The key to treating all emergency diseases is the ‘golden time shooter’. However, once ruptured, even this ‘golden time’ becomes meaningless, a disease that is a cerebral aneurysm. A rupture of a cerebral aneurysm can be sufficiently prevented with early diagnosis and appropriate treatment. How to deal with it wisely?
The cerebral arteries play an important role in supplying blood to the brain. It is a blood vessel that receives a lot of hemodynamic stress because it repeatedly increases and decreases according to changes in blood pressure. When oxidative stress increases due to the accumulation of such hemodynamic stress or a sharp increase in free radicals in the body, a specific part of the brain artery swells like a ‘balloon’ or ‘balloon’. This is called a ‘cerebral aneurysm’, and if the aneurysm ruptures if left unattended, it leads to subarachnoid hemorrhage (cerebral hemorrhage).
A cerebral aneurysm is difficult to detect because there are no symptoms until it ruptures. However, in rare cases, symptoms such as strabismus, double vision, and ptosis (drooping eyelids) due to cranial nerve compression may appear. When a cerebral aneurysm ruptures, blood flows into the subarachnoid space of the brain, and symptoms such as severe headache and vomiting appear as ‘like being hit in the head with a sledgehammer’ or ‘like being struck by lightning in the head’. Depending on the bleeding pattern, paralysis or speech impairment may occur, and in severe cases, death may occur.
Seo Dae-cheol, head of the clinical department of neuro-interventional medicine at Gangnam Peter Hospital, advised, “If you experience drooping eyelids along with a headache, this is a precursor to a ruptured brain aneurysm, so you should see a specialist for treatment immediately.”
The cause of cerebral aneurysm has not yet been clearly elucidated. However, the most representative risk factors include high blood pressure, arteriosclerosis, diabetes, and smoking. Women are 1.6 times more likely to develop a brain aneurysm than men, 1.5 times more likely to develop high blood pressure, 2 times more likely to develop heart disease, and 1.8 times more likely to develop a cerebral aneurysm in patients with a family history of stroke. In terms of age, it starts in the 30s and is most likely to develop in the 40s and 60s.
To determine whether a brain aneurysm has occurred, first, angiography computed tomography (CT) is performed for a primary examination. At this time, if suspicious findings are found, magnetic resonance imaging (MRI) or magnetic resonance angiography (MRA) is additionally performed to confirm the detailed location, shape, and size of the aneurysm.
Currently, there are no drugs that can treat cerebral aneurysms. Instead, there are two treatments, ‘clip ligation’ and ‘coil embolization’. Clip ligation is an operation that requires opening the head, and coil embolization is a procedure in which a coil is inserted through the femoral artery in the groin.
Clip ligation involves opening the skull and using a special clip to tie the neck of the aneurysm to block blood flow to the brain aneurysm and prevent the aneurysm from bursting. It is a useful method to treat large or wide neck aneurysms. However, due to the nature of craniotomy that directly opens the skull, brain tissue or blood vessels may be damaged, so careful technique is required.
Coil embolization accesses the cerebral artery by inserting a small metal tube through the femoral artery in the groin without opening the skull. A platinum thread called a ‘coil’ is then filled into the brain aneurysm. The coil blocks blood flow to the aneurysm and prevents the aneurysm from swelling and bursting.
Seo Dae-cheol, head of the clinical department of neuro-interventional medicine at Gangnam Peter Hospital, said, “Cerebral aneurysms before rupture show almost no symptoms. The best treatment is to check brain health regularly through health checkups, etc. to detect rupture in advance.”
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