Aneurysmas

Aneurysmas, in English more commonly called aneurysms, are focal dilations of a blood vessel or heart chamber resulting from weakness in the vessel wall. They most often involve arteries and can occur in the brain (intracranial or cerebral), the aorta, or peripheral vessels. True aneurysms involve all three layers of the vessel wall, whereas pseudoaneurysms (false aneurysms) arise when a breach in the wall is contained by surrounding tissue.

Causes and risk factors include atherosclerosis, chronic hypertension, and degenerative changes with aging. Genetic or connective tissue disorders (such as Marfan or Ehlers-Danlos syndromes), infections, inflammatory conditions, trauma, and smoking also increase risk. Aneurysms may remain asymptomatic for years, or grow and press on neighboring structures.

Symptoms depend on location and rupture status. Many aneurysms are silent until they enlarge or rupture. Ruptured cerebral aneurysms cause a sudden severe headache, often with neck stiffness or altered consciousness; ruptured abdominal aortic aneurysms lead to sudden back or abdominal pain and collapse. Unruptured aneurysms may produce local effects by mass or nerve compression.

Diagnosis relies on imaging. Abdominal ultrasound screens abdominal aortic aneurysms; CT angiography, MR angiography, or conventional catheter angiography assess most aneurysms. Management is tailored to size, location, and rupture risk. Small unruptured aneurysms may be monitored with risk-factor modification. Cerebral aneurysms can be treated with surgical clipping or endovascular coiling; aortic aneurysms with open repair or endovascular aneurysm repair (EVAR). Ruptured aneurysms require emergency intervention.

Prognosis varies by location and rupture status; rupture carries high mortality. Prevention focuses on controlling blood pressure, smoking cessation, lipid management, and targeted screening in high-risk individuals.