Aneurysm of cerebral vessels

Aneurysm of cerebral vessels is a local expansion of the arteries, most often the arterial circle of the big brain (the Willis circle).

Etiology. As a rule, an aneurysm is a congenital defect, sometimes a consequence of an infection (an emotional or a mycotic aneurysm). The role of trauma, atherosclerosis, hypertension play a role.

Pathogenesis. Objective neurological disorders with an unexploded aneurysm are rare and are caused by mechanical pressure on adjacent intracranial structures. Aneurysm rupture leads to subarachnoid or parenchymal-subarachnoid hemorrhage (see Brain stroke).

Symptoms, course. There are apoplectic and much more rare paralytic (tumor-like) forms of aneurysm. An aneurysm for many years can be asymptomatic. In 25% of cases, patients suffer from episodic cephalgia, which in half the cases are similar to the migraine clinic. The paralytic type of an aneurysm is characterized by a slowly progressing lesion of individual cranial nerves, most often the oculomotor and visual, and sometimes hemispheres of the brain or its trunk. As a rule, patients suspect a brain tumor or basal arachnoiditis. Reliable diagnosis is only possible with angiography. In some cases, it reveals not saccular aneurysm, but arteriovenous angioma. This congenital vascular defect (malformation) is clinically characterized by signs of focal brain lesions and convulsive seizures. With auscultation of the head, vascular noise is sometimes heard. In addition to the compression of the brain, malformation, as a rule, is manifested by repeated subarachnoid hemorrhages; In contrast to aneurysms, subarachnoid hemorrhages caused by angiomas can occur in childhood.

Treatment is surgical.