An aneurysm (or aneurism) ( ) is a localized, blood-filled dilation (balloon-like bulge) of a blood vessel caused by disease or weakening of the vessel wall.
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An aneurysm (or aneurism) ( ) is a localized, blood-filled dilation (balloon-like bulge) of a blood vessel caused by disease or weakening of the vessel wall.
Aneurysms most commonly occur in arteries at the base of the brain (the circle of Willis) and in the aorta (the main artery coming out of the heart, a so-called aortic aneurysm). As the size of an aneurysm increases, there is an increased risk of rupture, which can result in severe hemorrhage or other complications including sudden death.
Diagnosis
Diagnosis of a ruptured cerebral aneurysm is commonly made by finding signs of subarachnoid hemorrhage on a CT scan (Computed Tomography, sometimes called a CAT scan, a computerized test that rapidly X-rays the body in cross-sections, or slices, as the body is moved through a large, circular machine). If the CT scan is negative but a ruptured aneurysm is still suspected, a lumbar puncture is performed to detect blood in the cerebrospinal fluid (CSF). Computed Tomography Angiography (CTA) is an alternative to the traditional method and can be performed without the need for arterial catheterization. This test combines a regular CT scan with a contrast dye injected into a vein. Once the dye is injected into a vein, it travels to the brain arteries, and images are created using a CT scan. These images show exactly how blood flows into the brain arteries.
Classification
Aneurysms can be classified in several different ways:
- True or false
- Morphology
- Location
- Arterial vs. venous
- Underlying condition
True or false
In a true aneurysm the inner layers of a vessel have bulged outside the outer layer that normally confines them. The aneurysm is surrounded by these inner layers.
A false- or pseudoaneurysm does not primarily involve such distortion of the vessel. It is a collection of blood leaking completely out of an artery or vein, but confined next to the vessel by the surrounding tissue. This blood-filled cavity will eventually either thrombose (clot) enough to seal the leak or it will rupture out of the tougher tissue enclosing it and flow freely between layers of other tissues or into looser tissues. Pseudoaneurysms can be caused by trauma that punctures the artery and are a known complication of percutaneous arterial procedures such as arteriography or of arterial grafting or of use of an artery for injection, such as by drug abusers unable to find a usable vein. Like true aneurysms they may be felt as an abnormal pulsatile mass on palpation.
Morphology
Aneurysms can be described by their shape. Traditionally, they are described as either "fusiform" (resembling a narrow cylinder) or "saccular" (berry) (resembling a small sac), though alternatives have been proposed.
Location
Most frequent (?%) site of occurrence is in the anterior cerebral artery from the circle of Willis.
