The cerebral aneurysms are dilations of the arteries that cause brain hemorrhage.

Abundant subarachnoid hemorrhage in TAC

They can present in any age, but mainly after the 50 years, and exists a greater predisposition in females. It is considered that 50% of the patients die before arriving at the Hospital, representing one of the more frequent causes of sudden death in the adult.

These injuries are located mainly in any cerebral artery but in those related to the well-known Circles of Willis such as internal carotid, middle cerebral and anterior cerebral artery as well as anterior communicating artery that corresponds to anterior circulatory circuit. In the posterior region they are observed above the posterior cerebral artery, vertebral and basilar arteries, mainly. Nevertheless, the frequency of these injuries in the later circulation is less frequent.

The cardinal symptom is the sudden headache and corresponds to the worst and most intense pain ever experienced. Additionally, the patients can present seizures, paralysis of cranial nerves and also coma.

The diagnosis is made by means of specific exams such as:

• Cerebral Angiogram with digital subtraction
• Magnetic angiogram
• Cerebral angiotomogram

The treatment of the cerebral aneurisms is always based on surgery through a craniotomy for clipping using a Titanium device or by endovascular therapy using for metallic filaments (coils). The best treatment must be made during the first later days to avoid rebleeding and the high possibility of developing spasms of the arteries (vasospasm), which would complicate the clinical picture aggravating its prognosis.

LEFT:
Clip is being placed on the neck of the aneurism.

RIGHT:
Positioning of Coil intravascularly within aneurism.

The prognosis of the aneurysms depends on the patient's state in the moment before the surgical treatment.