Arterial aneurysms of cerebral vessels

An aneurysm is a local widening of the lumen of an artery as a result of changes or damage to its walls. Most often, brain aneurysms are a disease of the arterial triads of the polygon of Willis.

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Symptoms of cerebral arterial aneurysms

• Prehemorrhagic period (asymptomatic or low-symptom course, less often tumor-like course with large aneurysms).
• Hemorrhagic period (clinical presentation of hemorrhagic stroke, mainly of the subarachnoid hemorrhage type).

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Forms

• Bifurcation-hemodynamic aneurysms (so-called congenital):
  • Bifurcation-hemodynamic aneurysms in systemic arterial hypertension;
  • Bifurcation-hemodynamic aneurysms in regional hemodynamic disorders (fibromuscular dysplasia, moyamoya disease, developmental anomalies of the cerebral arterial circle);
  • Bifurcation-hemodynamic aneurysms in some hereditary diseases (Marfan, Ehlers-Danlos, Gronblad-Strandberg, Friedreich, Bloom syndromes, Pompe disease).
• Degenerative necrotic aneurysms (radiation, atherosclerotic).
• Traumatic (with traumatic brain injury).
• Inflammatory (as a result of vasculitis, embolic bacterial or mycotic).
• Oncogenic.
• Dysembriogenetic.
• Iatrogenic.

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Treatment of cerebral arterial aneurysms

• Open (transcranial) interventions.
• Endovascular interventions using:
  • balloon catheters;
  • stents;
  • spirals (coils).