ANEURYSM

An aneurysm is the enlargement of an artery caused by weakness in the arterial

wall. Often there are no symptoms, but a ruptured aneurysm can lead to fatal
complications.

Types

The rupture of an aneurysm can be fatal.

 Aneurysms are classified by their location in the body. The arteries of the brain and
heart are the two most common sites of a serious aneurysm.

The bulge can take two main shapes:

 Fusiform aneurysms bulge all sides of a blood vessel

 Saccular aneurysms bulge only on one side

The risk of rupture depends on the size of the bulge.

Aortic aneurysm

The aorta is the large artery that begins at the left ventricle of the heart and passes
through the chest and abdominal cavities. The normal diameter of the aorta is
between 2 and 3 centimeters (cm) but can bulge to beyond 5 cm with an aneurysm.

The most common aneurysm of the aorta is an abdominal aortic aneurysm (AAA).
This occurs in the part of the aorta that runs through the abdomen. Without
surgery, the annual survival rate for an AAA of over 6 cm is 20 percent.

AAA can rapidly become fatal, but those that survive the transfer to a hospital have
a 50 percentchance of overall survival.

Less commonly, a thoracic aortic aneurysm (TAA) can affect the part of the aorta
running through the chest. TAA has a survival rate of 56 percent without treatment
and 85 percent following surgery. It is a rare condition, as only 25 percent of aortic
aneurysms occur in the chest.
 Cerebral aneurysm

Aneurysms of the arteries that supply the brain with blood are known as
intracranial aneurysms. Due to their appearance, they are also known as "berry"
aneurysms.

A ruptured aneurysm of the brain can be fatal within 24 hours. Forty percent of
brain aneurysms are fatal, and around 66 percent of those who survive will
experience a resulting neurological impairment or disability.

Ruptured cerebral aneurysms are the most common cause of a type

of stroke known as subarachnoid hemorrhage (SAH).

Peripheral aneurysm

An aneurysm can also occur in a peripheral artery. Types of peripheral

aneurysm include:

 Popliteal aneurysm: This happens behind the knee. It is the most common
peripheral aneurysm.

 Splenic artery aneurysm: This type of aneurysm occurs near the spleen.

 Mesenteric artery aneurysm: This affects the artery that transports blood to the
intestines.

 Femoral artery aneurysm: The femoral artery is in the groin.

 Carotid artery aneurysm: This occurs in the neck.

 Visceral aneurysm: This is a bulge of the arteries that supply blood to the bowel
or kidneys.
Peripheral aneurysms are less likely to rupture than aortic aneurysms.
PATIENT’S PROFILE
NAME: MARITESS FLORES
BIRTH: MARCH 4, 1976
DIED: NOVEMBER 14, 2017
OCCUPATION: TEACHER
CIVIL STATUS: WIDOWED

MEDICAL HISTORY
 NO SURGERIES
 DIABETIC AT AGE 30
 HYPERTENSIVE AT AGE 36
 Experienced a sudden severe headache, pain behind the eyes, double vision.
DIAGNOSIS:
ANEURYSM
PLAN:
CT scan, a specialized X-ray exam, is usually the first test used to determine if you
have bleeding in the brain.
MRI, uses a magnetic field and radio waves to create detailed images of the brain,
either 2-D slices or 3-D images
Cerebral angiogram, A series of X-ray images can then reveal details about the
conditions of your arteries and detect an aneurysm.
Cerebrospinal fluid test. If you've had a subarachnoid hemorrhage, there will
most likely be red blood cells in the fluid surrounding your brain and spine
(cerebrospinal fluid). Your doctor will order a test of the cerebrospinal fluid if you
have symptoms of a ruptured aneurysm but a CT scan hasn't shown evidence of
bleeding.
Screening for brain aneurysms
The use of imaging tests to screen for unruptured brain aneurysms is generally not
recommended. However, you may want to discuss with your doctor the potential
benefit of a screening test if you have:
A parent or sibling who has had a brain aneurysm, particularly if you have two
such first-degree family members with brain aneurysms
A congenital disorder that increases your risk of a brain aneurysm

TREATMENT
There are two common treatment options for a ruptured brain aneurysm.
Surgical clipping is a procedure to close off an aneurysm. The neurosurgeon
removes a section of your skull to access the aneurysm and locates the blood vessel
that feeds the aneurysm. Then he or she places a tiny metal clip on the neck of the
aneurysm to stop blood flow to it.
Endovascular coiling is a less invasive procedure than surgical clipping. The
surgeon inserts a hollow plastic tube (catheter) into an artery, usually in your groin,
and threads it through your body to the aneurysm.
He or she then uses a guide wire to push a soft platinum wire through the catheter
and into the aneurysm. The wire coils up inside the aneurysm, disrupts the blood
flow and essentially seals off the aneurysm from the artery.
Both procedures pose potential risks, particularly bleeding in the brain or loss of
blood flow to the brain. The endovascular coil is less invasive and may be initially
safer, but it may have a slightly higher risk of need for a repeat procedure in the
future due to reopening of the aneurysm.
OTHER TREATMENTS (RUPTURED ANEURYSM)
Pain relievers, such as acetaminophen (Tylenol), may be used to treat headache
pain.
Calcium channel blockers prevent calcium from entering cells of the blood vessel
walls. These medications may lessen the erratic narrowing of blood vessels
(vasospasm) that may be a complication of a ruptured aneurysm.
One of these medications, nimodipine (Nymalize, Nimotop), has been shown to
reduce the risk of delayed brain injury caused by insufficient blood flow after
subarachnoid hemorrhage from a ruptured aneurysm.
Interventions to prevent stroke from insufficient blood flow include
intravenous injections of a drug called a vasopressor, which elevates blood
pressure to overcome the resistance of narrowed blood vessels.
An alternative intervention to prevent stroke is angioplasty. In this procedure, a
surgeon uses a catheter to inflate a tiny balloon that expands a narrowed blood
vessel in the brain. A drug known as a vasodilator also may be used to expand
blood vessels in the affected area.
Anti-seizure medications may be used to treat seizures related to a ruptured
aneurysm. These medications include levetiracetam (Keppra), phenytoin (Dilantin,
Phenytek, others), valproic acid (Depakene) and others. Their use has been debated
by several experts, and is generally subject to caregiver discretion, based on the
medical needs of each patient.
Ventricular or lumbar draining catheters and shunt surgery can lessen
pressure on the brain from excess cerebrospinal fluid (hydrocephalus) associated
with a ruptured aneurysm. A catheter may be placed in the spaces filled with fluid
inside of the brain (ventricles) or surrounding your brain and spinal cord to drain
the excess fluid into an external bag.
Sometimes it may then be necessary to introduce a shunt system — which consists
of a flexible silicone rubber tube (shunt) and a valve — that creates a drainage
channel starting in your brain and ending in your abdominal cavity.
Rehabilitative therapy. Damage to the brain from a subarachnoid hemorrhage
may result in the need for physical, speech and occupational therapy to relearn
skills
TREATING UNRUPTURED ANEURYSM

Surgical clipping or endovascular coiling or a flow diverter can be used to seal off
an unruptured brain aneurysm and help prevent a future rupture. However, in some
unruptured aneurysms, the known risks of the procedures may outweigh the
potential benefit.
A neurologist, in collaboration with a neurosurgeon or interventional
neuroradiologist, can help you determine whether the treatment is appropriate for
you.

Factors to consider in making treatment recommendations include:

The size, location and overall appearance of the aneurysm
Your age and general health
Family history of ruptured aneurysm
Congenital conditions that increase the risk of a ruptured aneurysm

DIET:
 Lifestyle changes to lower your risk

 Don't smoke or use recreational drugs. If you smoke or use recreational

drugs, talk to your doctor about strategies or an appropriate treatment
program to help you quit.

 Eat a healthy diet and exercise. Changes in diet and exercise can help
lower blood pressure. Talk to your doctor about changes appropriate for you.
DOCUMENTATION
 IMPORTANCE OF KNOWLEDGE IN BIOCHEMISTRY

 Inability to oxidize and de oxidize the brain due to blood

clot or blockage in the vein resulting to inhibition of normal
functions of cells, tissues, and organs.
 brain metabolism on-line during aneurysm surgery, by combining
the use of a multiparameter (brain tissue oxygen, brain carbon
dioxide, pH, and temperature) sensor with microdialysis
(extracellular glucose, lactate, pyruvate, and glutamate). The case
illustrates the potential value of these techniques by
demonstrating the effects of adverse physiological events on
brain metabolism and the ability to assist in both intraoperative
and postoperative decision-making
 UNIVERSITY OF PERPETUAL HELP SYSTEM LAGUNA
STO. NINO BINAN LAGUNA
BS NURSING

WRITTEN REPORT IN BIOCHEMISTRY

SUBMITTED BY: FRANCES CAMILLE G. GARCIA

SUBMITTED TO: ENGR. NELIA U. RETONDO