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Aneurysm

Aneurysm - splenic artery; Aneurysm - popliteal artery; Aneurysm - mesenteric artery

 

An aneurysm is an abnormal widening or ballooning of a part of an artery due to weakness in the wall of the blood vessel.

Causes

 

It is not clear exactly what causes aneurysms. Some aneurysms are present at birth (congenital). Defects in some parts of the artery wall may be a cause.

Common locations for aneurysms include:

  • Major artery from the heart such as the thoracic or abdominal aorta
  • Brain (cerebral aneurysm)
  • Behind the knee in the leg (popliteal artery aneurysm)
  • Intestine (mesenteric artery aneurysm)
  • Artery in the spleen (splenic artery aneurysm)

High blood pressure, high cholesterol, and cigarette smoking may raise your risk for certain types of aneurysms. High blood pressure is thought to play a role in abdominal aortic aneurysms. Atherosclerotic disease (cholesterol buildup in arteries) may also lead to the formation of some aneurysms. Certain genes or conditions such as fibromuscular dysplasia can result in aneurysms.

Pregnancy is often linked to the formation and rupture of splenic artery aneurysms.

 

Symptoms

 

The symptoms depend on where the aneurysm is located. If the aneurysm occurs near the body's surface, pain and swelling with a throbbing lump is often seen.

Aneurysms in the body or brain often cause no symptoms. Aneurysms in the brain may expand without breaking open (rupturing). The expanded aneurysm may press on nerves and cause double vision, dizziness, or headaches. Some aneurysms may cause ringing in the ears.

If an aneurysm ruptures, pain, low blood pressure, a rapid heart rate, and lightheadedness may occur. When a brain aneurysm ruptures, there is a sudden severe headache that some people say is the "worst headache of my life." The risk of coma or death after a rupture is high.

 

Exams and Tests

 

The health care provider will perform a physical exam.

Tests used to diagnose an aneurysm include:

  • CT scan
  • CT angiogram
  • MRI
  • MRA
  • Ultrasound
  • Angiogram

 

Treatment

 

Treatment depends on the size and location of the aneurysm. Your provider may only recommend regular checkups to see if the aneurysm is growing.

Surgery may be done. The type of surgery that is done and when you need it depend on your symptoms and the size and type of aneurysm.

Surgery may involve a large (open) surgical cut. Sometimes, a procedure called endovascular embolization is done. Coils or stents of metal are inserted into a brain aneurysm to make the aneurysm clot. This reduces the risk for rupture while keeping the artery open. Other brain aneurysms may need to have a clip placed on them to close them off and prevent a rupture.

Aneurysms of the aorta may be reinforced with surgery to strengthen the blood vessel wall.

 

When to Contact a Medical Professional

 

Call your provider if you develop a lump on your body, whether or not it is painful and throbbing.

With an aortic aneurysm, go to the emergency room or call 911 if you have pain in your belly or back that is very bad or does not go away.

With a brain aneurysm, go to the emergency room or call the local emergency number (such as 911) if you have a sudden or severe headache, especially if you also have nausea, vomiting, seizures, or any other nervous system symptom.

If you are diagnosed with an aneurysm that has not bled, you will need to undergo regular testing to detect if it increases in size.

 

Prevention

 

Controlling high blood pressure may help prevent some aneurysms. Follow a healthy diet, get regular exercise, and keep your cholesterol at a healthy level to also help prevent aneurysms or their complications.

DO NOT smoke. If you do smoke, quitting will lower your risk for an aneurysm.

 

 

References

Britz GW, Zhang YJ, Desai VR, Scranton RA, Pai NS, West GA. Surgical approaches to intracranial aneurysms. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 383.

Cheng CC, Cheema F, Fankhauser G, Silva MB. Peripheral arterial disease. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 62.

Deaton DH. Arterial aneurysms: general considerations. In: Cronenwett JL, Johnston KW, eds. Rutherford's Vascular Surgery. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 129.

Text only

 
  • Cerebral aneurysm

    Cerebral aneurysm - illustration

    An aneurysm is a sac-like protrusion of an artery caused by a weakened area within the vessel wall. If a cerebral (brain) aneurysm ruptures, the escaping blood within the brain may cause severe neurologic complications or death. A person who has a ruptured cerebral aneurysm may complain of the sudden onset of "the worst headache of my life."

    Cerebral aneurysm

    illustration

  • Aortic aneurysm

    Aortic aneurysm - illustration

    Abdominal aortic aneurysm involves a widening, stretching, or ballooning of the aorta. There are several causes of abdominal aortic aneurysm, but the most common results from atherosclerotic disease. As the aorta gets progressively larger over time there is increased chance of rupture.

    Aortic aneurysm

    illustration

  • Intracerebellar hemorrhage - CT scan

    Intracerebellar hemorrhage - CT scan - illustration

    Intracerebellar hemorrhage shown by CT scan. This hemorrhage followed use of t-PA.

    Intracerebellar hemorrhage - CT scan

    illustration

    • Cerebral aneurysm

      Cerebral aneurysm - illustration

      An aneurysm is a sac-like protrusion of an artery caused by a weakened area within the vessel wall. If a cerebral (brain) aneurysm ruptures, the escaping blood within the brain may cause severe neurologic complications or death. A person who has a ruptured cerebral aneurysm may complain of the sudden onset of "the worst headache of my life."

      Cerebral aneurysm

      illustration

    • Aortic aneurysm

      Aortic aneurysm - illustration

      Abdominal aortic aneurysm involves a widening, stretching, or ballooning of the aorta. There are several causes of abdominal aortic aneurysm, but the most common results from atherosclerotic disease. As the aorta gets progressively larger over time there is increased chance of rupture.

      Aortic aneurysm

      illustration

    • Intracerebellar hemorrhage - CT scan

      Intracerebellar hemorrhage - CT scan - illustration

      Intracerebellar hemorrhage shown by CT scan. This hemorrhage followed use of t-PA.

      Intracerebellar hemorrhage - CT scan

      illustration

    A Closer Look

     

      Self Care

       

        Tests for Aneurysm

         
           

          Review Date: 4/4/2018

          Reviewed By: Luc Jasmin, MD, PhD, FRCS (C), FACS, Department of Surgery, Holston Valley Medical Center, TN; Department of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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