Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
The most common types of
aneurysms involve the aorta, the large vessel that carries oxygen-containing
blood away from the heart. In particular, aneurysms most commonly develop in the
abdominal portion of the aorta and are designated abdominal aortic aneurysms. Abdominal aortic aneurysms are most common in men
over the age of 60. Most aortic aneurysms are caused by atherosclerosis
("hardening of the arteries") since this condition can weaken the walls of the
aorta and lead to thinning and widening of the affected areas.
Another type of aneurysm is a
brain aneurysm. Brain aneurysms are widened areas of arteries or veins
within the brain itself. These may be caused by head injury, an inherited (congenital) malformation of the vessels, high blood
pressure, or atherosclerosis. A special type of brain aneurysm is known as a
berry aneurysm. Berry aneurysms are small, berry-shaped outpouchings of the main
arteries that supply the brain and are particularly dangerous since they are
susceptible to rupture, leading to often fatal bleeding within the brain. Brain
aneurysms can occur at any age but are more common in adults.
Blood to the brain is supplied by four major blood vessels that join
together at the Circle of Willis at the base of the brain. Smaller branch
arteries leave the circle to supply brain cells with oxygen and nutrients.
Artery junction points may become weak, causing ballooning of the blood
vessel wall that can form a small sac or aneurysm.
Cerebral aneurysms are common, but most are asymptomatic and are found
incidentally at autopsy.
Aneurysms can leak or rupture causing symptoms from severe headache to
stroke-like symptoms, or death.
The health care practitioner needs to maintain a high incidence of suspicion to make
the diagnosis, since many patients may have an initial small leak of blood
causing symptoms before a catastrophic bleed occurs.
Diagnosis of a brain aneurysm may require CT scans, lumbar puncture, or angiography.
Treatment to repair the aneurysm may involve neurosurgery to put a clip
across the weak blood vessel wall or clipping by interventional radiology.
What is a brain aneurysm and what causes a brain aneurysm?
The Circle of Willis is the junction of the four many arteries that supply the brain with nutrition (oxygen and glucose), two carotid arteries and two vertebral arteries. This loop of arteries is located at the base of the brain and sends out smaller branch arteries to all parts of the brain. The junctions where these arteries come together may develop weak spots. These weak spots can balloon out and fill with blood, creating the outpouchings of blood vessels known as aneurysms. These sac-like areas may leak or rupture, spilling blood into surrounding tissues.
Aneurysms have a variety of causes including
high blood pressure and atherosclerosis,
trauma, heredity, and abnormal blood flow at the junction where arteries come together.
There are other rare causes of aneurysms. Mycotic aneurysms are caused by
infections of the artery wall. Tumors and trauma can also cause aneurysms to
form. Drug abuse, especially cocaine, can cause the artery walls to inflame and
weaken.
Brain aneurysms (aneurysms within arteries in the brain) are a common
occurrence. At autopsy,
incidental asymptomatic aneurysms are found in more than 1% of people. Most
aneurysms remain small and never become an issue or are diagnosed. Some,
however, may gradually become larger and exert pressure on surrounding brain tissue
and nerves and may be diagnosed because of symptoms such as:
The greater concern is a brain aneurysm that leaks or ruptures,
and potentially causes stroke or death. Bleeding leaks into one of the membranes
that covers the brain and spinal canal and is known as a subarachnoid hemorrhage
(sub= beneath + arachnoid=one of the brain coverings + hemorrhage=bleeding).
High blood pressure, also known as hypertension, is a repeatedly
elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
A hematoma is a collection of blood that is outside a blood vessel. There are different areas where hematomas occur including the inside the skull, scalp, ear, septum, bones, finger and toenails, and intra-abdominal. Treatment for hematomas depend on the type and location of the hematoma.
Internal bleeding occurs when an artery or vein is damaged and blood to escapes the circulatory system and collects inside the body. Internal bleeding can be caused by a variety of situations such as blunt trauma, deceleration trauma, medications, fractures, and spontaneous bleeding. Treatment of internal bleeding depends on the cause of the bleeding.
Drug addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.
When a portion of the brain loses blood supply, through a blood clot or embolus, a transient ischemic attack (TIA, mini-stroke) may occur. If the symptoms do not resolve, a stroke most likely has occurred. Symptoms of TIA include: confusion, weakness, lethargy, and loss of function to one side of the body. Risk factors for TIA include vascular disease, smoking, high blood pressure, high cholesterol, and diabetes. Treatment depends upon the severity of the TIA, and whether it resolves.
Coma is the inability to waken or react to the surrounding environment. The Glasgow Coma Scale is frequently used to measure the depth of coma. Causes of coma include trauma, bleeding, edema, lack of oxygen, poisoning, or hypoglycemia. Prognosis for a patient in a coma depends on the cause of the coma.
Polycystic kidney disease (PKD) is characterized by numerous cysts in the kidneys. Polycystic kidney disease is a genetic disorder. There are two major inherited forms of PKD, autosomal dominant PKD, and autosomal recessive PKD. Symptoms include headaches, urinary tract infections, blood in the urine, liver and pancreatic cysts, abnormal heart valves, high blood pressure, kidney stones, aneurysms, and diverticulosis. Diagnosis of PKD is generally with ultrasound, CT or MRI scan. There is no cure for PKD, so treatment of symptoms is usually the general protocol.
A brain hemorrhage is a type of stroke caused when an artery bursts in the brain, causing localized bleeding in the surrounding tissue. Causes of brain hemorrhage include aneurysm, liver disease, brain tumor, head trauma, high blood pressure, and blood vessel abnormalities. Symptoms include sudden severe headache, nausea, vomiting, loss of balance, tingling, numbness, vision changes, loss of consciousness, and loss of fine motor skills. Treatment depends upon the cause, location, and size of the brain hemorrhage.
Brain lesions (lesions on the brain) are caused by trauma, inflammation, autoimmune diseases, cancers, other diseases, stroke, bleeding, pituitary adenomas, and cerebral palsy. Symptoms of brain lesions include headache, nausea, fever, neck pain and stiffness, affected vision and speech, weakness or paralysis to one side of the body. Diagnosis of brain lesions is generally with imaging studies like CT or MRI scans. Treatment and prognosis of brain lesions depends on the cause of the lesion.
Heart attacks are the major causes of unexpected, sudden death among men and women. A heart attack is also a significant cause of heart failure. Learn the risk factors for heart attack such as high blood pressure, diabetes, and other heart conditions. Lowering your risk factor, lifestyle changes, and in some cases medication are the most effective way of preventing a heart attack.
Double vision (diplopia) is a symptom that my indicate Graves' disease, myasthenia gravis, stroke, multiple sclerosis, Guillain-Barre syndrome, diabetes, cataracts, aneurysm, brain tumor, or migraine. Symptoms and signs include eye pain, droopy eyelids, nausea, headache, and a cross-eyed appearance. Treatment of double vision depends upon the underlying cause.
While the general public understands that internal
bleeding means bleeding that can't be seen on the outside of the body, medical
personnel tend to use terms that describe precisely where inside the body the
bleeding is found. The internal bleeding may occur within tissues, organs, or in
cavities of the body including the head, chest, and abdomen. Examples of other
potential sites of bleeding include the eye, lining tissues of the heart, muscles, and joints.
Bleeding outside the body is quite easy to recognize. If the skin is damaged by
a laceration,
puncture, or abrasion, blood can
be witnessed as it streams out of the body. The scalp, with its rich blood
supply, is notorious for demonstrating massive blood loss. Internal bleeding can
be much more difficult to identify. It may not be evident for many hours after
it begins, and symptoms occur when there is significant blood loss or if a
blood
clot is large eno...