June 29, 2022

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Unruptured intracranial aneurysm:  Surgery or keep observed?

Unruptured intracranial aneurysm:  Surgery or keep observed?

 

Unruptured intracranial aneurysm:  Surgery or keep observed? If there is a severe headache, it is really possible that there is an “explosion” in the head-intracranial aneurysm rupture and bleeding.

An aneurysm is not a tumor in the true sense. It is caused by various reasons that cause local cystic expansion of the arterial walls of the brain that bulge outward, resembling a “tumor” growing on the blood vessel. When the blood in the tumor is filled to the limit Sometimes it will rupture, causing fatal emergencies such as subarachnoid hemorrhage.

The mortality rate of intracranial aneurysms with first ruptured hemorrhage is 30%, and the mortality rate of rebleeding is as high as 60% to 80%. Most of the survivors have disabilities, so surgical treatment of ruptured aneurysms is the first choice.

With the improvement of detection level and people’s attention to health, the potential population of intracranial aneurysms has been discovered in recent years. In the two months before and after the Spring Festival, the Department of Neurosurgery of our hospital received a total of 40 patients with aneurysms, 13 of which were ruptured with bleeding, and the remaining 27 were unruptured. All were performed in clinical departments such as neurosurgery and neurology. It was accidentally discovered during MRA or CTA examinations. After evaluation by the department, 7 patients were cured and discharged after neurosurgery craniotomy or interventional embolization. Other patients were followed up regularly.

Unruptured intracranial aneurysm:  Surgery or keep observed?

What are the factors influencing the risk of aneurysm rupture?

There are many factors influencing the rupture and bleeding of unruptured aneurysms. Patient-related factors include: gender, age, history of smoking, history of hypertension, history of subarachnoid hemorrhage; factors related to aneurysm include: size, shape, and shape of aneurysm Location, presence or absence of ascos, multiple. The risk of aneurysm rupture requires a comprehensive assessment by neurosurgeons based on the above factors.

 

What are the causes of rupture of unruptured intracranial aneurysms?

The rupture of an intracranial aneurysm is sometimes accidental, but it boils down to the following reasons:

①Blood pressure factor: If the blood pressure fluctuates significantly, increase the probability of rupture;

②Factors for increased intracranial pressure: blocked stools can lead to increased abdominal pressure, leading to increased intracranial pressure;

③ Tension, sexual activity, and overly intense exercise can be induced;

④ Cerebrovascular sclerosis: Tobacco, alcohol, high-fat, high-calorie food can cause the disease and induce the development of the disease.

Unruptured intracranial aneurysm:  Surgery or keep observed?

 

 

How to choose the treatment of unruptured intracranial aneurysms?

The treatment of unruptured aneurysms should consider many factors, mainly including aneurysm factors and patient factors. The following types of unruptured intracranial aneurysms require surgical intervention:

①Symptomatic unruptured aneurysm;

②For asymptomatic aneurysms with a diameter >5 mm;

③ During the follow-up, an aneurysm with progressive enlargement and morphological changes was found;

④Because of unruptured aneurysm causing psychological disorders in patients, more active treatment strategies should be adopted.

Can unruptured intracranial aneurysms be treated with drugs?

For intracranial aneurysms that have occurred, no drug has been found to reverse it.

What should be paid attention to when considering conservative treatment for unruptured intracranial aneurysms?

The occurrence of aneurysms is not terrible, and patients do not need to be overly anxious. In response to the rupture of aneurysm, patients should quit smoking and control blood pressure, blood sugar, blood lipids and other factors. In daily life, maintain good bowel habits, avoid strenuous exercise, maintain a steady state of mind, and avoid irritability, excitement, anger, tension and other irritating emotions.

Experts recommend that an aneurysm is first discovered 6 to 12 months after imaging review, after the imaging is confirmed to be stable, it can be reviewed every year or every 2 years. For first-degree relatives who have a history of aneurysm, are older than 30 years old, and have a history of smoking, non-invasive imaging screening is recommended.

 

(source:internet, reference only)


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