What is a cerebral aneurysm?
A cerebral aneurysm is a localized thinning of the cerebral artery wall that protrudes outward to form a cystic “bubble”, mostly congenital.
Are aneurysms malignant?
No. Aneurysms are not tumors and are not considered benign or malignant.
Where are aneurysms commonly found?
Aneurysms are commonly found at the bifurcation of the cerebral arteries, such as the beginning of the posterior communicating artery, the bifurcation of the internal carotid artery, the anterior communicating artery, and the bifurcation of the middle cerebral artery.
How is an aneurysm diagnosed?
Cerebral angiography (DSA) is the “gold standard” for diagnosing cerebral aneurysms. DSA can identify the exact location, size, shape and course of the aneurysm, and provide a strong basis for further treatment planning.
Are there any risks associated with cerebral angiography?
In general, cerebral angiography is relatively safe. However, because it is an invasive test, a 2mm-thick catheter is inserted through the femoral artery and injected into the large blood vessels, and then the intracranial cerebral vessels are radiographed. The risks include drug allergy, bleeding at the puncture site, and very few patients experience intracranial complications such as stroke, with a transient complication rate of 0.4% and a permanent complication rate of 0.2%.
Do aneurysms always bleed?
Not necessarily. Generally speaking, the annual rupture rate of unruptured intracranial aneurysms found on physical examination is about 2%, and the relative bleeding rate is higher in sites with irregular morphology and strong blood flow impact. Once an aneurysm bleeds, there are often serious sequelae and even life-threatening consequences.
What are the symptoms of an aneurysm?
There are usually no obvious symptoms when the aneurysm has not ruptured. Larger aneurysms may have hemiplegic headache and droopy eyelids. The main symptoms of a ruptured aneurysm include severe headache (cracking), nausea and vomiting, and in severe cases, unconsciousness.
What should I do for an aneurysm?
There are currently two types of treatment: craniotomy and minimally invasive interventional embolization. The literature and statistics suggest that the recurrence rate of open surgery is low, but the risk and complication rate of surgery is high, while the risk and complication rate of minimally invasive interventional embolization is lower than that of open surgery, and the recovery is faster, and the relative recurrence rate is higher than that of open surgery, and with the progress of interventional technology and interventional embolization materials, the recurrence rate of interventional embolization surgery has a tendency to decrease.
Can aneurysms be treated with drugs?
No.
Which is better, open surgery or minimally invasive interventional embolization?
This depends on the patient’s specific situation, especially the shape of the aneurysm, and it is not possible to say absolutely which one is better.
Which option is less risky?
Minimally invasive interventional embolization is relatively less traumatic in medical terms.
How is minimally invasive embolization done?
Minimally invasive interventional embolization is performed by inserting an embolic spring coil into the sac cavity of the aneurysm through a special catheter, which forms a thrombus in the aneurysm cavity and prevents blood from flowing into the aneurysm, thereby reducing its bleeding rate and curing the aneurysm. The recurrence rate is significantly reduced after aneurysm dense filling.
Can aneurysms recur after surgery?
Most people do not have recurrence after complete clamping.
Can craniotomy result in hemiplegia?
Although the relative risks and complication rates of craniotomy are higher than those of interventional embolization, most patients will not have hemiplegic sequelae.
Is the cost of craniotomy and minimally invasive interventions high?
The cost varies from case to case and is generally related to the location, shape, size and length of hospital stay of the aneurysm, ranging from tens of thousands to hundreds of thousands of RMB. Most of the materials for aneurysm intervention embolization are now covered by medical insurance reimbursement.