The vessels feeding the brain join at the base of the brain to form a vascular network called the polygon of Willis. Brain aneurysms occur as a result of abnormal enlargement of any of the vessels forming this network. Since the walls of these dilated vessels are weak and thin, they may rupture spontaneously or after exertion and cause cerebral hemorrhage.
A picture of subarachnoid hemorrhage (SAH) occurs when the cerebral vessels that travel between the membranes surrounding the brain, cerebellum and spinal cord bleed for various reasons.
General Information
*Unfortunately, a significant portion of the patients (10%) die in the early period due to a severe clinical picture or because of wrong medical evaluation.
*The mortality rate in the first 30 days is approximately 50%.
*The average age of incidence is around 55-60 and it is slightly higher in women than men (3/2).
*Again, the frequency of bleeding is higher in spring and autumn.
*The probability that it may occur during sleep (30%) is a significant danger.
*Survival is approximately 50%, of which only 33% are able to return to their former lives.
*30% of survivors have to lead a bedridden life.
Why Does An Aneurysm Occur?
• Thin and weak vessel wall (congenital)
• Arteriosclerotic changes in vessel wall
• Trauma
• Infection
• Hypertension
• Use of cigarettes, alcohol, addictive substances
• Birth control drugs
• Having the disease in one of the family members can be counted.
What are the signs and symptoms of the disease?
When aneurysms rupture and bleed, patients brought to the hospital complain of a sudden and severe headache, often accompanied by vomiting and sometimes temporary loss of consciousness. Patients describe it as the most severe headache they have ever experienced in their lives. Most patients have a history of mild warning headache a few months ago, which resolves within 1 day. Patients with an unruptured and non-bleeding aneurysm; They apply with complaints such as headache, olfactory disorder, double vision, dilated pupils, and decreased visual acuity.
How Is Aneurysm Detected?
• It can be detected incidentally in Brain Tomography and MRI performed for any reason
• If there are signs of compression on the cranial nerves (For example, impaired smell, double vision, visual impairment…)
• If the aneurysm has bled, it can be detected by further examinations.
Diagnosis and Treatment Methods:
Patients are evaluated by a team of neurosurgery, neurology and interventional neuroradiology specialists. In subarachnoid hemorrhages, the first non-medicated brain tomography gives sufficient information about whether there is bleeding or not. In the second stage, catheter angiography must be performed. After the examinations are completed, the same team determines the appropriate treatment option for the patient. The main treatment options in aneurysms are; SURGICAL TREATMENT and endovascular treatment are based on closing and deactivating the ruptured bubble with the help of a catheter inserted through the inguinal artery (Coil embolization method).
Purpose of surgical treatment; to eliminate the risk of re-bleeding by closing the aneurysm, to reduce the effects of the existing damage to the brain and to prevent the sequelae of cerebral hemorrhage that may occur in the late period.
