CEREBRAL AEURYSM: CLINICAL MANIFESTATIONS AND SURGICAL MANAGEMENT

Abstract

A cerebral aneurysm is an abnormal dilation of an artery that supplies the brain, which can cause serious complications if it ruptures. Clinical manifestations and surgical management depend on several factors, such as the size, location, type and condition of the aneurysm, as well as the patient's clinical conditions. Early diagnosis and appropriate treatment are essential to reduce morbidity and mortality associated with cerebral aneurysm. Objective:  evaluate scientific evidence on the clinical manifestations and surgical management of cerebral aneurysm, as well as risk factors, diagnostic methods and clinical outcomes. Methodology: A search was carried out in the databases PubMed, Scielo, Web of Science, using the descriptors: “aneurysm”, “cerebral”, “clinical manifestations”, “surgical treatment” and “outcome”. Articles published in the last few years were included. 10 years, in Portuguese or English, that addressed the proposed topic. Articles that were not original, that did not present sufficient data or that had low methodological quality were excluded. The selection of studies was made according to the PRISMA checklist. Results: There were 10 studies selected. The most common clinical manifestations of cerebral aneurysm are intense and sudden headache, nausea, vomiting, stiff neck or low back pain when flexing the neck, blurred or double vision, drooping eyelids or increased sensitivity to light, drowsiness , mental confusion, loss of consciousness or seizures.The risk factors most associated with cerebral aneurysm are high blood pressure, smoking, hereditary connective tissue disorders or a family history of aneurysm. Surgical management of cerebral aneurysm aims to prevent or treat complications resulting from aneurysm rupture, such as subarachnoid hemorrhage, stroke, permanent brain damage or death. There are two main types of surgery for brain aneurysm: open surgery and endovascular surgery. The surgical indication depends on several factors, such as the size (surgery is generally indicated for aneurysms equal to or larger than 5 millimeters), the location, type and status of the aneurysm (whether ruptured or not), as well as the clinical conditions of the aneurysm. patient. Some of the possible outcomes are: complete or partial recovery of neurological functions, permanent sequelae (such as motor, sensory or cognitive deficits), complications (such as hydrocephalus, vasospasm or infections) or death. Conclusion: Brain aneurysm is a serious condition that requires immediate medical attention. Clinical manifestations and surgical management depend on several individual and contextual factors. Early diagnosis and appropriate treatment can improve clinical outcomes and patients' quality of life. The systematic literature review allowed the synthesis of scientific evidence on the topic, contributing to the advancement of knowledge and evidence-based clinical practice.