Neurosurgery


Aneurysm

Cerebral artery aneurysm is a permanent ballooning that emerges with weakening of cerebral vascular structure. They are frequently seen in bifurcation regions of the vessels and the structure that has ballooned out is less stable than a normal vessel.

Genetic factors, age, gender play an important role in the formation of brain aneurysms. Its incidence increases steadily after the age of 25, and it is most common in the age range of 45-60. It is 3 times more common in women than men. In addition, hypertension, diabetes, smoking, alcoholism, infections such as inflammation of blood, blows to the head play a role in the formation of an aneurysm.

More than 90% of brain aneurysms occur by rupture and bleeding of aneurysm. Such bleeding is a severe brain hemorrhage. Up to 50% of aneurysm bleeding is fatal. 25% of patients surviving after aneurysm bleeding suffer from permanent neurological disorders, partial paralysis, etc. and degradation of body functions. In more severe cases, coma may occur. Therefore, in the case of an aneurysm accompanied by brain hemorrhage, treatment should be carried out in a very well equipped center by effective operation of neurosurgery, intensive care and radiology departments.

Aneurysms do not usually show symptoms without bleeding. Due to the pressure applied by the aneurysm to the region in which it has developed, the following very rare symptoms may occur:

  • Speech disorders
  • Gait disorders
  • Loss of strength or sensation on one side of the body
  • Visual disturbances and pain in the eye region
  • Regional and persistent headaches
  • Dementia

When bleeding occurs as a result of brain vessel aneurysm, it manifests itself by a sudden, persistent headache with a severity that has never been experienced before, which is unmitigated by any means. This pain is accompanied by nausea and vomiting, stiffness in the nape which is so severe that the patient can not bend his head, sensitivity to light, and loss of sensation.

Today, there are three major treatment options for patients who are diagnosed with an aneurysm:

  • Observation and non-surgical treatment ( follow-up only )

The only treatment for an unruptured brain aneurysm is a medical treatment. Control of blood pressure is essential in medical treatment. Moreover, smoking and alcohol, which are among the factors causing aneurysm, should be given up during this process. Planning administration of drugs that lower blood pressure to control blood pressure and supporting the treatment by a proper diet and exercise program are essential. In this process, size of aneursym and whether it has grown or not should be monitored and for this purpose, radiographic examinations need to be done.

  • Surgical treatment and closure of the aneurysm ( clipping )

It is a permanent treatment method. A small window is opened in the skull and a metal clip is placed between neck of the aneurysm and the relevant vessel so entry of blood into the aneurysm is prevented. Clip application in the treatment of cerebral aneurysm performed for the first in 1937 and since then, it has been a frequently used method.

  • Stenting and blocking by intravenous ( endovascular ) treatment

Endovascular aneurysm treatment is based on reaching inside of aneurysm using catheters with very small diameter by angiography device, filling aneursym sac with metal wires with a very soft structure, called coils, and preventing entry of blood into the aneurysm. This process is called ”coiling aneursym”. It is the most widely used method in the treatment of aneurysms worldwide.