Sacular Aneursyms

Sacular Aneurysm

A Sacular aneurysm can also be called an intracranial berry aneurysm. This aneurysm consists of a saclike “out pouching” in a cerebral blood vessel. 1 in a 1000 people a year has an incidence of these types of aneurysms. This type of aneurysm can be very dangerous and are very likely to rupture and cause a stroke. These types of aneurysms should not be take lightly and are very dangerous. These types of aneurysms have a 70-90% mortality rate.

Sacular aneurysms occur when there is weakening of the blood vessel wall in the cerebrum. This weakening can start to bulge out because of increase blood pressure forming an aneurysm within the blood vessel. The circle of Willis is very susceptible to secular aneurysms because of the small vessels that lead to larger vessels in the brain. Other typical sites that these aneurysms can occur are the vertebral artery and the basilar artery.

Risk Factors of Sacular Aneurysms

Conditions that can cause secular aneurysms include: hypertension, renal disease, conditions causing weakening of blood vessels, genetic disorders, and head trauma. There can be many complications that deal with secular aneurysms, if an aneurysm ruptures then the patient can be at risk for stroke, vasospasm, and a subarachnoid hemorrhage.

Signs and Symptoms

1. Headaches
2. double vision
3. loss of vision
4. eyes and neck pain

Symptoms of a ruptured aneurysm include :

1. A sudden sever headache
2. confusion
3. seizures
4. eyelids drooping
5. fatigue
6. confusion
7. Sudden mood swings

Diagnosis and Treatment

These types of aneurysms can be diagnosed by CT, MRI, angiography, and cerebrospinal fluid analysis. If aneurysms are discovered and have not yet ruptured most of the time the patient is taken to surgery and they can have a Micro Vascular clip put in. When the clip is put in, the blood flow is cut off to the aneurysm and it usually does not return. This treatment is known to be highly effective. Another procedure they can use is called an Occulsion. An occlusion is when the entire artery that is involved with the aneurysm is clamped off and the blood supply is rerouted away from the artery with the aneurysm. If a patient is diagnosed it is very important for them to control there blood pressure, not smoke, and avoid cocaine and other drugs that can elevate blood pressure which could eventually rupture the aneurysm.

Blowout Fractures

Blow-Out Fractures of the Orbit

Blow out fractures are caused by direct trauma to the eye. When there is trauma to the eye from being hit by a fist or a ball larger than the orbit, an increase in pressure within the orbit can occur. A blowout fracture by definition is, “a break in one of the thinner orbit bones and the possibility of the nerves and eye muscles in the orbit are being pushed through the break in the orbit.” The orbit rim basically buckles which results in an orbital floor fracture.

Symptoms

When trauma to the orbit is caused, blood vessels can become broken in the eye and the blood will rush to the eye and tissues surrounding the eye causing a black eye. Another symptom of a blow out fracture is when the swelling goes down the eye can look sunken in the orbital bones. Double vision can occur in the eye that was inflicted by the trauma. Sometimes the upper back teeth of the effected side and cheek can become numb as well. Not to often nausea can occur right after the injury has been sustained. When the patient is being examined in for facial/orbit trauma, the orbits will be examined along with the pupil size and the patient’s vision. Sometimes the orbit can become so swollen that an examination cannot be performed and the doctor will have to wait to reassess the orbit.

Treatment

Treatment for blowout fractures depends on how severe the damage is to the orbit. The orbits will be assessed by either: CT images, diagnostic, and sometimes MRI. The main injury in blowout fractures has to do with the orbital bone. If the damage is not extensive it can be left alone to heal without any type of treatment. If the patient is experiencing dilated pupils, double vision, and/or a sunken eyeball surgery could be required. If surgery is required the orbit will be repaired by sealing the hole in the orbit bones by a thin plastic implant. The good thing is if surgery is required the surgery can be postponed for up to two weeks and scarring is little to none with not a long recovery time. Most of the time surgery can be a permanent cure the only side effects are that double vision and the eye being sunken in can come back rarely does that happen, but it is possible. This condition is very treatable.