Retrograde aneurysm

The article will discuss retrograde aneurysm.

An aneurysm is a dissection of the vessel wall with a protrusion of the inner membrane, which delaminates and extends into the lumen of the vessel. Aneurysm is often associated with atherosclerosis and hypertension. Occurs in 5–10% of cases of all vessels affected by plaque or formation, or in the presence of other factors predisposing to vessel dilation (vasculitis, systemic connective tissue diseases, trauma, infective endocarditis).

Typically, aneurysmal dilatation of the intracranial artery is observed with clinical signs of arterial hypertension, cerebral atherosclerosis, cerebrovasculitis, and less often due to damage to the arteries, leading to communication between the channels. The location of aneurysms depends on their size. Thus, large ones (> 5 cm in diameter) are located mainly along the carotid system. Small (2–3 cm) - mainly in the vertebrobasilar region and are usually filled with cerebrospinal fluid; less often they can be observed in the roots of the cranial nerves. The frequent location of aneurysms in the basilar artery is explained by its hyperplasticity in the absence of its compression by the tortuosity of the surrounding vascular membrane. With a high density of cholesterol plaques, multiple circulatory disorders of varying severity occur, and their frequency increases as the number and volume of these cerebral circulatory disorders increases.

**The clinical picture** depends on the location, size of the aneurysm, and the direction of its expansion relative to the blood flow. Most often, there is an acute development of signs of ischemic stroke, depending on the level of damage and the nature of the spread of the aneurysm: hemisection of the brain most often suffers without loss of functions, motor functions and behavior are predominantly impaired. The most acute development of stroke is associated with hemorrhage into the aneurysm. Jacquot's triad is characteristic: acute seizures (“fainting”) when moving the head forward and to the sides.

In the general diagnostic search for aneurysms and small vessels, CT or MRI is used, supplemented by direct methods using retrograde contrast methods: angiography, transcr