Aneurysms
An aneurysm is a localized dilation of a blood vessel, most commonly an artery, resulting from a weakness in the arterial wall. This condition can occur due to various factors such as hypertension, atherosclerosis, blunt trauma, or bacterial endocarditis. Aneurysms can manifest in different shapes, including fusiform, which bulges uniformly around the artery, and saccular, which distends on one side. Although many aneurysms may present no symptoms, they can sometimes cause sudden and severe pain or a pulsing sensation near the affected blood vessel. Notably, aortic aneurysms, particularly in the abdominal region, are often linked to advanced atherosclerosis and can have a poor prognosis if they rupture.
Treatment for aneurysms typically involves surgical intervention, especially for thoracic aortic aneurysms, which may require bypass techniques to restore proper blood flow. Recent research has also shed light on genetic factors associated with certain types of aneurysms, such as mutations in the PPIL4 gene linked to intracranial aneurysms. Understanding these genetic factors may help identify individuals at higher risk, potentially guiding preventative strategies in the future. Overall, aneurysms are serious medical conditions that warrant careful monitoring and management.
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Subject Terms
Aneurysms
ANATOMY OR SYSTEM AFFECTED: Blood vessels, brain, circulatory system, head, heart, nervous system
DEFINITION: A localized dilatation of a blood vessel, particularly an artery, that results from a focal weakness and distension of the arterial wall.
CAUSES: Dilatation of a blood vessel (particularly an artery) from hypertension, arteriosclerosis, blunt trauma, bacterial endocarditis
SYMPTOMS: Often none; sometimes sudden and severe pain, lump, or pulsing sensation near blood vessels
DURATION: Acute
TREATMENTS: Surgery
Causes and Symptoms
The arterial distension associated with aneurysms will take one of several forms. For example, fusiform aneurysms create a uniform bulge around an artery, while those of the saccular variety distend on one side of the blood vessel. Some saccular aneurysms found in the are called berry aneurysms for their protruding shapes.
Hypertension and arteriosclerosis commonly produce dilatation of the aorta. Very large aneurysms of the abdominal (possibly the most common type) are usually caused by advanced atherosclerosis. The processes associated with the production of aortic aneurysms are varied, but certain factors are common to all. The media (middle arterial layer) of the normal aorta must remain intact in order for the aorta to withstand the systolic blood pressure. When the media is damaged, there is progressive of the weakened area and an develops. An aortic aneurysm is a serious disease with poor prognosis. Many such aneurysms rupture and cause death before surgical intervention can take place.
There are several types of aneurysms. Dissecting aortic aneurysms are those in which blood enters the wall of the blood vessel and splits the media of the vessel. The dissection of the media usually begins as a transverse tear in the region above the aortic valve and works downward between the layers of the aortic wall. Some believe that promotes the tear by increasing the tension on the aorta. Traumatic aneurysm is usually caused by penetrating or by blunt trauma; the most common cause of such injuries is automobile accidents. Mycotic aneurysms of the aorta may be associated with and sometimes with organisms such as salmonella. Aneurysms of the sinuses of Valsalva may be attributable to syphilitic aortitis, bacterial endocarditis, or congenital defect.
Treatment and Therapy
Surgical therapy for thoracic aortic aneurysms varies with the type and location of the lesion. Aneurysms involving the aortic arch are often surgically corrected by employing a bypass technique. One method sutures a large prosthetic graft between the ascending and descending aortas, thus bypassing the diseased area. Surgical techniques sometimes offer the only hope for the survival of a patient with aneurysm. A 2013 study identified that small aneurysms grow more slowly than larger aneurysms. It suggested that diagnostic imaging of patients with small aneurysms can occur with less frequency, increasing the cost effectiveness of treatment.
In 2021, researchers from Yale University identified the role of a gene (PPIL4) in intracranial aneurysms. The gene plays an important role in creating blood vessels when the brain is developing. Researchers studied the genomes of more than three hundred patients with intracranial aneurysms and found many more PPIL4 mutations than in the general population. If these mutations can be identified in a developing brain, they might indicate who is at an increased risk of the aneurysms as an adult.
Bibliography
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