Aneurysm

What is it 

Aneurysm is localised abnormal widening of the blood vessel due to weakening of the vessel wall. Although the widening of blood vessel can compress on important organs, the most dangerous complication of aneurysm is rupture of the aneurysm when it increases to a certain size. Aneurysms can occur in any artery, but rupture of aneurysms in the aorta or brain is usually fatal.

Symptoms 

Aneurysm is usually clinically silent and diagnosed incidentally or when it ruptures. But aortic aneurysm can cause deep, diffuse chest pain, or rarely, difficulty in swallowing (compression on gallup) or hoarseness (compression of nerve) when it grows bigger. Aneurysm in the brain may cause a headache.

Rupture of aneurysm of the aorta or brain is usually fatal due to severe shock caused by massive leakage of blood into the chest or abdomen and major stroke caused by haemorrhage in the brain, respectively.

Diagnosis   

If large enough, aneurysm in the abdomen can be detected as a mass by examination. Otherwise, ultrasound, CT scan or MRI of the chest or abdomen is required to confirm the diagnosis. These investigations are also used to monitor the size of aneurysm over time to assess the risk of rupture and timing of surgery.

Treatment 

High blood pressure needs to be controlled to reduce the risk of expansion and rupture of aneurysm. Surgery is required when aneurysm reaches a certain size or is rapidly expanding, as the risk of rupture is high. Aneurysm of the brain is usually diagnosed when it ruptures causing a stroke. Immediate drainage of blood and surgical repair of the aneurysm are required to save lives and minimise brain damage.