Aneurysms – Treatment & Prevention
For those who are fans of the famous show “Game of Thrones”, they well know that Emilia Clarke suffered two aneurysms while filming the show. Aneurysms are the literal worst kind of headaches that one can have in case of cerebral types and they can lead to worse problems, no matter if they rupture or not.
In medical terms, an aneurysm can be depicted as a cherry hanging from a stem. Do not let this seemingly beautiful depiction fool you. There is nothing beautiful in it. While aneurysms can happen almost anywhere in the body, the most cause for concern is aortic and cerebral aneurysms as they can be particularly life-threatening.
Aneurysms can almost go unnoticed when they are in their initial stages. Cerebral aneurysms are the most noticeable since while even intact, they can cause painful experiences. Depending on what stage the aneurysm is in, the symptoms can vary for cerebral aneurysms:
Unruptured aneurysms can cause pain around areas of one eye, a dilated pupil, changes in vision or double vision or even numbness on one side of the face. However, these are symptoms if the aneurysm is significantly large.
Leaking aneurysms are precursors to fully ruptured aneurysms. They can cause sudden, extreme headaches.
A ruptured cerebral aneurysm is the worst condition that can be experienced. Along with sudden, extreme headaches, a stiff neck, blurred or double vision, sensitivity to light, drooping eyelids and loss of consciousness, patients can often experience nausea and vomiting, seizures and a period of confusion.
Aortic aneurysms will rarely make themselves known if they are intact until they rupture and will be a case of surgical emergency, with high mortality rates. Depending on where the aneurysm is on the path of the aorta, generally, the pain will be experienced in the abdomen or the back.
The exact cause for aneurysms to form is not known, but a variety of factors can pose a potential risk. Some of them could be hereditary, which are way beyond anyone’s control. But some factors can be kept in check and really help in preventing the occurrence. Smoking, high blood pressure, drug abuse, and heavy alcohol consumption are some of the factors that you could easily keep in check.
The crux of the situation is how to tell a headache apart, whether it is due to an aneurysm or migraine. Migraine headaches often last longer, anywhere from 4 to 72 hours and cause a constant level of discomfort. Aneurysm headaches are shorter and instant, they don’t gradually build up or stay longer. You’d most often experience something called a ‘thunderclap’ headaches. Associated with that, you’d either cough, sneeze or bear down when having a bowel movement.
Now that we have the point across about how to find a potential aneurysm headache, it is important that we also look at the kind of treatment that you could expect. For diagnosis, the doctor might suggest an aortic ultrasound study for aortic aneurysms. For cerebral ones, a CT scan could be suggested, followed by a cerebrospinal fluid test, a magnetic resonance imaging, and a cerebral angiogram.
Doctors who have obtained their license after clearing the United States Medical Licensing Exam, USMLE, will generally ask you about your family’s medical history before suggesting any kind of tests or examinations. That normally narrows down the possibility of if a patient would be potentially suffering from an aneurysm.
Treatment of aneurysms requires neurosurgical attention. In brain aneurysm surgery there are two methods that can be adopted, based on a case-to-case basis. In surgical clipping, a part of the skull is removed and a metal clip is attached to the blood vessel that is feeding the aneurysm. That stops the blood flow to the aneurysm and prevents it from enlarging or rupturing. In endovascular coiling, a rather less invasive method compared to surgical clipping, where a soft platinum wire is coiled around the aneurysm, disrupting the blood flow from the artery. While the latter process is less invasive and might be initially safer, there is a chance the aneurysm could reopen and need further surgical attention.
Flow diverters are a form of surgery where the blood flow is directed away from the aneurysm and this stimulates the body to heal the area and repair the artery on its own. However, it is up to the surgeon’s discretion based on your health factors and the condition of the aneurysm to suggest this method.
Some well known include pain relievers like acetaminophen to lessen complications and reduce discomfort. Calcium channel blockers prevent the entry of calcium into the blood vessel walls and reduce the risk of delayed brain injury post a subarachnoid hemorrhage. Vasopressor could be used as an intravenous injection to elevate blood pressure to overcome the refusal of narrowed blood vessels. Angioplasty could also be opted to prevent a stroke resulting from insufficient blood flow post an aneurysm rupture. Anti-seizure medications could be given based on the health conditions of the patients and the decision is based on the discretion of the doctor and the caregiver. Ventricular or lumbar drainage catheters and shunt surgery can help in case of excess cerebrospinal fluid (hydrocephalus), where a catheter is used to drain excess fluid into an external bag. The shunt might then be introduced that creates a drainage channel from your brain into your abdominal cavity.
In the case of unruptured aneurysms, mostly aneurysm clips or endovascular coiling could be used as surgical options to prevent further complications. For any such kind of treatment, the size, location, and appearance of the aneurysm make for an important point. The age and general health of the patient is to be taken into consideration, as well as the family history of ruptured aneurysm apart from congenital conditions that could give rise to the risk of a ruptured aneurysm.
As plain and simple advice, if you experience any ‘thunderclap’ advice, waste no time in consulting a doctor. If you have had a history of high blood pressure related problems, it might be high time to check for a change in medication or get a new prescription. Stay away from cigarettes and other substances that can be categorized as stimulants.
PUBLISHED: 5/5/2019 – IGOR A. SAVCHUK
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