What is an intracranial aneurysm? Aneurysm is not a tumor, but a localized bulging of the vessel wall due to weakness of the arterial vessel wall under the constant impact of blood flow. Therefore, intracranial aneurysm is like a balloon blown up on the wall of cerebral blood vessels. Under the stimulation of mental tension, emotional excitement, exertion, forceful defecation, heavy lifting, going upstairs, sexual life and other triggering factors, the sudden increase of blood pressure at any time triggers the rupture of intracranial aneurysm and causes subarachnoid hemorrhage, which threatens the life of patients. According to statistics, the mortality rate after the first rupture of intracranial aneurysm is about 30-40%. What’s more, the chance and risk of re-rupture of aneurysm after bleeding are greatly increased, about 40-60% of patients will have re-rupture within one month after aneurysm bleeding, and the mortality rate after the second rupture is about 60-80%. Therefore, intracranial aneurysm is like an “unscheduled bomb” buried in the brain, which is at risk of rupture at any time. Who is the most common group of aneurysms? What are the signs and symptoms of aneurysm? Aneurysms can occur at any age, with the majority occurring in middle-aged people between the ages of 40 and 60. The most common symptom is a sudden severe headache caused by a small amount of blood leaking from the aneurysm; in addition, symptoms related to the enlargement of the aneurysm and compression of adjacent nerves, such as inability to open one eye and double vision. If you suspect the above symptoms, you should go to a hospital immediately to seek medical consultation. It is important to note that headaches caused by cerebral aneurysms have distinctive features. Once a brain aneurysm ruptures, a sudden, severe headache like a splitting headache usually occurs, rather than a slow headache little by little. The headache may extend to the neck, shoulders, lower back and lower extremities, and is accompanied by nausea, vomiting, pallor, and cold sweats, and more than half of the patients experience varying degrees of confusion. It is worth noting that about 20% of patients tend to have headaches only, and can even have recurrent attacks, similar to what people often call vascular headaches. Therefore, when a headache occurs for the first time or is of a different nature than before, it is important to undergo an aggressive vascular examination to rule out an intracranial aneurysm, which is an extremely dangerous condition. How can aneurysms be detected? With the advancement of medical imaging technology and the widespread use of CT and MR, the early detection of intracranial aneurysm by non-invasive examination methods has become a reality; CTA and MRA are simple and easy to perform with an accuracy rate of over 85%. However, the most accurate test is digital subtraction angiography (DSA), which is still the “gold standard” for diagnosing intracranial aneurysms. For this reason, cerebral angiography should be performed as soon as possible when an aneurysm is detected by a non-invasive test or when an aneurysm is highly suspected. How is an intracranial aneurysm treated? For the treatment of intracranial aneurysm, the key is early detection and early treatment. In fact, intracranial aneurysm is not terrible, it is a disease that can be completely cured, what is terrible is that people do not realize the importance of early treatment. In developed countries such as Europe and America, at least 70% of aneurysms are detected and treated in time before they rupture. In China, this percentage is very low, not even 5% in most areas. The most commonly used methods are craniotomy and endovascular embolization. Craniotomy clamping is the main means to completely cure aneurysm, which is done by surgically exposing the neck or the aneurysm-carrying artery and clamping it with a titanium clip to isolate the aneurysm from the circulation, thus reducing its risk of rupture. At present, this method is still the main means of treating cerebral aneurysm in China. It can remove the hematoma intraoperatively, and intraoperative leakage can reduce the incidence of hydrocephalus, and it can resect the huge aneurysm and release the occupying effect, with low cost and low rebleeding rate, but it is relatively traumatic and requires good surgical tolerance of patients. Endovascular embolization, which is often referred to as interventional therapy, requires only a small 2-3 mm opening with a needle at the root of the thigh, a very fine catheter and guidewire inserted into the cerebral aneurysm within the vessel, and then the aneurysm cavity is gradually filled through microcatheters delivering microspring coils, etc. until the aneurysm is completely occluded for the purpose of cure. Such a surgical method is characterized by less trauma and faster recovery, but is relatively more expensive. It should be reminded that since nearly half of the patients will experience rebleeding within the first month after intracranial aneurysm rupture, once the presence of intracranial aneurysm is highly suspected or has been clearly established, all should reach the hospital that is in a position to treat it within the shortest possible time!