Aneurysms

A patient arrives in the ER with major headaches and is very confused. She had just given birth to twins three weeks prior and a history of high blood pressure. After being evaluated by the ER doctor, it was noticed that her blood pressure was extremely high. A CXR and CT head was completed and showed a ruptured aneurysm and a subarachnoid hemorrhage. The patient was immediately transferred to the ICU where they could make her stay more comfortable, because at this point she was pretty well brain dead. What is an aneurysm? It is a bulging in a blood vessel, which can occur anywhere, but happens more often in the aorta and the brain. The patient that I helped to treat had a brain aneurysm, which means that the blood pooled between the brain and the brain covering. Some symptoms include a sudden headache, confusion, blurred vision, loss of consciousness, nausea, vomiting, etc. According to the Mayo clinic, "50% of ruptured aneurysm are fatal". Aneursms are caused from a thinning in the vessel wall. Common risk factors are age, genetics, HBP, smoking, increased alcohol consumption, AVM's (as recently discussed in a previous blog), and low estrogen levels. Patients who chose not to breastfeed, estrogen and prolactin levels decrease after pregnancy. Imaging modalities that are used are CT, MRI, and angiography to visualize blood vessels. Aneurysms can sometimes be fixed by using an aneurysm clip to clip off the bulge or an endovascular coil can be placed within the vessel. Certain medications for HBP, calcium channel blockers, or vassopressors may be used to decrease the chances of having an aneurysm. Risks can be decreased by not smoking, exercising, eating a healthy diet, and decreasing caffeine and aspirin intake.

References:
mayoclinic.com
babyboomercaretaker.com
ideasforsurgery.com