Beware of headaches and dizziness! Brain aneurysms can be fatal if ruptured

Text/Yangcheng Evening News All Media Reporter Zhang Hua

Figure/respondent provided

Eyelids drooping suddenly and uncontrollably; severe headache, dizziness, nausea and vomiting… These symptoms are likely to be the signal of rupture of intracranial aneurysm.

Recently, Professor Qi Songtao, director of neurosurgery of Nanfang Hospital, said in an interview with reporters that after entering autumn and winter, patients with hypertension, diabetes, and atherosclerosis should pay attention to preventing intracranial aneurysms (also known as cerebral aneurysms). Experts also pointed out that in recent years, intracranial aneurysms tend to be younger, because young people’s bad living habits lead to damage to cerebral blood vessels and the formation of intracranial aneurysms. And once the intracranial aneurysm ruptures, it is very likely to cause subarachnoid hemorrhage, and about 30%-50% will die without emergency treatment in the hospital.

Professor Qi Songtao, Director of Neurosurgery, Southern Hospital

Difficulty surviving after 30%-50% of aneurysms bleed

How do intracranial aneurysms form?

Professor Feng Wenfeng, director of the Neurosurgery and Cerebrovascular Subspecialty Department of Nanfang Hospital, explained that intracranial aneurysms are caused by local congenital defects in the intracranial arterial wall, acquired vascular wall damage, and blood flow impact. The small bubbles that come out and appear on the blood vessel wall are like blowing up a balloon, which is an intracranial aneurysm. It is clear that the aneurysm is not a tumor, but a blood blister that bulges outward from the blood vessel wall.

Cerebrovascular damage comes from two aspects: on the one hand, congenital abnormal development of blood vessels, many children and young people have aneurysms; high blood pressure, etc.

Professor Feng Wenfeng pointed out: “In recent years, cerebral aneurysms have become younger, because many young people have bad eating habits and poor living habits. The proportion of high blood pressure, obesity, hyperlipidemia is not low, coupled with smoking and drinking, etc. , which makes their brain blood vessels damaged at a young age.”

Clinically, due to magnetic resonance angiography, CT angiography and other examinations, more and more people have been found to have intracranial aneurysms. Professor Feng Wenfeng said that according to current statistics, the detection rate of intracranial aneurysm is 2%-7%. “The common small aneurysm is less than 3 mm in diameter, while the small to medium aneurysm is 3-10 mm. Small and medium aneurysms in the brain often do not have any symptoms, so screening is difficult, but if the aneurysm ruptures Bleeding has serious consequences and a very high fatality rate. According to statistics, 30%-50% of aneurysms are difficult to survive after bleeding. This is why we attach great importance to intracranial aneurysms.” Professor Feng Wenfeng said.

Be vigilant and deal with it quickly within 24 hours

   “Clinically, we have many aneurysm patients from ophthalmology, endocrinology and neurology. Therefore, we believe that not only the public should be vigilant about aneurysms, but also medical staff should be aware of the different manifestations of aneurysms.” Professor Feng Wenfeng said that a 35-year-old woman had a severe headache recently. After the relief, her left eyelid drooped and she couldn’t lift it up. After seeing the ophthalmologist, the doctor found nothing unusual. The family still felt that something was wrong, and an MRI examination was performed in the hospital, and it was found that there was an aneurysm in the cerebral blood vessels, and it was this aneurysm that caused the damage to the ocular nerve.

Professor Qi Songtao, director of neurosurgery at Nanfang Hospital, said: “Ruptured intracranial aneurysm is the most common cause of spontaneous subarachnoid hemorrhage. Sometimes there is a small amount of bleeding, but this means that a large amount of bleeding will come soon, and this time is The most critical window for patients to be rescued, therefore, anyone who has a sudden severe headache should actively go to the hospital for cerebrovascular screening, without letting go of any potential patient or giving up any opportunity for treatment.”

Professor Qi Songtao also emphasized that patients with severe headache and high suspicion of aneurysm hemorrhage must be immediately sent to a large neurosurgery center for treatment. Generally speaking, emergency treatment within 48 hours, preferably within 24 hours, because the location of the aneurysm is different, the size is different, and the bleeding situation is different. Therefore, the sooner the aneurysm is detected, the sooner the treatment effect will be better. it is good.

Large neurosurgery centers were chosen because of the complexity of aneurysm management.

Professor Qi Songtao said: “At present, for the treatment of nerve aneurysms, more and more experts prefer endovascular interventional therapy, but microsurgical techniques are still the basis and guarantee, that is, when the blood vessels are ruptured and embolized during intervention, Surgical craniotomy is still required when the embolized vessel is blocked. Usually, for aneurysms with good clinical condition and low grade, aneurysm clipping or interventional embolization can reduce the risk of rebleeding. For patients with higher risk of rebleeding, especially It is a young high-grade patient who is suitable for early surgical intervention.”

If it is an unbroken aneurysm, the treatment method is relatively simple. “For large, giant and other complex intracranial aneurysms, we use the Pipeline blood flow to guide the dense mesh stent to give the problem blood vessels and re-strip new ones. On the way, the operation time is greatly shortened.” Director Feng Wenfeng said.

According to the reporter’s understanding, the neurosurgery of Nanfang Hospital is a key specialty in the country and one of the most important neurosurgery bases in the country. The hospital participated in the release of important domestic guidelines for the treatment of cerebrovascular diseases.

Professor Feng Wenfeng, Director of Neurosurgery and Cerebrovascular Subspecialty Department of Southern Hospital

Physical examination of high-risk groups plus non-invasive examinations such as CTA

Once an aneurysm ruptures, nearly 30% to 50% of patients die before reaching the hospital. After the other half arrives at the hospital, many patients are still in danger of life and have different degrees of functional impairment, which also brings difficulties to the patient’s own life and family and society, so prevention is very important.

Prof. Songtao Qi pointed out that there are various methods of examination. CTA, MRA and DSA are the main types of examinations for cerebral aneurysms. Aneurysms can be screened out through imaging or artificial intelligence. handled very aggressively.

 “Of course, how to screen out intracranial aneurysms from the population is very important.” Professor Qi Songtao believes that people with high risk factors should be careful, such as hypertension, diabetes and vascular atherosclerosis, breathing and sleep disorders of patients, who are more likely to develop aneurysms due to structural damage to the vessel walls. In addition, people who drink, smoke, and have a family history of aneurysms should be given special attention in routine screening. Generally speaking, the predisposing age of aneurysm is between 40-60 years old. After the age of 40, if conditions permit, it is recommended to do a non-invasive examination such as CTA and MRA. When a patient is found to have any signs of an aneurysm, it should be evaluated by a specialist, treated aggressively, and followed up regularly.

It is worth reminding that the common symptoms caused by intracranial aneurysm include headache, dizziness, eye pain, ptosis, visual disturbance, diplopia, epilepsy, etc. It may also be bleeding from the aneurysm, or not much bleeding. It’s an early warning sign, so be careful. (For more news, please pay attention to Yangcheng Pie

Source | Yangcheng Evening News Yangcheng School

Editor in charge | Liu Xinyu

Proofreading | Peng Jiye