Fusiform and dolichoectatic aneurysms

Fusiform dolichoectatic aneurysms are another type of brain aneurysm. Fusiform dolichoectatic aneurysms lack distinct neck. They represent a widening of a segment of an artery around the entire vessel rather than just arising from a side of an artery's wall. They can rupture but usually do not. These aneurysms are thought to arise from a build up of fatty streaks or plagues inside blood vessels. High fat diets and smoking may play a role in their formation, as may genetic factors. They can also develop after mechanical injury to the inner part of the blood vessel such as dissection. As these lesions grow, the entire vessel wall may become expanded or ecstatic. When this expansion is considerable, they are referred to as dolichoectatic aneurysms. On imaging scans these lesions appear as long, wide, serpentine aneurysms. Their mass can compress surrounding structures such as the brain-stem. Any fibrofatty thrombus that they contain can fracture, flow through the circulation to other regions of the brain, and cause a stroke. Once these aneurysms become large, they are notoriously difficult to treat. In their early stages, that is as smaller fusiform aneurysms is symptomatic, for example causing stroke-like factors. This process can involve improving diet and exercise, using medications to lower blood thinner or anti-clotting medication. Open surgical and endovascular options are reserved for such aneurysms that are unresponsive to medical treatments. These options are frequently high risk. Treatment may involve some form of trapping the aneurysm or sacrificing its parent vessel, with or without an open surgical brain bypass graft. A brain bypass is similar to a heart bypass, where another vessel is harvested by the surgeon and sewn in place to allow blood to pass by the diseased segment.