Aneurysm

8 mins read

Summary and Overview
An aneurysm is a balloon-like bulge in an artery or vein. It can be defined as dilatation of the aorta greater than 150% of its normal diameter for a given segment. Aneurysms can occur in the brain (cerebral), thorax (chest) or abdomen.

They are serious health conditions and if they rupture can cause internal hemorrhaging. If an aneurysm in the brain ruptures, it releases blood into the brain and causes a stroke. The health effects are serious and can be fatal.

Causes
A person might have an inherited tendency to form aneurysms. Or they may develop because of hardening of the arteries (arteriosclerosis). The risk also markedly increases with age: most people develop them over the risk of 40. Risk factors also include high blood pressure and smoking.

In the brain, most or about 85 percent of aneurysms occur in the Circle of Willis, a ring of arteries at the base of the brain. Cerebral aneurysms are sometimes called “berry aneurysms” because they look like a berry hanging from a stem.

Symptoms
Often aneurysms have no symptoms, and so they are only detected when visiting the doctor and having other, unrelated body scans. Even large aneurysms often have no symptoms. The most likely way you will notice an aneurysm is if it grows big enough to press against nerve-bearing tissue, causing pain. Unfortunately, this means the aneurysm has grown recently, so the warning comes late. Fast-growing aneurysms are the ones most likely to rupture.

Symptoms of thoracic aneurysms are rare but include-

  • chest pain
  • upper back pain
  • coughing up of blood
  • difficulty in swallowing
  • hoarseness
  • drooping eyelid
  • absence of sweating on one side of the face
  • wheezing

Most abdominal aortic aneurysms produce no symptoms. When they produce symptoms, the most common symptom is pain. The pain typically has a deep quality as if it is boring into the person. It is felt most prominently in the middle of the abdomen and can radiate to the back. The pain is usually steady but may be relieved by changing position. The person may also feel prominent abdominal pulsation.

Brain aneurysms are more symptomatic. They can cause problems by pressing on areas in the brain. When this happens, a sudden, severe headache is the key symptom. Some people with a ruptured aneurysm will suffer a warning headache several days or weeks before the rupture. This is commonly referred to as a “sentinel headache.” Other symptoms of a brain aneurysm include-

  • blurred vision
  • changes in speech,
  • neck pain,
  • nausea and vomiting
  • confusion
  • seizure
  • a drooping eyelid
  • sensitivity to light

If a cerebral aneurysm ruptures, it can cause paralysis or even death

Diagnostic Tests
As aneurysms often have no symptoms, they may show up when having other diagnostic tests, such as

  • Computerized Tomography (CT),
  • Magnetic Resonance Imaging (MRI),
  • Echocardiography,
  • Computerized Tomography (CT),
  • Lumbar Puncture (spinal tap),
  • Angiogram

Once detected, your doctor may likely do further tests to determine their location and size of the aneurysm. The type of diagnostic test will depend on the location of the aneurysm. For example, CT scans are the most common way of imaging the brain to detect a cerebral aneurysm and the necessity of surgical or other treatment.

Treatment options
The treatment of an aneurysm depends on its size, location and how likely to rupture. Autopsy studies have revealed that 3-6% of adults in the United States have aneurysms inside their brains. Fortunately, many of these aneurysms are small and not at risk to break. The risks of brain surgery may outweigh the risk of rupture. It’s important for you to talk to your doctor about all your treatment options.

  • Watchful waiting means that you won’t receive immediate surgery, but you’ll be given regular check-ups so that your aneurysm can be carefully monitored. This usually involves having a diagnostic study every three or six months. Hypertension is a risk factor for aneurysm breakage, and so during this time, you may try to reduce the risk by taking measures to lower your blood pressure.

There are two common treatment options:

  • Surgical clipping is when surgeons place a tiny metal clip on the neck of the aneurysm to stop blood flow to it.
  • Endovascular coiling is where the surgeon inserts a hollow plastic tube (catheter) into an artery, usually in your groin, and threads it through your body to the aneurysm. He or she then inserts a platinum wire through the catheter and into the aneurysm. The wire coils up inside the aneurysm, disrupts the blood flow, causing it to clot. This clotting essentially seals off the aneurysm from the artery. Endovascular coiling is less invasive, although the known risks of the procedure may still outweigh the potential benefit.

Alternative Therapies

  • While alternative therapies may help improve the health of your heart, the best treatment for aneurysm still remains surgery. It is best to talk to your doctor before incorporating any natural herbs, supplements or therapy approaches for treating aneurysm.
  • Since one of the main causative factors for developing aneurysms is arteriosclerosis, alternative therapy options which help in arteriosclerosis can also benefit people with aneurysm.
  • Various herbs are known to extend long term benefits in preventing and treating atherosclerosis (build-up of fats, cholesterol and other substances that clog the arteries). The anti-oxidant properties of hawthorn [1,2] can help protect against the formation of plaques and also lowering the levels of bad cholesterol. This ancient science has also determined the role of herbs like arjuna (Terminalia arjuna) [3,4,5], guggul (Commiphora mukul) [7], pushkarmool (Inula racemosa) [8]in treating various heart conditions including atherosclerosis. Arjuna is known to reduce the buildup of plaques in arteries, improve the circulation of blood as well as strengthening the heart muscles [5,6].  The active components of guggul help in reducing LDL (Low-density lipoprotein) or bad cholesterol levels while pushkarmool is related to reducing angina.
  • Ayurveda recommends garlic (Allium satium) [9,11] as an effective treatment for atherosclerosis. The heart protective functions are as a result of its anti-coagulant properties. Garlic is also rich in allium [10] which acts as an anti-oxidant thereby reducing the buildup of plaques. It also lowers the levels of bad cholesterol and prevents the formation of blood clots thereby reducing the risk of blocking the artery further.
  • Curcumin [12] which is present in large quantities in turmeric and ginger is well known for its anti-oxidant and free radical scavenging properties. Both these properties can help in reducing cell damage due to free radicals as well as improving blood flow and lowering serum lipids [13,14].
  • Nutritional and dietary supplements also extend certain heart protective properties. Omega-3 fatty acids which are found in fish oil can reduce the risk of developing atherosclerosis by preventing the formation of plaques and blood clots [15]. These friendly fatty acids also extend its benefits in protecting against other heart diseases, lowering the levels of cholesterol and blood pressure [18]. Studies have also outlined the benefits of Coenzyme Q 10 in rendering protection against atherosclerosis by inhibiting the formation of blood clots and improving the levels of anti-oxidants in the blood [17,18]. Vitamins A, C and E have also been studied for reducing the risk of atherosclerosis [19].
  • Dietary modulations can also help in reducing the incidence of artery blockage. Including foods rich in unsaturated fats can significantly improve the levels of blood cholesterol. Also, high fiber foods like whole grains, fresh vegetables and fruits, nuts can all add to reducing the risk of atherosclerosis. Avoiding high fats foods like fried and junk food, reducing the intake of salt and refined, processed foods is also of significant value in negating the risk of the disease.
  • Homeopathy targets to treat the ‘angina’ or pain associated with atherosclerosis [21]. Remedies like Plumbum metallicum, Cactus grandifloras, Digitalis and Aurum metallicum are all useful in treating angina pectoris [22]. Other remedies like Baryta carbonica, Olea europaea, Crataegus oxyacantha [20] are seen to prevent the buildup of plaques in the arteries.
  • Studies have shown that acupuncture in combination with moxibustion—a traditional Chinese medicine technique which involves burning of mugwort (a small, spongy herb) — helps in improving the blood flow in case of carotid atherosclerosis [23]. Atherosclerosis patients with severe angina can benefit from electrical acupuncture.
  • Studies have shown that yoga and meditation can help reduce the risk factors for cardiovascular diseases such as hypertension, diabetes, obesity etc. This ancient holistic practice can be adapted to acquire both primary and secondary prevention of cardiovascular diseases [24,25].

Prevention

  • Avoid Smoking: Smoking markedly increases risk for aneurysm. The risk is directly related to number of years smoking and decreases in the years following smoking cessation.
  • Avoid Blood “thinners” (such as Warfarin), some medications and prescription drugs that act as stimulants such as ephedrine and amphetamines (like diet pills), and harmful drugs like cocaine as they can cause aneurysms to rupture and bleed.
  • Other risk factors include hardening of the arteries (arteriosclerosis), certain blood infections and high blood pressure. A healthy diet and exercise will reduce your risk of high blood pressure and arteriosclerosis, lowering your overall risk and improving general health.

Conclusion
Aneurysms can occur in the brain (cerebral), thorax (chest) or abdomen. They are serious health conditions. If they rupture, they can cause internal bleeding, paralysis or even death. Aneurysms have a number of risk factors, including arteriosclerosis and hypertension. A healthy, balanced diet, quitting smoking and regular exercise will help reduce your chances of developing an aneurysm.

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