What is an aneurysm?
Arteries are made up of three layers, the intima, the media and the outer layer. When an aneurysm occurs, it is due to weakness of the middle layer, which does not exist, forming a balloon that can bleed and cause a stroke. These aneurysms have some important risk factors, caused by smoking, infections, trauma, drug use, tumors…
What are the risk factors?
The risk factors that contribute most to aneurysm rupture are smoking and hypertension. But there are other factors that are hereditary and familial: trauma, infectious tumors and drug use.
What are its symptoms and how is it diagnosed?
The alarm signs and symptoms must be differentiated between ruptured and non-ruptured patients. In the unruptured ones, they may present dilated pupils, headaches, eye pain, drooping eyelid, etcetera. And in those that bleed, which unfortunately have a mortality rate of more than 50%, it is a stroke that can lead in most cases to a loss of consciousness or coma, or an insufferable pain similar to meningitis. The diagnosis is mainly made clinically, but from the imaging point of view it can be seen by brain scan, MRI and angioresonance. And, to definitively see the form of treatment, is the superselective cerebral angiography.
What treatments are there?
From the point of view of treatment, which at present and in our department is endovascular in more than 95% of cases, there are four modalities. The simple modality, which would be the ideal, using only platinum coils to fill the aneurysmal sac. Another possibility is to place a stent and through it introduce coils in case of wide neck to prevent them from protruding into the normal artery. A very effective technique is the remodeling technique, i.e., we place a catheter in the aneurysm and a balloon blocking the entrance of the aneurysm to fill the aneurysm sac. The fourth technique that we have been using for some years is to place a flow shunt, ie, a stent that allows the passage of blood to the normal artery blocking the entry into the aneurysm occluding it completely.