An aneurysm is an abnormal bulge or balloon in the wall of an artery that can be caused by damage to the blood vessel or weakness in the vessel walls. A saccular aneurysm looks like a small, irregular sac. While aneurysms can occur anywhere in the body, the most likely locations are the brain or the brain and the aorta, a large blood vessel that travels from the left ventricle of the heart, through the chest, carrying blood to vital organs . When the aorta reaches the lower abdomen, it branches into two smaller arteries that carry blood to the pelvis and legs.
A cerebral saccular aneurysm usually occurs in the circle of Willis area of the brain, in the middle cerebral artery. There was a time when they were thought to be congenital, although studies now seem to contradict that assumption. There are some genetic abnormalities, such as autosomal dominant polycystic kidney disease (ADPKD), that are associated with intracranial aneurysms. A significant number of patients diagnosed with cerebral saccular aneurysm actually have multiple lesions, although this is much more likely to occur in women than in men.
The most common cause of cerebral aneurysms is hemodynamically induced degenerative vascular injury. Rare cases can also be the result of trauma, cocaine use, tumors, or infections. Treatment is generally recommended, although the method depends on the location of the injury. Surgical methods include trimming the area or an endovascular process called rolling.
A saccular aneurysm is more likely to form in the aorta, and most of these are abdominal. Men between the ages of 40 and 80 are more likely to develop abdominal aneurysms, usually as a result of atherosclerosis, or hardening of the arteries. An abdominal saccular aneurysm is unlikely to rupture if it develops slowly and does not get larger than one and a half to two inches (4-5 cm). If the aneurysm grows faster or larger, intervention is recommended. Surgical repair involves removing the weakened part of the artery and replacing it with a polyester tube.
Aortic aneurysms can also be thoracic, meaning they form above the diaphragm. This can occur in people who have connective tissue disorders or be caused by trauma, such as a car accident, prolonged high blood pressure, and previous tearing of artery walls. Surgical repair depends on where the saccular aneurysm is located. If it is in the ascending aorta, which is in the front near the heart, surgery is recommended if it is about two inches (5 cm) in size. If the injury is in the descending aorta, surgery is usually delayed until the injury is nearly two and a half inches (about 6 cm).
Aneurysms are considered silent killers because they can grow for years without showing any symptoms. If symptoms do occur, they vary depending on the location of the saccular aneurysm. An aortic injury will not usually show any symptoms unless it is large enough to impede blood flow, press against other parts of the body, or rupture. If symptoms do occur, they will usually include a throbbing sensation in the abdomen or back or abdominal pain.
When a thoracic saccular aneurysm does reveal symptoms, they usually involve back, neck, or jaw pain, cough, hoarseness, and shortness of breath. Brain aneurysms can cause droopy eyes, blurred or double vision, dilated pupils, and facial numbness. In all cases, a rupture is usually accompanied by a sharp pain in the affected area. Nausea, vomiting, clamming, and loss of consciousness follow. Internal bleeding can quickly lead to shock and death unless the patient receives immediate emergency medical attention.