After 40, beware a sudden ‘thunderclap headache’ — cerebral aneurysms are often symptom-free
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Gangnam St. Peter's Hospital 26-06-23 08:18Main content
Someone with no symptoms at all may suddenly collapse with a severe headache. One cause is a ‘cerebral aneurysm’, a condition in which part of the wall of a brain blood vessel balloons out and which is often difficult to notice before it ruptures. Because rupture can lead to fatal cerebral hemorrhage such as subarachnoid hemorrhage, caution is needed.
Cerebral aneurysms are often called a ‘time bomb in the head’. Not every aneurysm ruptures straight away, however. The risk varies with size, location and shape, and with the patient's age and underlying conditions.
Professor SUH, Dae Chul of Interventional Neuroradiology at St. Peter's Hospital said, “An unruptured cerebral aneurysm causes no symptoms, so patients find it hard to notice on their own,” adding, “In summer in particular, heat waves and air conditioning can widen swings in blood pressure, so high-risk groups need to pay closer attention to their cerebrovascular health.”
Most cerebral aneurysms are 10 mm or smaller, but there are also giant aneurysms that grow to 25 mm or more. The exact cause is still not clearly understood. It is known, however, that repeated blood flow pressure on a weakened vessel wall damages the wall and reduces its elasticity, and that this process plays a part. Hypertension, smoking, family history and age are cited as risk factors.
As health screening and brain MRI and MRA examinations have increased, more patients are being found with unruptured cerebral aneurysms before any rupture occurs.
Rupture of a cerebral aneurysm is a leading cause of subarachnoid hemorrhage. Because there is a risk of rebleeding within 24 hours of the first hemorrhage, an emergency response is essential. Anyone with a sudden, severe headache or reduced consciousness should go to the emergency room without delay.
People with risk factors would do well to check proactively whether testing is needed. Those over 40 who have hypertension, a history of smoking, or a family history of cerebral aneurysm or cerebral hemorrhage are particularly advised to consult a specialist.
Testing is carried out with brain CT, MRI and MRA. Not everyone found to have a cerebral aneurysm undergoes surgery or a procedure straight away. The decision whether to monitor or to treat is made by assessing size, location, shape, whether it is growing, the risk of rupture and the patient's overall condition together.
Blood pressure management also matters in summer. Heavy sweating in hot weather makes dehydration likely, and repeatedly moving between high outdoor temperatures and air-conditioned indoor spaces can place a burden on the blood vessels and blood pressure. For people with hypertension or a risk of cerebrovascular disease, drinking enough water, refraining from excessive alcohol, avoiding abrupt temperature changes and checking blood pressure regularly all help.
When an unruptured cerebral aneurysm is found, a treatment strategy is set according to the patient's condition. Traditionally, ‘aneurysm neck clipping’, in which the skull is opened and the neck of the aneurysm is closed with a clip, has been performed. More recently, embolization, which reaches the aneurysm through the blood vessels without an incision, is also widely used.
In embolization, a thin catheter is usually inserted through the femoral artery in the groin and advanced to the cerebral vessels, and the inside of the aneurysm is then packed with coils or similar devices so that blood cannot enter. Recently, a variety of devices and methods have been developed to suit the shape and location of the aneurysm.
Among them, WEB (Woven EndoBridge) embolization is a treatment in which a mesh-like device is placed inside the aneurysm to block blood flow. It is drawing attention as a way of widening the treatment options for certain aneurysm shapes in which conventional coil embolization is difficult.
Professor SUH, Dae Chul said, “What matters most with a cerebral aneurysm is finding and managing it before it ruptures,” adding, “If an unruptured aneurysm is identified in advance, a strategy suited to the patient — follow-up imaging, surgery or an endovascular procedure — can be set to lower the risk of rupture.”
Source: Health Joongang (https://jhealthmedia.joins.com)
Cerebral aneurysms are often called a ‘time bomb in the head’. Not every aneurysm ruptures straight away, however. The risk varies with size, location and shape, and with the patient's age and underlying conditions.
Professor SUH, Dae Chul of Interventional Neuroradiology at St. Peter's Hospital said, “An unruptured cerebral aneurysm causes no symptoms, so patients find it hard to notice on their own,” adding, “In summer in particular, heat waves and air conditioning can widen swings in blood pressure, so high-risk groups need to pay closer attention to their cerebrovascular health.”
Most cerebral aneurysms are 10 mm or smaller, but there are also giant aneurysms that grow to 25 mm or more. The exact cause is still not clearly understood. It is known, however, that repeated blood flow pressure on a weakened vessel wall damages the wall and reduces its elasticity, and that this process plays a part. Hypertension, smoking, family history and age are cited as risk factors.
As health screening and brain MRI and MRA examinations have increased, more patients are being found with unruptured cerebral aneurysms before any rupture occurs.
Rupture of a cerebral aneurysm is a leading cause of subarachnoid hemorrhage. Because there is a risk of rebleeding within 24 hours of the first hemorrhage, an emergency response is essential. Anyone with a sudden, severe headache or reduced consciousness should go to the emergency room without delay.
People with risk factors would do well to check proactively whether testing is needed. Those over 40 who have hypertension, a history of smoking, or a family history of cerebral aneurysm or cerebral hemorrhage are particularly advised to consult a specialist.
Testing is carried out with brain CT, MRI and MRA. Not everyone found to have a cerebral aneurysm undergoes surgery or a procedure straight away. The decision whether to monitor or to treat is made by assessing size, location, shape, whether it is growing, the risk of rupture and the patient's overall condition together.
Blood pressure management also matters in summer. Heavy sweating in hot weather makes dehydration likely, and repeatedly moving between high outdoor temperatures and air-conditioned indoor spaces can place a burden on the blood vessels and blood pressure. For people with hypertension or a risk of cerebrovascular disease, drinking enough water, refraining from excessive alcohol, avoiding abrupt temperature changes and checking blood pressure regularly all help.
When an unruptured cerebral aneurysm is found, a treatment strategy is set according to the patient's condition. Traditionally, ‘aneurysm neck clipping’, in which the skull is opened and the neck of the aneurysm is closed with a clip, has been performed. More recently, embolization, which reaches the aneurysm through the blood vessels without an incision, is also widely used.
In embolization, a thin catheter is usually inserted through the femoral artery in the groin and advanced to the cerebral vessels, and the inside of the aneurysm is then packed with coils or similar devices so that blood cannot enter. Recently, a variety of devices and methods have been developed to suit the shape and location of the aneurysm.
Among them, WEB (Woven EndoBridge) embolization is a treatment in which a mesh-like device is placed inside the aneurysm to block blood flow. It is drawing attention as a way of widening the treatment options for certain aneurysm shapes in which conventional coil embolization is difficult.
Professor SUH, Dae Chul said, “What matters most with a cerebral aneurysm is finding and managing it before it ruptures,” adding, “If an unruptured aneurysm is identified in advance, a strategy suited to the patient — follow-up imaging, surgery or an endovascular procedure — can be set to lower the risk of rupture.”
Source: Health Joongang (https://jhealthmedia.joins.com)