Aneurysm
An aneurysm
is a bulging, weakened area in the wall of a blood
vessel resulting in an abnormal widening or ballooning
greater than 50 percent of the normal diameter
(width). An aneurysm may occur in any blood vessel,
but is most often seen in an artery rather than
a vein.
An aneurysm may be located
in many areas of the body, such as blood vessels
of the brain, the aorta (the largest artery
in the body), the intestines, the kidney, the
spleen, and the vessels in the legs. The most
common location of an aneurysm is the aorta,
which carries oxygenated blood from the heart
to the body. An aneurysm can be characterized
by its location, shape, and cause.
The
shape of an aneurysm is described as being fusiform
or
saccular, which helps to identify a true aneurysm.
The more common fusiform-shaped aneurysm bulges
or balloons out on all sides of the blood vessel.
A saccular-shaped aneurysm bulges or balloons
out only on one side.
A pseudoaneurysm,
or false aneurysm, is an enlargement of only the
outer layer of the blood vessel wall. A false
aneurysm may be the result of a prior surgery
or trauma. Sometimes, a tear can occur on the
inside layer of the vessel resulting in blood
filling in between the layers of the blood vessel
wall creating a pseudoaneurysm.
Because an aneurysm
may continue to increase in size, along with
progressive weakening of the artery wall, surgical
intervention may be needed. Preventing rupture
of an aneurysm is one of the goals of therapy.
The larger an aneurysm becomes, the greater
the risk of rupture (bursting). With rupture,
life-threatening hemorrhage (uncontrolled bleeding),
and possibly death, may result.
An aneurysm
may be caused by multiple factors that result
in the breaking down of the well-organized structural
components (proteins) of the aortic wall that
provide support and stabilize the wall. The exact
cause is not fully known. Atherosclerosis (hardening
of the arteries) is thought to play an important
role in aneurysmal disease. Risk factors associated
with atherosclerosis include, but are not limited
to, the following:
- older age
- male
- family history
- genetic factors
- hyperlipidemia (elevated
fats in the blood)
- hypertension (high
blood pressure)
- smoking
- diabetes
Other
specific causes of aneurysms are related to the
location of the aneurysm. Examples of aneurysms
in the body and their causes may include, but
are not limited to, the following:
|
Type of Aneurysm
|
Causes of Aneurysms
|
| Abdominal
Aortic Aneurysm (AAA) |
- atherosclerosis
(especially in the segment of the abdominal
aorta below the kidneys, called an infrarenal
aortic aneurysm)
- genetic disorders
- giant cell
arteritis (a disease that causes inflammation
of the temporal arteries and other arteries
in the head and neck, causing the arteries
to narrow, reducing blood flow in the
affected areas; may cause persistent
headaches and vision loss)
- infection
|
| Cerebral
Aneurysm |
- congenital
(present at birth)
- high blood
pressure
- atherosclerosis
- head trauma
|
| Common
Iliac Artery Aneurysm |
- atherosclerosis
- pregnancy
- infection
- trauma after
lumbar or hip surgery
|
| Femoral
and Popliteal Artery Aneurysm |
- atherosclerosis
- trauma
- congenital
disorders
|
Aneurysms
may be asymptomatic (no symptoms) or symptomatic
(with symptoms). Symptoms associated with aneurysms
depend upon the location of the aneurysm in the
body.
Symptoms
that may occur with different types of aneurysms
may include, but are not limited to, the following:
|
Type of Aneurysm
|
Symptoms Associated
with Aneurysm Type |
| Abdominal
Aortic Aneurysm (AAA) |
constant
pain in abdomen, chest, lower back, or groin
area |
| Cerebral
Aneurysm |
sudden
severe headache, nausea, vomiting, visual
disturbance, loss of consciousness |
| Common
Iliac Aneurysm |
lower
abdominal, back, and/or groin pain |
| Femoral
and Popliteal Artery Aneurysm |
easily
palpated (felt) pulsation of the artery
located in the groin area (femoral artery)
or on the back of the knee (popliteal artery) |
The
symptoms of an aneurysm may resemble other medical
conditions or problems. Always consult your physician
for more information.
Selection
of a type of diagnostic examination is related
to the location of the aneurysm. In addition to
a complete medical history and physical examination,
diagnostic procedures for an aneurysm may include
any, or a combination, of the following:
- computed tomography
scan (Also called a CT or CAT scan.) - a diagnostic
imaging procedure that uses a combination of
x-rays and computer technology to produce cross-sectional
images (often called slices), both horizontally
and vertically, of the body. A CT scan shows
detailed images of any part of the body, including
the bones, muscles, fat, and organs. CT scans
are more detailed than standard x-rays .
- magnetic resonance
imaging (MRI) - a diagnostic procedure that
uses a combination of large magnets, radiofrequencies,
and a computer to produce detailed images of
organs and structures within the body.
- echocardiogram (Also
called echo.) - a procedure that evaluates the
structure and function of the heart by using
sound waves recorded on an electronic sensor
that produce a moving picture of the heart and
heart valves.
- arteriogram (angiogram)
- an x-ray image of the blood vessels used to
evaluate various conditions, such as aneurysm,
stenosis (narrowing of the blood vessel), or
blockages. A dye (contrast) will be injected
through a thin flexible tube placed in an artery.
This dye will make the blood vessels visible
on the x-ray.
- ultrasound - uses
high-frequency sound waves and a computer to
create images of blood vessels, tissues, and
organs. An ultrasound is used to view internal
organs as they function, and to assess blood
flow through various vessels.
Specific
treatment will be determined by your physician
based on:
- your age, overall health,
and medical history
- extent of the disease
- your signs and symptoms
- your tolerance of specific
medications, procedures, or therapies
- expectations for the
course of the disease
- your opinion or preference
Treatment
options for an aneurysm may include one or more
of the following:
- controlling or modifying
risk factors - steps such as quitting smoking,
controlling blood sugar if diabetic, losing
weight if overweight or obese, and controlling
dietary fat intake may help to control the progression
of the aneurysm
- medication - to control
factors such as hyperlipidemia (elevated levels
of fats in the blood) and/or high blood pressure
- surgery - the type
of surgery performed will depend on the location
and type of the aneurysm
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