Cerebral Aneurysm and Complications

Abstract

An aneurysm is a swelling along a blood vessel. The majority of aneurysms are saccular in shape and result from a combination of factors. Prevalence of unruptured aneurysms varies from 0.4–3.6% to 3.7–6%. The frequency of asymptomatic aneurysm rupture is about 1–2%. The clinical presentation of aneurysms occurs due to: rupture (subarachnoid haemorrhage SAH, intraparenchymal haemorrhage, intraventricular haemorrhage); Warning Leak; nonhaemorrhagic manifestation. The incidence of SAH is steady at 10.5/100 000 per year. Clinical diagnosis of SAH may be straightforward if all major symptoms are present. However, in case of few symptoms or headache as the only symptom (Warning Leak) diagnosis may be difficult and the risk of misdiagnosis is high. In case of suspect SAH, CT is the first choice examination. However, lumbar puncture is still an indispensable step in the exclusion of SAH in patients with a convincing history and negative imaging. In case of untreated ruptured aneurysm there is a 3–4% risk of rebleeding in the first 24 hours, a 1–2% per day risk in the first month, and a long-term risk of 3% per year after three months. Urgent evaluation and treatment of patients with suspected SAH are strongly recommended.