What is cerebral aneurysm? 
Cerebral aneurysm is commonly found on the sides or bifurcations of cerebral arteries. It is formed by 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.
 
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 usually will 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 above 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.
 
What may cause the occurrence of 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.
 
Impact of cerebral aneurysm on the body after rupture:
  1. If an aneurysm ruptures, it should be treated as soon as possible to avoid the risk of rebleeding, because bleeding will cause brain damage, limb paralysis, coma, and even death.
  2. Vasospasm may occur. It usually takes place 3 to 14 days after the first bleeding. Severe vasospasm may cause the risk of stroke and rebleeding.
  3. Seizures requiring antiepileptic medication may be induced.
  4. Subarachnoid hemorrhage may affect the circulation and absorption of cerebrospinal fluid, which may cause hydrocephalus. If necessary, surgical treatment of ventricular and abdominal drainage tube is required.
 
Common examination and diagnosis methods:
  1. Computed tomography angiography: It covers the combination of computed tomography with a contrast medium injected into the blood vessel to capture images. Computer 3D image reconstruction is used to reflect the anatomical relationship between cerebral blood vessels and hemangioma.
  2. Cerebrovascular photography: The contrast medium is injected into the blood vessel, so that the contrast medium reaches the brain to generate an image where the distribution of hemangioma and peripheral blood vessels can be clearly seen.
  3. Magnetic resonance angiography: It covers the combination of magnetic resonance imaging with a contrast medium injected into the blood vessel to capture the image. Computer 3D image reconstruction is used to further determine the anatomical location of the hemangioma.
 
Treatments: 
  1. Treatment is determined by the neurosurgeon and radiologist in accordance with the patient's health status, hemangioma size, hemangioma location, and hemangioma rupture probability after a discussion with the patient and his/her family members. Hemangioma clipping or embolization surgery may be performed.
  2. If the patient has not undergone surgical treatment, then he/she should return to the clinic for a regular follow-up.
 
Notes on daily life:
  1. Maintain a normal life with rest and emotional stability and avoid engaging in stressful work.
  2. Keep a balanced diet, eat more fruits and vegetables to avoid constipation, and do not smoke, drink alcohol, and eat irritating or alcoholic food.
  3. Do not engage in dangerous activities such as bungy jumping, long-distance swimming, long-distance running, or long-haul flight.
  4. Maintain a stable blood pressure. If a patient has acute headache symptoms, then he/she should seek medical treatment immediately.
 
References
  1. Jiang, B., Paff, M., Colby, G. P., Coon, A. L., & Lin, L. M. (2016). Cerebral aneurysm treatment: modern neurovascular techniques. Stroke and vascular neurology, 1(3), 93-100. doi:10.1136/svn-2016-000027
  2. Taylor, C., Dalton, A., Prasad, K. M., & Mukerji, N. (2019). Observed rupture of unruptured intracranial aneurysms. British Journal of Neurosurgery, 1-6. doi:10.1080/02688697.2019.1685647
  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. doi:10.1016/j.wneu.2019.07.093
    Quiz
    Please answer the following questions:
    Nursing Instruction Satisfaction
    Please log in to rate