A cerebral aneurysm (also known as a brain aneurysm) is a weak or thin spot on an artery in the brain that balloons or bulges out and fills with blood. The bulging aneurysm can put pressure on the nerves or brain tissue. It may also burst or rupture, spilling blood into the surrounding tissue (called a hemorrhage). A
ruptured aneurysm can cause serious health problems such as hemorrhagic stroke, brain damage, coma, and even death. Some cerebral aneurysms, particularly those that are very small, do not bleed or cause other problems. These types of aneurysms are usually detected during imaging tests for other medical conditions. Cerebral aneurysms can occur anywhere in the brain, but most form in the major arteries along the base of the skull. Brain aneurysms can occur in anyone and at
any age. They are most common in adults between the ages of 30 and 60 and are more common in women than in men. People with certain inherited disorders are also at higher risk. All cerebral aneurysms have the potential to rupture and cause bleeding within the brain or surrounding area. Approximately 30,000 Americans per year suffer a brain aneurysm rupture. Much less is known about how many people have cerebral aneurysms, since they don’t always cause symptoms. There are no
proven statistics but a consensus of scientific papers indicate that between 3 and 5 percent of Americans may have an aneurysm in their lifetime. top Unruptured aneurysm A larger aneurysm that is steadily growing may press on tissues and nerves causing: Ruptured aneurysm Leaking aneurysm If you experience a sudden, severe headache, especially when it is combined with any other symptoms, you should seek immediate medical attention. top Type Size top Cerebral aneurysms form when the walls of the arteries in the brain become thin and
weaken. Aneurysms typically form at branch points in arteries because these sections are the weakest. Occasionally, cerebral aneurysms may be present from birth, usually resulting from an abnormality in an artery wall. Risk factors for developing an aneurysm Sometimes cerebral aneurysms are the result of inherited risk factors, including:
Other risk factors develop over time and include:
Less common risk factors include:
Additionally, high blood pressure, cigarette smoking, diabetes, and high cholesterol puts one at risk of atherosclerosis (a blood vessel disease in which fats build up on the inside of artery walls), which can increase the risk of developing a fusiform aneurysm. Risk factors for an aneurysm to rupture Not all aneurysms will rupture. Aneurysm characteristics such as size, location, and growth during follow-up evaluation may affect the risk that an aneurysm will rupture. In addition, medical conditions may influence aneurysm rupture. Risk factors include:
top How are cerebral aneurysms diagnosed?Most cerebral aneurysms go unnoticed until they rupture or are detected during medical imaging tests for another condition. If you have experienced a severe headache or have any other symptoms related to a ruptured aneurysm your doctor will order tests to determine if blood has leaked into the space between the skull bone and brain. Several tests are available to diagnose brain aneurysms and determine the best treatment. These include:
top What are the complications of a ruptured cerebral aneurysm?Aneurysms may rupture and bleed into the space between the skull and the brain (subarachnoid hemorrhage) and sometimes into the brain tissue (intracerebral hemorrhage). These are forms of stroke called hemorrhagic stroke. The bleeding into the brain can cause a wide spectrum of symptoms, from a mild headache to permanent damage to the brain, or even death. After an aneurysm has ruptured it may cause serious complications such as:
Seizures. Aneurysm bleeding can cause seizures (convulsions), either at the time of bleed or in the immediate aftermath. While most seizures are evident, on occasion they may only be seen by sophisticated brain testing. Untreated seizures or those that do not respond to treatment can cause brain damage. top How are cerebral aneurysms treated?Not all cerebral aneurysms require treatment. Some very small unruptured aneurysms that are not associated with any factors suggesting a higher risk of rupture may be safely left alone and monitored with MRA or CTA to detect any growth. It is important to aggressively treat any coexisting medical problems and risk factors. Treatments for unruptured cerebral aneurysms that have not shown symptoms have some potentially serious complications and should be carefully weighed against the predicted rupture risk. Treatment considerations for unruptured aneurysms
Individuals should also take the following steps to reduce the risk of aneurysm rupture:
Treatments for unruptured and ruptured cerebral aneurysms Surgery
Endovascular treatment
Other treatments
Rehabilitative therapy. Individuals who have suffered a subarachnoid hemorrhage often need physical, speech, and occupational therapy to regain lost function and learn to cope with any permanent disability. top What is the prognosis?An unruptured aneurysm may go unnoticed throughout a person’s lifetime and not cause symptoms. After an aneurysm bursts, the person’s prognosis largely depends on:
About 25 percent of individuals whose cerebral aneurysm has ruptured do not survive the first 24 hours; another 25 percent die from complications within 6 months. People who experience subarachnoid hemorrhage may have permanent neurological damage. Other individuals recover with little or no disability. Diagnosing and treating a cerebral aneurysm as soon as possible will help increase the chances of making a full recovery. Recovery from treatment or rupture may take weeks to months. top What research is being done?The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is a component of the National Institutes of Health (NIH), the leading federal supporter of biomedical research in the world. As part of its mission, the NINDS conducts research on cerebral aneurysms and supports studies through grants to medical institutions across the country. The NINDS-funded International Study of Unruptured Aneurysm Study collected natural history data that guides medical decision-making based on size and location of asymptomatic aneurysms. Genetics Scientists have long known about the link between cerebral and aortic aneurysm (the aorta is the body's main artery). However, they still do not fully understand the relationship between the two types of aneurysm. Recent genome-wide association studies (GWAS) provide molecular evidence for shared biological function and activities (pathophysiology) of these aneurysms. A specific site on chromosome 9p21 has been identified as increasing the risk for both cerebral and aortic aneurysms. This GWAS data, along with linkage data to other susceptible locations for genes or DNA sequences, indicate that individuals and families harboring one type of aneurysm may be at especially increased risk of the other. Other scientists are studying additional chromosomes and chromosomal regions to identify aneurysm-related genes. Diagnostic tools Cerebral aneurysms located at the posterior communicating artery and in the arteries in the back part of the brain (called the vertebral and basilar arteries) are common and have higher risk of rupture than aneurysms at other locations. NINDS-funded scientists are working to identify the features associated with rupture and use these factors to build a scoring scale to guide and support clinical decisions. The risk of having an aneurysm burst is difficult to determine and there can be serious complications from surgical treatments. Researchers are developing a new model to diagnose brain aneurysms based on the presence of molecules that can potentially tell whether there is a high chance of an aneurysm burst. This procedure can be done by using brain imaging without the need to open the skull. Not only would this new tool be less invasive, it would also allow for people to be treated before an aneurysm bursts. Hormones and medication Studies indicate aspirin lessens inflammation in cerebral aneurysms and reduces the risk of rupture. However, aspirin also inhibits the blood cells (platelets) that are important in stopping bleeding once a rupture occurs. Researchers are using mouse models to examine how inflammation impacts the formation and rupture of cerebral aneurysms, and the molecular mechanisms that contribute to the protective effect of aspirin. Cerebral aneurysms and subarachnoid hemorrhage are more common in postmenopausal women than in men. Estrogen replacement therapy reduces the risk for subarachnoid hemorrhage in post-menopausal women. Researchers are investigating exactly how estrogen protects women against developing aneurysms. They hypothesize protection primarily occurs through inflammatory cells. Treatments Other research projects include studies of the effectiveness of microsurgical clipping and endovascular surgery to treat ruptured and unruptured aneurysms, the use of various types of coils and other materials to block the flow of blood into the aneurysm, and the influence of blood flow speed and pressure on the success or failure of treatment. top Where can I get more information?For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute's Brain Resources and Information Network (BRAIN) at: BRAIN Information also is available from the following organizations: Brain Aneurysm Foundation American Stroke Association: A Division of American Heart
Association American Association of Neurological Surgeons Joe Niekro Foundation "Cerebral Aneurysms Fact Sheet", NINDS, Publication date May 2018. NIH Publication No. 18-NS-5506 Back to Cerebral Aneurysms Information Page See a list of all NINDS disorders Publicaciones en Español Aneurismas Cerebrales Prepared by: NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history. All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated. Which are two major risk factors for head and neck cancer especially when in combination?Alcohol and tobacco use (including secondhand smoke and smokeless tobacco, sometimes called “chewing tobacco” or “snuff”) are the two most important risk factors for head and neck cancers, especially cancers of the oral cavity, hypopharynx, and voice box (3–7).
Which risk factors can result in head and neck cancer in a patient select all that apply?The primary risk factors associated with head and neck cancer include tobacco use, alcohol consumption, human papillomavirus (HPV) infection (for oropharyngeal cancer), and Epstein-Barr virus (EBV) infection (for nasopharyngeal cancer).
Which cell type is involved in the initiation of head and neck cancer?HNSCC originates from mucosal epithelial cells that line the oral cavity, pharynx, larynx and sinonasal tract.
Which is considered the priority in treatment planning for patients with head and neck cancers?Patients with HNSCC overwhelming prioritize cure, followed by survival and swallow. The decreased prioritization of survival by older age supports further examination of treatment preference by age.
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