Aneurysm / Rupture

Aneurysm / Rupture: Overview

An aneurysm is the abnormal enlargement or bulging of an artery caused by damage to or weakness in the blood vessel wall.  Although aneurysms can occur in any type of the body's blood vessels, they almost always form in an artery.  Most aneurysms occur in the abdomen or the brain.

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Some of the different types of aneurysms include:

  • Abdominal / aortic – in an artery in the abdomen (mid-section) or closer to the heart
  • Cerebral – in an artery in the brain
  • Thoracic aortic – in an artery in the chest area
  • Peripheral – in the large arteries that run down the legs and behind the knees

An abdominal/aortic aneurysm is an enlargement of the lower part of the aorta that extends through the abdominal area.  The aorta is the main blood vessel that carries blood from the heart to the rest of the body.  An aortic aneurysm can rupture, causing life-threatening bleeding.

A cerebral aneurysm (brain aneurysm) is a weak bulging spot in an artery of the brain.  It resembles a small, thin balloon or a weak spot on a tire inner tube.

Causes and Development

Causes of abdominal/aortic aneurysms include:

Brain aneurysms are often the result of a congenital weakness (present at birth) in the muscle layer of the blood vessel wall.  They may also be caused by infections, injury and nutritional deficiencies.

Signs and Symptoms

Most people are unaware that they have an abdominal/aortic aneurysm because in most cases there are no symptoms.

A cerebral aneurysm may cause symptoms ranging from headaches, drowsiness, neck stiffness, nausea and vomiting to more severe symptoms such as mental confusion, vertigo (dizziness) and loss of consciousness.

Diagnosis and Tests

In the case of abdominal/aortic aneurysms, a pulsating enlargement or tender mass may be felt by a physician when performing a physical examination or pain in the back, abdomen or groin may be mistaken for a kidney stone attack or a ruptured disc.

A ruptured cerebral aneurysm is most often accompanied by a severe headache that demands medical attention since it can lead to bleeding inside the head.  The doctor takes an X-ray of the area to determine the exact location of the aneurysm.  This information determines the patient's treatment options.  In many cases the aneurysm simply heals, bleeding stops and the patient survives.  In more serious cases, the bleeding may cause brain damage with paralysis or coma.  In the most severe cases, a ruptured cerebral aneurysm can lead to death.

Brain aneurysms can be detected by imaging tests such as magnetic resonance imaging (MRI), computed axial tomography (CAT scans) and angiograms.

Treatment and Prevention

Conventional Treatment of Abdominal / Aortic Aneurysms:

  • Small (less than 2 inches in diameter): These rarely rupture and doctors usually prescribe blood pressure-lowering drugs.  The patient's condition is also regularly monitored.
  • Large (more than 2 inches in diameter): The aneurysm is surgically removed and that portion of the blood vessel is replaced with a flexible tube called a graft.

Conventional Treatment of Cerebral Aneurysms:

Patients with cerebral aneurysm require intensive care and as little stress as possible.  Once detected, most brain aneurysms can be repaired with microsurgery.  This type of surgery is performed with the aid of an operating microscope and tiny instruments.  During surgery, the aneurysm is identified and removed.

Signs, symptoms & indicators of Aneurysm / Rupture:

Symptoms - Head - Nose

Conditions that suggest Aneurysm / Rupture:

Circulation

Stroke

Sometimes cerebral aneurysms are the cause of stroke, although most strokes are caused by clotting rather than by a rupturing aneurysm.

Symptoms - Cardiovascular

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Risk factors for Aneurysm / Rupture:

Addictions

Cigarette Smoke Damage

278 consecutive patients with aneurysmal subarachnoid hemorrhage were compared with 314 hospitalized control patients.  Regression analysis showed that recent alcohol intake and smoking were significant independent risk factors for hemorrhage.  [Stroke 24: pp.639-46, 1993]

Studies have consistently found a 50% decrease in mortality from abdominal aortic aneurysms among former smokers compared with current smokers.  [ Medical Clinics of North America, March 1992;76(2): pp.333-53]

Alcohol-related Problems

See the link between Smoke Damage and Aneurysm.

Circulation

Atherosclerosis

Hardening of the arteries (atherosclerosis) weakens artery walls and predisposes the damaged portion to enlargement.

Infections

Chronic / Hidden Infection

Results of a small study suggest that an antibiotic may help people with abdominal aortic aneurysms.  The condition is usually treatable only with surgery.  The drug doxycycline appears to inhibit enzymes that play a role in weakening of the arterial walls.  This is a medical problem that might be influenced by an impaired immune system which allows an infection to take hold.  If doxycycline seems to help, then it is possible that either chlamydia or mycoplasma are involved.  [Annual Meeting Society for Vascular Surgery meeting in Washington, DC June 1999 ]

Nutrients

Potassium Need

Increased potassium produces a reduction in aneurysms.  Potassium is known to be the activator for several enzyme systems.  Since only minute amounts are needed for most of them, there could never be a deficiency which would inactivate the majority of them.  However, it may be that part of the weakened connective tissue is an indirect effect of a continuing potassium deficiency on the copper metabolism, especially as it pertains to the copper catalyzed enzyme lysyl oxidase.

A low incidence of cerebrovascular disease was associated with geographical regions where fresh fruit and vegetable consumption (increased potassium) was high.  It is possible that this association may also extend to aneurysms and subarachnoid hemorrhage in addition to stroke.  [Low fruits and vegetables, high-meat diet increase cerebrovascular event risk.  Medical Tribune March 10, 1997:26; N Engl J Med 316( 5): pp.235-40, 1987; Lancet: pp.1191-3, 1983]

Copper Deficiency

Copper deficiency can contribute to some cardiovascular risks.  Aortic aneurysms may be a genetic condition related to a defect in the ability to store or absorb copper.  Copper is a cofactor for lysyl oxidase, an enzyme that is responsible for the connective tissue integrity by crosslinking elastin.  Elastin is the main material of several important organs, which include blood vessels, spinal discs, lungs and skin.  In theory if you have a family or personal history of aneurysms, consider taking 2-4mg of copper per day, especially if significant amounts of zinc have been or are being consumed.

Men are more susceptible to aneurysms than are young women, probably because estrogen increases the efficiency of copper absorption.  However, women can be affected by this problem after pregnancy, probably because women must give the liver of their unborn babies large copper stores in order for them to survive the low milk copper.

Aneurysm / Rupture suggests the following may be present:

Circulation

Recommendations for Aneurysm / Rupture:

Lab Tests/Rule-Outs

Test for Cardiac Risk Factors

The authors of one study concluded that a high level of lipoprotein is an independent risk factor for thoracic aortic atherosclerosis and should be controlled in order to prevent aortic disease including aortic aneurysm.  [American Journal of Cardiology, July 15, 1993;72: pp.227-30 ]

High levels of total cholesterol and triglycerides have also been associated with increased risk.

Mineral

Copper

If copper levels are low, supplemental copper should be taken for its connective tissue strengthening effect.

Vitamins

Vitamin E

In evaluating 83 patients, it was found that serum cholesterol and triglyceride levels were higher in patients with aortic occlusive and aneurysmal disease than in control organ donors.  Vitamin E concentrations were highest in peripheral occlusive diseased tissue and as much as 3 times greater than in organ donors compared to patients with aortic occlusive disease and aneurysmal disease.  Signs of lipid peroxidation were markedly elevated in all diseased arterial tissue compared to controls.  These data supply evidence of altered vitamin E metabolism and free radical processes in the tissues of patients with various manifestations of atherosclerosis.  [Atherosclerosis, 1996;126: pp.289-297]

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