Symptoms and hazards of cerebral aneurysm Some aneurysms may not have any symptoms, such as small and medium-sized aneurysms. Some aneurysms may have the following symptoms: 1, compression symptoms: some medium and large aneurysms have corresponding compression symptoms: limited headache, eye pain, vision loss, nausea, neck stiffness and vertigo, the most common side of the eyelid ptosis (eyelids can not be opened), eye movement (abduction) is limited, and a small portion of the patients (large or huge type) have epilepsy, hyperalgesia, mild hemiplegia, aphasia and other manifestations. 2.Hemorrhagic symptoms: After aneurysm rupture, most of the patients show symptoms of subarachnoid hemorrhage (SAH), such as severe headache, nausea and vomiting, meningeal irritation, convulsions, etc., and then they may develop consciousness, coma, hemiplegia, etc. Some patients may suddenly fall down, deep coma, hemiplegia, etc., and some of them may have a sudden collapse. Some patients may suddenly collapse, deep coma, rapidly develop respiratory failure, and even die within a few minutes. The mortality rate is as high as 30-40%. Some aneurysms have triggers before rupture, such as exertion, cough, stool, etc. Some may have no triggers. Some aneurysms have no triggers. Most of the untreated ruptured aneurysms will bleed again, which is often more serious and dangerous than the last bleeding (mortality rate as high as 70～80%), therefore, aneurysms with a history of bleeding should be treated aggressively to prevent rebleeding. Examination 1, head CT is the preferred method for diagnosing SAH, and cranial MRI (magnetic resonance imaging) is the first examination method for patients with compression symptoms or asymptomatic patients. CT angiography (CTA) and magnetic resonance angiography (MRA) can be used to initially screen for aneurysms. 2. Cerebral angiography (DSA): It is the gold standard for the diagnosis of aneurysm, and can dynamically as well as three-dimensionally reconstruct the understanding of aneurysm, which is the main basis for decision-making on the treatment plan. Treatment of cerebral aneurysm There are currently two treatment methods: minimally invasive endovascular intervention (aneurysm embolization) and direct surgery (cranial aneurysm clamping). Each of these methods has its own advantages and disadvantages, and the choice of one or a combination of the two should be based on comprehensive consideration of the location, shape, number, and size of the aneurysm, its relationship with the surrounding tissues and blood vessels, as well as the patient’s age and other physical diseases. 1. Aneurysm embolization: It has the advantages of small trauma, relatively less operation time, fast recovery, and simultaneous treatment of multiple aneurysms in different parts of the left and right. The main use of micro-spring coil embolization of aneurysm cavity. DSA:Aneurysm: Aneurysm is no longer visible after embolization Aneurysms with a wide aneurysm neck opening, in order to prevent the spring coil from herniating into the aneurysm-carrying vessel, require balloon-assisted neck contouring and aneurysm neck stenting assisted techniques, which help to densely fill and preserve the aneurysm-carrying artery. Balloon-assisted shaping technique simulates the process of embolizing the aneurysm In the case of giant aneurysms, which are sometimes cured by occlusion of the aneurysm-carrying artery, a vascular balloon occlusion test (BOT) is required prior to the occlusion procedure. 2. Aneurysm clamping: After craniotomy, the neck of the aneurysm is clamped with an aneurysm clamp under the microscope, and the patency of the aneurysm-carrying artery is protected. In some cases where clamping is difficult, the aneurysm wall is reinforced with muscle sheets and biogel to prevent rebleeding (aneurysm wrapping). Intraoperative photo/aneurysm Intraoperative photo/clamping aneurysm 3. Other treatments after aneurysm rupture: Hemorrhage often leads to cerebral vasospasm, hydrocephalus, intraventricular hemorrhage, and intracerebral hematomas, which aggravate neurological dysfunctions and may lead to serious consequences, and therefore, appropriate treatments are needed depending on the circumstances, such as lumbar puncture placement of subarachnoid and ventricular drainage, hematoma removal and debridement, decompression surgery, and later cerebral surgery, as well as the use of a bone flap to reduce pressure. decompression surgery, and later cerebrospinal fluid shunting. Risks and complications of aneurysm treatment: Because cerebral aneurysms are inherently characterized by high rates of disability, mortality, and complications, there are greater risks and complications associated with aneurysm treatment and even cerebral angiography, such as headache, eye pain, vision loss or blindness, nausea, vertigo, ptosis, limited eye movement, epilepsy, aphasia, hyperalgesia, hemiparesis, intracerebral infections, consciousness disorders, deep coma, and even cerebral spinal fluid shunting. The causes are mostly due to hemorrhage compression of brain tissue, cerebral ischemia due to vascular compression and spasm, and cerebral edema, etc. The current techniques are difficult to avoid the above mentioned problems. It is difficult to avoid these risks and complications with the current technology. There is a certain percentage of recurrence after treatment of aneurysm, so regular review is required.