Care for Patient with Cerebral Aneurysm

Major point

  1. Cerebral aneurysms are commonly found at vascular bifurcations and are mostly spherical.
  2. When a subarachnoid hemorrhage occurs due to a ruptured aneurysm, there is usually a sudden very severe headache.
  3. Maintain a regular daily life and keep mood and blood pressure stable.

I. What is cerebral aneurysm?

The formation of cerebral aneurysm may be related to genetic or congenital vascular muscle layer defects, or damage to the arterial wall due to trauma, infection, atherosclerosis, and other related risk factors, including hypertension, smoking, and drug abuse. Cerebral aneurysm is commonly found on the sides or bifurcations of cerebral arteries. Its formation can be the swelling of a weak blood vessel wall due to the impact of blood flow and is mostly sac-shaped with a clear neck of aneurysm.


II. What are the symptoms of cerebral aneurysm?

Most patients with an unruptured cerebral aneurysm are generally asymptomatic. Other possible symptoms include localized headache, pain in the upper eye and eye socket, diplopia, loss of sensation, etc. When a patient experiences a ruptured aneurysm, which results in subarachnoid hemorrhage, the patient will usually experience a sudden and very severe headache, which is often accompanied by nausea, vomiting, stiff neck, blurred vision, light sensitivity, or limb weakness. Patients experiencing the mentioned symptoms are not necessarily suffering from cerebral aneurysm. If you have the above symptoms, please go to the outpatient clinic of the Division of Neurological Surgery.


III. Treatments:

  1. Neurosurgeons and radiologists will choose aneurysm clamping or aneurysm embolization after discussing with you and your family members based on your health status, aneurysm size, aneurysm location, and aneurysm rupture probability. 
  2. If you have not received any treatment, it should be controlled with medication, and you should return to the doctor regularly for follow-up.
  3. If combined with subarachnoid hemorrhage, it will affect the circulation and absorption of cerebrospinal fluid, which may cause hydrocephalus. If necessary, ventriculoperitoneal drainage tube surgery should be performed.

IV. Principles of care after surgery:

  1. There may be a problem of vasoconstriction and spasm, which usually occurs 3 to 14 days after the initial bleeding. Severe vasospasm may cause the risk of stroke and rebleeding.
  2. It may cause epilepsy (convulsions, epilepsy), and you need to follow the doctor's instructions to take medicine.
  3. Maintain a regular daily routine and maintain  stable mood, blood pressure, and avoid engaging in excessively stressful work.
  4. Eat a balanced diet, eat more fruits and vegetables to prevent constipation, do not smoke, drink alcohol and irritating or alcoholic foods.
  5. Do not engage in dangerous activities such as high-altitude jumping, swimming, running or flying for a long time.
  6. Keep blood pressure under stable control. If you have obvious headache symptoms, you should seek medical treatment immediately.
  1. Ramesh Chandra, V. V., Prasad, B. C. M., Goutham, T., Venkat, K., Sasank, D., & Lv, X.(2022). Recent advances in cerebral aneurysms. In X. Lv(Ed.), Endovascular Surgery of Cerebral Aneurysms(pp. 241-254). Springer, Singapore.
  2. Taylor, C., Dalton, A., Manjunath Prasad, K. S., & Mukerji, N. (2019). Observed rupture of unruptured intracranial aneurysms.  British Journal of Neurosurgery, 34(6), 661-666.
  3. Texakalidis, P., Sweid, A., Mouchtouris, N., Peterson, E. C., Sioka, C., Rangel-Castilla, L., Reavey-Cantwell, J., & Jabbour, P. (2019). Aneurysm formation, growth and rupture: the biology and physics of cerebral aneurysms. World Neurosurgery, 130, 277-284.
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