There’s a lot of confusion about aneurysms, balloon-like swellings in an artery. In and of them selves, if they are stable, what we do. That you will find out as read on is entirely dependent on the type of aneurysm that they are. Does it make a difference if they are in one body part or another. Absolutely yes. And what are the complications of aneurysms even if they are stable, over time. Like hemorrhage.
Disclaimer: This is for learning purposes only. Very little opinion here, but don’t over read into any of this when it comes to deciding what to do for an aneurysm that has been picked up incidentally on imaging, or if it’s clinically significant in a family member struggling with one.
Why Do Aneurysms Occur?
Aneurysms occur because there is a defect in an artery wall. This can occur from new trauma or inherent structural defects that can be from congenital conditions called collagen vascular diseases and the like or inflammatory conditions that are either infectious or non-infectious in nature, the latter known as vasculitis disorders.
Aneurysms are structurally divided into three major groups. One, just the basic swelling of an artery because the wall is inherently weak. These are known as Aneurisms. Sorry. Just messing with you. Sort of. Two, pseudoaneurysm, which means that the wall of the artery has actually broken slightly, and blood seeps out locally, producing the swelling locally. And three, dissection or dissecting aneurysm’s. This is when there’s not only a break in the wall of the vessel, but the blood that seeps out tracks extensively down that vessel. Three types of aneurysms, folks, basic aneurysms, pseudoaneurysms, and dissections. You’re on your way to being an expert.
Many parts of the body can have aneurysms. Brain vessels produce what are called berry aneurysms because they are shaped like berries. Wow, that was easy. The aorta can have aneurysms. And when it is the abdominal aorta, they are called AAA’s, abdominal aortic aneurysm. Holy cow. You’re ready to be a radiologist.
The complications of aneurysms are many, but the most significant is hemorrhage. And that hemorrhage isn’t like a balloon bursting. No. It’s more like a balloon-like object swelling so much the blood starts to lose out of it, affecting its surroundings.
Hemorrhage in a brain aneurysm will manifest mostly as problems to neighboring organs of the brain. In contrast, an abdominal aortic aneurysm rarely hemorrhages into an adjacent organ, and usually ruptures into the abdomen in between the organs. So, blood loss is going to be a bigger problem there.
The clinical significance of an aneurysm then is really the complications of the aneurysm. Aneurysms in and of themselves aren’t necessarily ticking time bombs. With the improved imaging that we have today, we can see what they look like, we can assess the risk, and we can see if anything needs to be done if the patient is asymptomatic, and we can carefully ascertain what needs to be done if they are symptomatic.