An aneurysm is a bulge in an artery caused by damage or weakness in the vessel walls. Saccular aneurysms can occur in the brain or aorta, and surgical treatment is recommended depending on the location and size of the lesion. A rupture can cause symptoms such as pain, numbness, and loss of consciousness, and requires immediate medical attention.
An aneurysm is an abnormal bulge or swelling in the wall of an artery that can be caused by damage to the blood vessel or weakness in the vessel walls. A saccular aneurysm looks like a small bumpy sac. While aneurysms can occur anywhere in the body, the most likely locations are the brain, or brain, and the aorta, a large blood vessel that travels from the heart’s left ventricle, through the chest, carrying blood to vital organs. When the aorta reaches the lower abdomen, it branches into two smaller arteries that carry blood to the pelvis and legs.
A cerebral saccular aneurysm usually occurs in the circle of Willis area of the brain, in the middle cerebral artery. These were once thought to be congenital, though studies now seem to contradict that assumption. There are some genetic abnormalities, such as autosomal dominant polycystic kidney disease (ADPKD), that are associated with intracranial aneurysms. A significant number of patients diagnosed with cerebral saccular aneurysm actually have multiple lesions, although this is much more likely to occur in females than males.
The most common cause of cerebral aneurysms is hymodynamic-induced degenerative vascular damage. Rare cases can also result from trauma, cocaine use, tumors, or infections. Treatment is usually recommended, although the method depends on the location of the lesion. Surgical methods include clipping the area or an endovascular process called a coil.
A saccular aneurysm is more likely to form in the aorta, and most of these are abdominal. Men between the ages of 40 and 80 are more likely to develop abdominal aneurysms, usually due to atherosclerosis or hardening of the arteries. An abdominal saccular aneurysm is unlikely to rupture if it develops slowly and becomes no larger than an inch and a half to two inches (4 to 5 cm). If the aneurysm grows faster or larger, surgery is recommended. Surgical repair involves removing the weakened portion of the artery and replacing it with polyester tubing.
Aortic aneurysms can also be thoracic, meaning they form above the diaphragm. These can occur in people who have connective tissue disorders or be caused by trauma, such as a car accident, prolonged high blood pressure, and previous tearing of the artery walls. Surgical repair depends on where the saccular aneurysm is located. If it is in the ascending aorta, which is in the front near the heart, surgery is recommended if it reaches about two inches (5 cm) in size. If the lesion is in the descending aorta, surgery is usually delayed until the lesion is nearly two and a half inches (about 6 cm) across.
Aneurysms are considered silent killers because they can grow for years without showing any symptoms. Whether symptoms occur, they vary depending on the location of the saccular aneurysm. An aortic tear generally doesn’t show any symptoms unless it becomes large enough to impede blood flow, press against other parts of the body, or rupture. If symptoms do occur, they usually include a throbbing sensation in the abdomen or shooting pain in the back or abdomen.
When a thoracic saccular aneurysm reveals symptoms, they usually involve back, neck, or jaw pain, cough, hoarseness, and difficulty breathing. Brain aneurysms can cause drooping eyes, double or blurred vision, dilated pupils, and numbness in the face. In all cases, a rupture is usually accompanied by sharp pain in the affected area. Followed by nausea, vomiting, sweating and loss of consciousness. Internal bleeding can quickly lead to shock and death unless the patient receives immediate emergency medical attention.
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