Cerebral aneurysm – a silent culprit causing strokes

A cerebral aneurysm is a condition in which a segment of a blood vessel in the brain swells or bulges from a weak spot in the endothelium of the vessel wall. “It is estimated that about 5% of the population has a cerebral aneurysm,” said Chu Tan Si, M.D., M.D., Head of Neurosurgery Department, Tam Anh General Hospital, Ho Chi Minh City, adding that the disease often progresses silently. so it is rarely detected early. Patients often know they have an aneurysm when they accidentally have a neurological examination.

This condition can occur at any age, often due to congenital causes, hypertension, atherosclerosis, or head trauma. Excessive exercise, drinking too much alcohol, smoking, and stress are also risk factors.

When the aneurysm ruptures, blood can spill into the brain, causing hemorrhage. Symptoms are severe headaches, which may be accompanied by nausea or vomiting, body weakness, facial distortion, and dizziness. Patients may also have seizures, sensitivity to light, stiff neck, loss of consciousness, and cardiac arrest. Rupture of a cerebral aneurysm causes subarachnoid hemorrhage, a dangerous form of stroke. A ruptured aneurysm can also lead to stroke and ischemic stroke by causing vasospasm and reducing blood flow to the brain.

According to Dr. Tan Si, the risk of re-rupture of an aneurysm within 72 hours after the first rupture is quite high, up to 23%. Re-rupture is often more serious. If not treated promptly, the patient has a high risk of death. A second brain hemorrhage can cause permanent brain damage.

Dr. Tan Si said that patients with small aneurysms under 7 mm, with no signs of rupture or serious symptoms, usually do not need immediate treatment intervention. However, patients need to have regular check-ups, at least 1-2 times per year so that doctors can monitor the progression of the aneurysm, using assessment tools such as the PHASE score to determine risk. The PHASE score evaluates the risk of rupture of a cerebral aneurysm based on factors such as age, ethnicity, location, aneurysm size, history of bleeding from another aneurysm or hypertension.

Doctors often prescribe surgery or endovascular intervention to remove promptly to avoid the risk of rupture for aneurysms that are 7 mm or larger in size or show signs of rapidly increasing in size, threatening to rupture, causing significant symptoms. fear.

Diagnostic imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI) or digital subtraction angiography (DSA) assist doctors in detecting and assessing the location, size, and risk of the disease. rupture muscle of the aneurysm. From there, the doctor offers appropriate treatment for each case.

For example, with surgical sacs, modern equipment such as AI brain surgery robots help the team safely access the aneurysm, limit damage to the brain structure and surrounding nerve fiber bundles, and slowly remove the aneurysm. Or the doctor uses a less invasive method of endovascular intervention to occlude or redirect blood flow away from the aneurysm site. Then, remove the aneurysm from the cerebrovascular circulation.

In case the aneurysm rupture causes a stroke and hemorrhagic stroke, the surgical team can choose the method of awake brain surgery using a brain surgery robot. The patient is awake and able to interact with the doctor during the surgery, bringing many advantages and improving treatment effectiveness. At Tam Anh General Hospital, surgeons performed emergency surgery on brain hemorrhage using awakening brain surgery using the new ENRICH technique.

Regular general health and cranial nerve health checks help patients have the opportunity to early detect brain aneurysms as well as other problems to prevent unexpected strokes.

A stroke is a medical emergency that occurs when blood flow to the brain is cut off due to a clogged or ruptured blood vessel, causing brain cells to quickly die. Patients need to be taken to a medical facility with expertise in stroke emergency care quickly and properly. It is best to take a stroke person to the hospital by ambulance, with a team of doctors and emergency specialists on board.

The “golden” time in stroke emergency care is about the first 3-4.5 hours (for strokes due to cerebral vascular occlusion) and the first 6-8 hours (for strokes due to ruptured cerebral blood vessels) from the onset of symptoms. proof. Depending on the case and intervention method, emergency time can be extended up to 24 hours or more. The earlier the emergency treatment, the higher the effectiveness of treatment and recovery.