Brain Aneurysm: Causes, Symptoms, Diagnosis & Treatment Explained

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 What is an Aneurysm?

An aneurysm is an abnormal bulging or ballooning of a blood vessel wall due to weakness in that area. It can occur in different parts of the body, most commonly in the brain (cerebral aneurysm) and aorta (aortic aneurysm). If an aneurysm ruptures, it can cause life-threatening bleeding.

Goals of Management

  • Prevent rupture

  • Reduce risk factors

  • Detect aneurysm early

  • Treat safely using medical or surgical methods

1. Conservative (Medical) Management

Used for small, unruptured, and asymptomatic aneurysms.

a) Blood Pressure Control

  • Maintain normal BP to reduce stress on vessel walls

  • Drugs: Antihypertensives (e.g., beta-blockers, ACE inhibitors)

b) Lifestyle Modifications

  • Stop smoking

  • Limit alcohol

  • Healthy low-salt, low-fat diet

  • Regular moderate exercise

  • Stress management

c) Monitoring & Follow-up

  • Periodic imaging: CT angiography / MRI

  • Regular clinical assessment

2. Emergency Management (Ruptured Aneurysm)

A ruptured aneurysm is a medical emergency.

Immediate Measures

  • Secure airway, breathing, circulation (ABC)

  • Control blood pressure carefully

  • Pain and anxiety control

  • IV fluids and oxygen

Complication Prevention

  • Prevent re-bleeding

  • Manage raised intracranial pressure

  • Prevent vasospasm (especially in brain aneurysms)

3. Surgical Management

Recommended for large, symptomatic, or high-risk aneurysms.

a) Open Surgical Clipping

  • Common for cerebral aneurysms

  • A metal clip is placed at the aneurysm neck

  • Prevents blood flow into aneurysm

b) Endovascular Coiling

  • Minimally invasive

  • Coils placed inside aneurysm via catheter

  • Induces clot formation

c) Endovascular Stent Grafting (EVAR)

  • Used in aortic aneurysms

  • Stent graft reinforces weakened vessel wall

4. Nursing Management (Exam-Oriented)

  • Monitor vital signs and neurological status

  • Observe for signs of rupture:
    sudden severe headache, loss of consciousness, hypotension

  • Maintain strict BP control

  • Administer prescribed medications

  • Provide psychological support

  • Educate patient on lifestyle changes and follow-up care

5. Prevention of Aneurysm Complications

  • Early screening in high-risk individuals

  • Strict control of hypertension

  • Smoking cessation programs

  • Regular follow-up imaging

Key Points for Students

  • Small aneurysms → medical management + monitoring

  • Ruptured aneurysm → emergency + surgery

  • Endovascular techniques are less invasive

  • Nursing care is crucial for early detection and recovery

Conclusion

Management of aneurysm depends on size, location, symptoms, and rupture risk. Early diagnosis, risk-factor control, and timely intervention can significantly reduce morbidity and mortality.

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