken to diagnose aneurysms. It can also be used to detect other abnormalities such as stenosis (narrowing of the blood vessel), or blockages. A dye (contrast) is injected into an artery through a thin flexible tube to create a clear picture of the blood vessels on the X-ray.
• CT Angiography (CTA): This combines the use of a CT scan and a special dye to get clear images of blood flow.
• Ultrasound: It uses high-frequency sound waves to check the blood flow and vessel structure of the internal organs.
• Cerebrospinal fluid test: This test detects brain aneurysms. A needle is used to draw cerebrospinal fluid from the back to check for red blood cells.
• Echocardiogram: It helps to assess the structure and function of the heart by producing a moving picture of the heart and heart valves.
• Magnetic Resonance Imaging (MRI): This procedure utilises radio waves and strong magnets to produce detailed images.

Management of Aneurysm:
Aneurysms can be managed by:

• Quitting smoking and controlling risk factors like high blood pressure
• Lowering fat intake in the diet
• Intake of medication that helps to manage cholesterol or blood pressure
• Surgery, which may be minimally invasive

There is a risk of bursting if the size of the aneurysm is large. In that case, surgery is required. Surgery can be of the following types:

• Endovascular aneurysm repair (EVAR): In this procedure, a catheter (thin tube) is inserted into the vessel. The surgeon then inserts a graft (section of specialised tubing) through the catheter to repair the artery.
• Open surgery: In open surgery, a surgeon removes the aneurysm through an incision.
• Endovascular coiling: This is used to treat cerebral aneurysms. In this procedure, the surgeon inserts multiple coils through a catheter to pack the aneurysm, eliminating the risk of rupture.
• Microvascular clipping: This is also used to treat cerebral aneurysms in which a metal clip is placed at the base of the aneurysm to cut off blood supply.
• Catheter embolization: A catheter is injected into the affected artery to place medication or embolic agents that prevent bleeding.

Prevention

One can reduce the risk of developing an aneurysm by adopting a healthy lifestyle. This can be done by:

• Eating a healthy diet
• Exercising regularly
• Maintaining weight
• Quitting smoking