"Drunk Rage" or Real Illness? A Giant Time Bomb Hidden in the Brain!

Zhang Wen (pseudonym), a 37-year-old, suffered a sudden severe headache after drinking alcohol, accompanied by constant shouting and pounding. His family initially attributed the headache to alcohol and the shouting to "drunk rage." However, his perceptive cousin sensed something unusual, believing his headache was not ordinary, and rushed him to the hospital.

At 2:00 AM, the medical team began the race against time.

Excruciating Headache, Pounding, and Shouting

A Giant Cerebral Aneurysm Had Ruptured

Two months ago, Zhang Wen arrived at HeYou Hospital with a severe headache, constantly shouting and pounding his head. The doctor immediately performed a head CT scan, which revealed significant subarachnoid hemorrhage. Cranial decompression was performed, successfully controlling the bleeding and significantly alleviating the headache symptoms.

Subsequently, a head CT angiography scan confirmed that the bleeding was caused by a ruptured aneurysm at the ophthalmic segment of the internal carotid artery. The aneurysm measured 25 × 12 mm, classifying it as a giant aneurysm.

Cerebral aneurysms are extremely dangerous and can cause sudden death. The mortality rate after a single rupture can be as high as 40%. It is like a "time bomb" lurking in the skull. Without prompt and standardized treatment, the aneurysm is highly likely to rupture and bleed again, leading to brain herniation, cardiac and respiratory arrest, or cerebral vasospasm resulting in paralysis, coma, or even death.

Given this, Professor Li Baomin, Director of the Neurointerventional Department, who participated in the consultation, immediately led the team to manage the case. "Treatment options for cerebral aneurysms generally include surgical clipping and endovascular embolization. Given the giant size and specific location of his aneurysm, we decided to proceed with endovascular embolization," said Director Li. Endovascular embolization is the optimal method to prevent a second rupture and bleeding of a cerebral aneurysm.

3-Hour Meticulous Procedure to Occlude the Aneurysm

Risk of Expansion and Rupture Eliminated

Although Zhang Wen's condition was stable at the time, a re-rupture could occur at any moment. The team promptly held a preoperative discussion and formulated a detailed two-stage surgical strategy. Why two surgeries? According to Director Li, Zhang Wen's aneurysm was giant, and simple stent-assisted coiling would have a high recurrence rate. The primary goal of the first surgery was to stop the bleeding. After the bleeding was controlled, a second surgery would be performed to completely occlude the aneurysm.

During the procedure, Director Li, leveraging his exceptional skill and experience, skillfully redirected the blood flow, effectively preventing further expansion and rupture of the aneurysm. The surgery was completed successfully, and angiography showed dense packing of the aneurysm with no opacification of the sac. On the third day post-surgery, Zhang Wen was able to get out of bed and move around, with normal limb movement and language function. "He felt completely at ease and could even chat happily with the doctors and nurses," his family said with a smile.

Recently, Zhang Wen successfully underwent the second-stage surgery at HeYou Hospital. Director Li completely sealed the aneurysm and remodeled the arterial channel, eliminating the risk of recurrence.

Quiet as Still Water, Fierce as a Beast Fierce as a Beast

6 Tips for Preventing Cerebral Aneurysms

Although the term "aneurysm" contains the word "tumor," it is not a tumor. It is a localized abnormal dilation of the inner wall of a cerebral artery, forming a sac-like protrusion at a weak point.

Congenital vascular defects or developmental abnormalities are significant causes of aneurysm formation. Additionally, long-term conditions like hypertension and hyperlipidemia leading to atherosclerosis can also trigger aneurysms. Infections, trauma, and certain rare factors may also contribute to their development.

The clinical manifestations of a cerebral aneurysm differ depending on whether it has ruptured:

When Unruptured: May be asymptomatic or present only with mild headache, dizziness, etc. When the aneurysm is large, it may compress adjacent nerves or brain tissue, causing corresponding compression symptoms such as oculomotor nerve palsy (manifested as unilateral ptosis, dilated pupil, etc.), trigeminal neuralgia, or facial numbness.

When Ruptured: Presents with a sudden, severe headache (often described by patients as "my head is going to explode"), frequent vomiting, profuse sweating, fever, neck stiffness, altered consciousness, or even coma. Some patients have triggers such as fatigue or emotional agitation before the hemorrhage, while others have no obvious trigger or experience onset during sleep.

Cerebral aneurysms are also described as "Quiet as still water, fierce as a beast." How to prevent this "beast"? Focus on the following 6 aspects:

1. Control Hypertension: Hypertension is a major risk factor for cerebral aneurysms. Regular monitoring and maintaining blood pressure within the normal range is crucial.

2. Healthy Diet: Maintain a low-salt, low-fat, high-fiber diet. Eat plenty of vegetables, fruits, whole grains, and fish rich in high-quality protein.

3. Weight Management: Obesity increases the risk of developing a cerebral aneurysm, so maintaining a healthy weight is important.

4. Quit Smoking and Limit Alcohol: Smoking and excessive alcohol consumption increase the risk of cerebral aneurysms. Quit smoking and limit alcohol intake as early as possible.

5. Maintain Mental Health: Actively managing stress and maintaining a positive mindset and emotional state can also help reduce the risk of cerebral aneurysms.

6. Regular Brain Check-ups: Individuals with a family history or high-risk factors should undergo regular brain examinations for early detection and treatment of cerebral aneurysms.

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Author of this article >>>> Niu Si

Professional Guidance >>>> Li Baomin, Chief Physician, Professor, Director of the Neurosurgery Interventional Department (Former Lead of Neurointerventional Specialty at PLA General Hospital)