Intracranial aneurysm. medical. surgical

medical surgical

1. Intracranial aneurysm https://www.slideshare.net/slideshow/intracranial-aneurysm-by-dr-avinash/249332358 https://www.slideshare.net/slideshow/cerebral-aneurysm-57493227/57493227 https://www.slideshare.net/slideshow/cerebral-aneurysm-81586508/81586508 https://www.slideshare.net/slideshow/brain-abscess-87156487/87156487

2. introduction Blood to the brain is supplied by four major blood vessels that join together forming Circle of Willis at the base of the brain, which are: Anterior cerebral artery. Posterior cerebral artery. Internal carotid artery. Basilar artery.

3. introduction

4. introduction Artery junction points may become weak, causing ballooning of the blood vessel wall that can form a small sac or aneurysm.

5. introduction An intracranial aneurysm is a weakness in the tunica media, the middle layer of the blood vessel. The most common type of intracranial aneurysm is the saccular or berry-like structure. The muscular walls of the artery weaken and lead to formation of sac-like or berry-like structure

6. incidence Aneurysm are most prevalent between the ages of 35-60years The female to male ratio is 3:2 , but before 40 male and female s are equally affected About 10-30%of patients can have multiple aneurysms About 3-5% of new strokes are due to aneurysm rupture related to subarachnoid hemorrhage

7. causes Congenital or familial inheritance Atherosclerosis Hypertension Connective tissue disorders Sickle cell anemia Infections Trauma Cigarette smoking Illicit drug use Alcohol

8. causes 6. Infections Trauma Cigarette smoking Illicit drug use Alcohol

9. Clinical manifestation Headache: This is characterized by the acute onset of severe pain, which patients often describe as "the worst headache of my life.“ Facial pain: Aneurysms may produce facial pain. Manifestations of meningeal irritation: Neck pain or stiffness

10. Clinical manifestation Alterations in consciousness: The sudden elevation of ICP associated with aneurysmal rupture may lead to a severe decline in cerebral perfusion pressure, causing syncope (50% of cases). Confusion or mild impairment in alertness also may be noted. Seizures: are present in 25% of aneurysmal SAH cases, with most events occurring within 24 hours of onset.

11. Clinical manifestation Autonomic disturbances: Subarachnoid accumulation of products of blood degradation may elicit fever. Nausea or vomiting, sweating, chills, and cardiac arrhythmias also may be present. Visual symptoms: Blurring of vision, diplopia, or visual field defects may be present.

12. diagnosis 1- The history of the headache: An acute onset of the worst headache of the patient's life, associated with a stiff neck

13. diagnosis 2- CT-scan & MRI: This will show a subarachnoid hemorrhage in more than 90% of cases of ruptured aneurysm.

14. diagnosis 3- Lumbar puncture: In the few cases that are not recognized by CT, the health care practitioner may consider performing a  lumbar puncture  to identify blood in the cerebrospinal fluid that runs in the subarachnoid space.

15. diagnosis 4- Angiography: ( angio =artery + graphy = picture) is a procedure in which a small flexible tube is threaded into one of the brain's arteries, and dye is injected while pictures are taken

16. Management