Cerebral+Aneurysm

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A **cerebral (brain) aneurysm** refers to the localized ballooning of a cerebral artery, typically affecting 2-5% of the global population . It first arises due to a focal weakening in the artery. Over many years, compounding [|hemodynamic] forces will act on this weakened region, resulting in an intracranial aneurysm. Eventually, the wall may thin to the point that the aneurysm spontaneously ruptures. The most common outcome of such an event is a subarachnoid hemorrhage (SAH), the bleeding into the [|subarachnoid space].  media type="youtube" key="WWFP4IxU1Ts" height="296" width="382" align="right"  An intracranial aneurysm may arise from a myriad of risk factors, including [|hypertension], female sex, smoking, [|arteriosclerosis], and familial history. Various techniques exist to diagnose an unruptured aneurysm, including [|magnetic resonance imaging], [|computed tomography scan], [|angiography] ([|CT], [|MR], catherer) or a combination. However, an aneurysm is mostly asymptomatic, and not typically diagnosed until a rupture occurs. At point of rupture, the bleeding must first be stopped, by either microsurgical clipping or endovascular coiling. If diagnosed before rupture, these techniques may also be employed to remove an aneurysm.

 Unfortunately, even after stopping bleeding, the prognosis of aneurismal SAH patients remains poor. Most notably, many patients will develop delayed neurological deficits, leading to poor outcome and perhaps death. Various pathophysiological mechanisms to account for the delayed neurological decline have been suggested, with most revolving around changes to the cerebral vasculature. Traditionally, cerebral vasospasm has been touted as the main contributor to poor outcome, though some series are now suggesting this is not the case. More contemporary hypotheses include microvascular constriction, microembolism, cortical spreading depression[__5__ ].

  In terms of post-surgical treatment, most target the reversal of cerebral perfusion deficits after cerebral vasospasm, though none have been particular successful [ __5__ ] <span style="font-family: 'Times New Roman',Times,serif; font-size: 14.6667px;">. More efforts are underway to investigate other possible avenues to prevent neurological decline, including anti-inflammatory and anti-coagulatory drugs.

<span style="font-family: 'Times New Roman',Times,serif; font-size: 20px;">**References**
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