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An aneurysm occurs when part of a blood vessel (artery) or cardiac chamber swells, – either the blood vessel is damaged or there is a weakness in the wall of the blood vessel. As blood pressure builds up it balloons out at its weakest point. The swelling can be quite small or very large – when large it tends to extend along the blood vessel. As the aneurysm grows there is a greater risk of rupture – this can lead to severe hemorrhage, and other complications, including sudden death.
An aneurysm can occur in any part of the body. They tend to most commonly occur on the wall of the aorta – the large trunk artery that carries blood from the left ventricle of the heart to branch arteries. The aorta goes down through the chest and into the abdomen, where it divides into the iliac arteries (two branches). There are two main types of aneurysms:

• Aortic aneurysm – occurs in the aorta.

  Can be abdominal, or thoracic (higher up).

• Cerebral aneurysm – occurs in an artery in the brain.

  People of any age and either sex can have an aneurysm, although they are more common in men and people over 65 years of age.

  What are the symptoms of an aneurysm?

  Symptoms are linked to how big the aneurysm is, how fast it is growing and its location. Very small aneurysms which do not grow may go completely unnoticed. A large cerebral aneurysm (in the brain) may press on nerve tissue and trigger numbness in the face, or problems with the eyes.

  
  

  Cerebral (brain) aneurysm symptoms

  The following symptoms may be experienced before a cerebral aneurysm ruptures:
  • Very severe headache that occurs suddenly
  • Nausea
  • Vomiting
  • Eyesight problems
  • Seizures (fits)
  • Loss of consciousness
  • Confusion
  • A drooping eyelid
  • Stiff neck
  • Light sensitivity

  If the cerebral aneurism bursts it will cause bleeding in the brain and a hemorrhagic stroke – it can also cause intracranial hematoma (blood leaks into the area surrounding the brain causing a blood clot in the skull).

  Aortic aneurysm symptoms

  The vast majority of aortic aneurysms occur in the patient’s abdominal aorta. It is not uncommon for a patient to have an aneurysm and experience no symptoms for several years. Many of them are difficult to detect because of this. Some aortic aneurysms will never rupture. It is hard to predict which ones will never grow, which grow slowly, and which ones grow rapidly.

  When symptoms occur, they tend to include:

  • A throbbing sensation in the abdomen
  • Back pain
  • Abdominal pain – this pain frequently spreads towards the back

  If the aneurysm continues to grow and presses on the spine or chest organs the patient may experience:

  • Coughing
  • Loss of voice
  • Breathing difficulties
  • Problems swallowing

  Sometimes an aortic aneurysm can be discovered by a GP (general practitioner, primary care physician) when performing a routine examination of the abdomen. He/she may detect a lump that pulses at the same rate as the patient’s heartbeat – it is often located high up in the abdomen, slightly to the right.

  What causes an aneurysm?

  Brain (cerebral) aneurysm causes:

  • Weakness in the artery wall (usually present since birth)
  • Hypertension (high blood pressure)
  • Arteriosclerosis (plaques of cholesterol, platelets, fibrin, and other substance form on the arterial wall)

  Most cerebral aneurysms develop at the forks or branches in arteries because the walls in these sections are weaker. They most commonly form at the base of the brain – but can form anywhere in the brain.

  Abdominal aortic aneurysm causes:

  • Atherosclerosis – accumulation of fatty deposits (cholesterol) on the artery walls.
  • Smoking – this is a major risk factor in the development of aortic aneurisms. Smoking contributes to atherosclerosis, hypertension and the acceleration of aneurysm growth…(VA Medical Center, Minneapolis.)
  • High blood pressure – especially if it is poorly controlled (not treated at all, or not treated properly).
  • Vasculitis (infection in the aorta) – this is an uncommon cause, and seems to run in families.
  • Cocaine use-Cocaine users in their mid-40s had more than four times the risk of coronary artery aneurysms as non-users

  Prevention

  A large percentage of aneurysms are caused by arteriosclerosis – a vascular disease. The following steps will help prevent the development of arteriosclerosis and aneurysms:

  • Quit smoking
  • Keep your blood pressure under control
  • Keep your blood cholesterol levels under control
  • Eat a healthy diet, rich in fruit and vegetables, unrefined carbohydrates, dietary fiber, good quality fats, and lean protein
  • Keep your bodyweight within the ideal limits for your height
  • Get at least 7 hours of good quality sleep each night
  • Keep yourself physically active (check with your doctor that this is OK for you)

  Comments to localanesthetics@yahoo.ca M.Sc. PharmD. CCPE Please visit
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