Intracranial Aneurysm Research Paper

○ History and physical examination is suggestive of disease by explicit clinical criteria (i.e., hypertension, sudden onset of seizure, neurologic deficits, coma)·

Cerebral vascular accident or a stroke is the destruction of brain substance, resulting from thrombosis, intracranial hemorrhage, or embolism, which causes vascular insufficiency. In addition, it is an area of the brain denied blood and oxygen that is required and damage is done to a part of the cells. The effect of the patient depends upon where the damage occurs and the severity of the stroke.

Intracranial aneurysms are classified as dissecting, saccular, and fusiform. There are many causes of intracranial aneurysms. Some of the most common causes would include fibromuscular dysphasia, atherosclerosis, and arteriovenous malformation. Some that are less common, but do occur would include drugs, infection, and trauma.

Collateral blood flow is an enlarged vessel that opens to cause a detour around a blockage.

An overriding aorta is where the major blood vessel is not in place or moved. In tetralogy

Cerebrovascular accidents, or strokes, will lead to brain damage that affects the functioning of executive function, memory, language, visuospatial performance and emotional states. Corresponding vertebral arteries and carotid arteries provide blood to the brain from the heart that the carotid arteries are internal and external sections of the thyroid cartilage. Where the optic nerve rests the internal artery distributes into the anterior and middle cerebral arteries. The vertebral arteries arise through the spinal vertebrae and meet the lower pons to form the basilar artery. The brain receives 15% to 20% of the oxygenated blood from the heart and can only endure fleeting interruptions of blood flow before neural operations

Correspondingly, there are two pathways that transports blood to the brain called internal carotid artery and vertebral artery. The internal carotid artery has three layers call the tunica adventitia, tunica media, and tunica intima. Tunica intima is made up of smooth muscle cells and elastin. The basilar artery forms and it branches out to the posterior cerebral arteries. The posterior cerebral arteries form the internal carotid arteries and when they connect they make cerebral arterial circle ( circle of willis). The middle cerebral arteries branch out two separate arteries called the anterior cerebral arteries. Each of these arteries are the force that direct the blood flow to the brain. There are three tiny vascular systems that work together to profuse the deep brain. Which are the pial, subependymal, and lenticulostriate arteries. The small area of white matter that depends on blood flow is called the subcortical “shed water” area. The subcortical is more prone than other areas of the brain to have ischemia. The leading cause of ischemia is the fibrin builds up and this cause a narrowing of the lumen. Which does not allow the flow of red blood cells and deprives the white matter of tissue of oxygen. The tissue then losses density and produces white matter lesions. The neurons become demyelinated which leads to loss of cognitive ability.

Occurs when there is intracranial bleedinginto thee cerebro-spinalfluidd- filled the space betweenarcaned andPiaamaterr membrane on the brain surface figure (9). The main cause to SAH remains a rupture of a cerebral aneurysm. Aneurysm (is a balloon on the blood vessel 's side as a result

Impaired cerebral blood flow disorders are extremely common and factors such as the lesion site, existing collateral’s, and the amount of tissue affected determines the actual neurological deficit that results. The impaired blood flow may have a number of causes. Things such as alterations in blood pressure, changes in the arterial walls, and occlusions of the arterial lumen are some of the more important causes.

The common cause of CVA/stroke is the hardening of the arteries wall, this allows fatty deposits to form on the blood vessels causing damage to them, which can lead to clots forming in the blood vessel("Stroke or Cerebral Vascular Accident (CVA)," 2015). CVA/stoke also can be caused by bleeding in the brain or blood vessels busting as a result of high blood pressure ("Stroke or Cerebral Vascular Accident (CVA),2015).

This patient most likely has a extradural (epidural) hematoma and the temporal fossa is the most common site of this type of hematoma caused by “injury to the middle meningeal artery or vein”(McCance & Huether, 2014, p. 584). “Expanding high-volume epidural hematomas can produce a midline shift and cause herniation of the brain. Compressed cerebral tissue can impinge on the third cranial nerve resulting in pupillary dilation and contralateral hemiparesis or extensor motor response”(Price, 2014, p. 3). Extradural hematomas are medical emergencies and surgical intervention is needed to remove the clot and reduce the pressure on the brain. Whether treated or untreated, this type of hematoma has an elevated risk of brain damage. However, left untreated, patients with extradural hematomas have a high risk of

A large part of the decision between these two procedures depends on the aneurysms. Factors such as size, location, anatomy and morphology contribute to the treatment team decision as to which procedure would be most beneficial to the patient. During surgical clipping a clip is placed across the neck of the aneurysm cutting off the blood flow to the aneurysm. Singer et al. describes the risks of this procedure being temporary arterial occlusion, intraoperative hemorrhage or new or exacerbated neurologic deficits. The other commonly used surgery, endovascular coiling consist of inserting coils in the lumen of the aneurysm. Thrombus then forms in reaction to the coils and clots off blood flow to the aneurysm, preventing it from rupture or leaking. Complications of this procedure are different from surgical clipping. Aneurysmal rupture and thromboembolism are the main complications of endovascular coiling. Some patients may be placed on a combination of a heparin and or antiplatelet therapy to help prevent a thromboembolic event (Singer et al.). New procedures are being developed for aneurysms such as bypass surgery. This technique redirects blood flow within the brain and uses a built vessel connection to permanently occlude the artery on which the aneurysm sits (Zhang et al. pg. 99). Bypass surgery is more challenging and requires specially trained neurosurgeons for a successful procedure. Decisions and information about regarding the ideal time to treat the aneurysm needs to be addressed as well. There is some controversy about the timing of treatment for both ruptured and unruptured aneurysms. As it in other procedures the risk versus benefits of treating need to be taken into consideration. Risk factors for treating a unuptured aneurysm and having poor outcomes include advanced age and having larger aneurysms. Characteristics of the aneurysm, size,

Surgical intervention is presently the only effective method of treating AAAs. The risk of surgical repair is outweighed by the risk of aneurysm rupture or aneurysm related death. Patients

Intracerebral hemorrhagic stroke occurs when vessels within the brain leaks blood into the brain itself. It often happens without warning. This type of stroke represents about 10% of all strokes. The most common cause is uncontrolled high blood pressure or (Hypertension.) Hypertension can cause small arteries inside the brain to become brittle and susceptible to cracking and rupture. Less often it may result from a blood vessel defect present since birth.

A stroke caused by a blocked artery by a blood clot or bursting of a blood vessel because of uncontrolled high blood pressure. There are main three types of the stroke. An ischemic stroke occurs when a blood clot blocks one of the arteries which supply blood to brain. A clot may be caused by fatty deposits (plaque) that build up in arteries and cause reduced blood flow (atherosclerosis) or other artery conditions. (mayo clinic). About 89%, strokes are ischemic strokes. Ischemic stroke includes thrombotic stroke. A thrombotic stroke occurs when a thrombus stuck in one of the arteries that supply blood to the brain. A clot build-up of fatty deposits in arteries. Another type of stroke is called the hemorrhagic stroke. This stroke occurs when a blood vessel leaks or ruptures in the brain. A bold vessel leaks or ruptures from many conditions like uncontrolled high blood pressure or overtreatment with anticoagulants and the weak spot in blood vessel walls. (mayo). Some people experience a mini-stroke it is known as a transient ischemic attack (TIA). A temporary decrease or clot stuck in a vessel in our brain causes TIA. It happens less than five minutes. This stroke does not have any symptom, because the blockage is