Diagnosis and treatment of cerebral aneurysm Cerebral aneurysm rupture and bleeding has a very high mortality and disability rate! What exactly is a brain aneurysm? What is the treatment of cerebral aneurysm and what are the alternatives to craniotomy? Here is a brief introduction. A brain aneurysm is a clinical condition in which the wall of the cerebral artery gradually thins and expands abnormally due to local defects and increased intraluminal pressure. The occurrence of cerebral aneurysm is related to congenital factors (there is a certain family tendency), but it is more often related to hypertension, atherosclerosis, infection, trauma and so on. The disease is more common in middle-aged and elderly people aged 40-60 years, with a slightly higher incidence in women than in men. Among the cerebrovascular accidents, cerebral aneurysm ranks third after cerebral thrombosis and hypertensive cerebral hemorrhage. Because of the weakness of the muscle layer of the arterial wall and the greatest impact of the blood, the weak point of the arterial wall expands outward and eventually forms an aneurysm under the pressure and impact of long-term blood flow. A cerebral aneurysm is like a balloon blown up on the wall of cerebral blood vessels, which may rupture at any time. When a sudden increase in blood pressure is caused by mental tension, emotional excitement, exertion, violent head swing, bending over, getting up sharply, drinking alcohol, straining to defecate, lifting heavy objects, going upstairs, or having sex, it can easily cause rupture and bleeding, which can threaten the patient’s life. According to statistics, the mortality rate of cerebral aneurysm after the first rupture is 30%, and it will also occur the second and third rupture. According to statistics, 40-50% of patients will have the second rupture within one month after the rupture, and the mortality rate is about 70% after the second rupture and 100% after the third rupture. Sometimes, although the aneurysm does not rupture, it can compress the nearby nerves because of the increase in size, thus causing corresponding symptoms, such as inability to open one eye, double vision, hemianopia, loss of vision, and facial pain. Therefore, once you have severe headache or unexplained cerebral nerve symptoms, you should consider the possibility of having a cerebral aneurysm. You should immediately go to a hospital for a cerebrovascular examination (such as CTA, MRA, DSA, etc.) to exclude or clarify a cerebral aneurysm, and visit a neurosurgery department. The main measures are to control various risk factors that can trigger aneurysm rupture, such as controlling blood pressure, quitting smoking, avoiding stress or relaxing by various methods, and also to perform regular imaging examinations to monitor the size and development of the aneurysm. For ruptured aneurysms and larger unruptured aneurysms, surgical treatment is the only correct option. In addition to traditional open surgical clamping, endovascular interventions are available. The latter is a minimally invasive treatment that involves merely puncturing a small hole in the patient’s blood vessel at the root of the thigh and filling the aneurysm through the delivery and manipulation of a microcatheter to stop the bleeding and prevent rebleeding. The patient suffers little pain and recovers quickly. As to whether open surgery or endovascular intervention is better for each patient’s aneurysm, the decision should be made by a specialized neurosurgeon based on the patient’s specific situation.