Classification

By Shape:

• Saccular: The most common type, balloon-shaped and connected to the artery by a narrow neck.

• Fusiform: Characterized by a widespread dilation along a section of the artery.

• Microaneurysms: Small in size and typically associated with hypertension.

By Size:

• Small: Less than 10 mm

• Large: Between 10–25 mm

• Giant: Greater than 25 mm

Risk Factors

• Genetic Predisposition: A family history is a significant risk factor.

• Chronic Diseases: Hypertension, atherosclerosis.

• Lifestyle: Smoking, alcohol consumption.

• Gender and Age: More common in women and individuals over the age of 40.

Symptoms

Unruptured Aneurysm:

• Headache

• Visual disturbances

• Pain around the eyes

• Neurological deficits (e.g., facial paralysis)

Ruptured Aneurysm:

• Sudden and severe headache (often described as “the worst headache of my life”)

• Nausea, vomiting

• Loss of consciousness

• Neurological impairments (paralysis, speech difficulties, etc.)

Diagnostic Methods

• CT Angiography (CTA): Commonly used to visualize the aneurysm.

• MR Angiography (MRA): Provides more detailed imaging.

• Digital Subtraction Angiography (DSA): The gold standard for detailed evaluation of blood vessels.

Treatment

• Surgical Clipping: A metal clip is placed on the neck of the aneurysm to stop blood flow into it.

• Endovascular Treatment:

  • Coiling: Platinum coils are inserted into the aneurysm to promote clotting.

  • Stent or Flow Diverter: Devices used to redirect blood flow and reduce pressure on the aneurysm.

• Medical Management: Monitoring unruptured aneurysms and controlling risk factors (e.g., managing blood pressure, quitting smoking).

Prognosis

Unruptured aneurysms can often be managed with careful monitoring, while ruptured aneurysms require emergency treatment. Complications following a subarachnoid hemorrhage (e.g., vasospasm, hydrocephalus) can significantly affect the outcome.