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| Patient Education -- Cranial Aneurysm |
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Cranial
Aneurysm
An aneurysm is an abnormal increase in the diameter (dilation)
of a blood vessel. These occur in all age groups but the
incidence increases steadily for patients over 25 years
old. The most devastating consequences of intracranial
aneurysms, which often lead to severe disability or death,
result from their rupture and bleeding into the space
around the brain. A major rupture is often preceded by
a "warning leak" which manifests itself as a new or uncharacteristic
headache. An aneurysm may also be detected prior to rupture
due to pressure on surrounding nerves. The outcome for
patients treated before a catastrophic hemorrhage is much
better than those treated after, so the need for adequate
evaluation of patients suspected of harboring an intracranial
aneurysm is of paramount importance.
Unruptured intracranial aneurysms can be detected by non-invasive
measures, including magnetic resonance imaging (MRI) and
magnetic resonance angiography (MRA). Aneurysmal rupture
can be detected by a computerized tomography (CT scan
or lumbar puncture. In these tests suggest the presence
of an aneurysm, formal cerebral angiography should be
performed.
Microsurgical clipping done by a surgical procedure inside
the skull remains the cornerstone of therapy for intracranial
aneurysms. A less invasive technique which does not require
an operation, called endovascular therapy, uses microcatheters
to deliver coils to the site of the enlarged blood vessel
that occludes (closes up) the aneurysm from inside the
blood vessel and may be more suitable for some patients.
While the best method of securing the aneurysm should
be made on an individual basis, in general, patients with
a ruptured intracranial aneurysm should be treated as
soon as possible.
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