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Cerebral aneurysms are a silent threat that should not be overlooked. According to the &#8220;Department of Disease Control,&#8221; stroke is the second leading cause of death worldwide, affecting approximately 80 million people, with around 5.5 million fatalities. Each year, there are about 13.7 million new cases, with one in four patients aged 25 and older. Moreover, 60% die prematurely. Assistant Professor Dr. Itthichai Sak-arunchai, a neurosurgeon and interventional radiologist at Phyathai 2 Hospital, will discuss prevention and treatment methods for cerebral aneurysms, emphasizing that “prevention is better than cure.”
&nbsp;
<h2>Diagnosis of the Disease</h2>
The diagnosis of cerebral aneurysms can be made through medical history taking, physical examination, and additional radiological imaging, as follows:
<ol>
<li>Computed Tomography (CT) Scan: This uses X-rays to create cross-sectional images of the brain and helps detect bleeding in specific areas. It is a straightforward and quick initial screening method that does not require contrast dye.</li>
<li>Computed Tomography Angiography (CTA): This involves a CT scan with contrast dye injected into a vein to enhance images of blood vessels, allowing for clearer identification of abnormalities and further treatment planning.</li>
<li>Magnetic Resonance Imaging (MRI): MRI uses electromagnetic waves and radio waves to create high-resolution images of the brain, effectively detecting bleeding and surrounding tissue details without using X-rays. This procedure takes longer and requires the patient to remain still.</li>
<li>Magnetic Resonance Angiography (MRA): This is an MRI focused on blood vessels, providing detailed images of aneurysms with high precision. MRA is safe, avoiding radiation exposure, and may not require contrast dye.</li>
<li>Cerebral Angiography: This invasive method involves inserting a catheter into an artery and injecting contrast dye to obtain detailed three-dimensional images of the cerebral vessels, recognized as the gold standard for accuracy, particularly for surgical planning.</li>
</ol>
&nbsp;
<h2>Treatment</h2>
The primary treatment is to prevent blood flow into the aneurysm sac to reduce the risk of brain hemorrhage, which can increase intracranial pressure. There are various methods to treat a brain aneurysm, depending on the size and location of the aneurysm as well as the patient&#8217;s general condition. Treatments include initial emergency care: if the patient is unconscious, intubation may be necessary to assist breathing, along with blood pressure control to maintain normal levels. Blood pressure-lowering medication is considered if the patient has acute hypertension. Anticonvulsants may be given if seizures occur, and medications to reduce brain pressure if there is significant brain swelling. Basic tests are also conducted in preparation for further treatment.
&nbsp;
In certain cases, initial surgical procedures can be performed, such as temporary placement of a ventricular drain if there is excess cerebrospinal fluid buildup, to rapidly reduce intracranial pressure. Specific treatments after diagnosis include:
<ol>
<li>Microsurgical Aneurysm Clipping: This involves craniotomy to clip the aneurysm and prevent re-bleeding, offering a high chance of success but requiring a surgical incision.</li>
<li>Endovascular Coiling: This less invasive method uses a catheter to place small coils inside the aneurysm to prevent rupture. It is performed under digital subtraction angiography (DSA), allowing real-time visualization during the procedure.</li>
</ol>
&nbsp;
<h2>Prevention</h2>
Preventing cerebral aneurysms involves lifestyle modifications and health management, such as:
<ul>
<li>Quitting smoking</li>
<li>Controlling blood pressure</li>
<li>Eating a healthy diet and exercising regularly</li>
<li>Having annual health check-ups to monitor for risk factors</li>
</ul>
&nbsp;
<h2>Screening for Cerebral Aneurysms</h2>
Screening is crucial for early detection of aneurysms before they rupture. Regular screening can prevent complications and involves methods like:
<ul>
<li>Medical history assessment and physical examination by a doctor</li>
<li>MRA for non-invasive imaging of brain vessels</li>
<li>CTA for detailed vessel imaging</li>
<li>Cerebral angiography for the most precise results, albeit with higher risks</li>
</ul>
&nbsp;
<h2>At-Risk Groups for Screening</h2>
<ul>
<li>Individuals with a family history of cerebral aneurysms</li>
<li>Those with genetic conditions associated with a higher risk</li>
<li>Patients with hypertension</li>
<li>Smokers</li>
<li>Individuals with a history of drug use</li>
</ul>
&nbsp;
Cerebral aneurysms present a high risk but can be diagnosed and treated effectively with appropriate care and lifestyle changes. Prevention and treatment strategies can reduce the risk of complications and improve the quality of life for patients. Screening is particularly important for high-risk groups, allowing for early detection through methods like MRI and MRA, which are safe and effective.

Cerebral aneurysms are a silent threat that should not be overlooked. According to the "Department of Disease Control," stroke is the second leading cause of death worldwide, affecting approximately 80 million people, with around 5.5 million fatalities.

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Clarifying Doubts: Diagnosis and Treatment of Aneurysms

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