Cerebral Aneurysms

Incidence

Diagnosis

Treatment Options

Daniel A Capen MD

Cerebral Aneursyms

Cerebral Aneurysms

Associated with Hernia, Peripheral Aneurysm

1 in 50 in US Population

1% of population at autopsy

At or Near Circle of Willis

At Arterial Junctions

Types of Aneurysms

Saccular—”Berry” Most Frequent

Fusiform –Usually do Not Rupture

Charco-Bouchard –Usually <15mm –Hypertension- Usually Slow Bleed

Giant Aneurysm > 2.5 cm Always Risk for Sudden Death or Hemorrhagic Stroke

Types of Aneurysms

Aneurysm Risk Factors

Marfan Syndrome

Polycystic kidney Disease

Neurofibromatosis

Hereditary Telangectasia

Ehlers – Danlos Type II and IV

CAUSES of Aneurysm

Genetic Tendency

Weakness of Connective Tissue

High Blood Pressure

Mycosis, Infection, Trauma

Drug Abuse—Cocaine, Amphetamines

SIGNS AND SYMPTOMS

Headache

Nausea- Vomiting

Confusion

Visual Disturbance

Focal Facial Numbness

Meningismus

Focal Neural Defecit

Sudden Coma

Diagnosis

CAT SCAN with Angiography

MRI for post- aneurysm Bleed

Screen For Any Of Risk Patients

Angiography

Treatment Options

Observation if Diagnosed But No Symptoms

Endovascular Embolization or Coil

Craniotomy For Clipping

Cerebral Aneurysms

Treatment Options

Results With Rupture

40% Mortality Rate

15% Die Before Reaching Hospital

Female > Male For Rupture

Once Aneurysm Ruptures >60% Have Permanent Neurologic Deficits

Multiple Aneurysms

Cerebral Aneurysms

Diagnosis

Types Of Aneurysms

Multiple Aneurysms