BEWARE OF BRAIN ANEURYSMS
After recent reports about the president of a prominent Asian country supposedly suffering a brain aneurysm — the unexpected bulging of blood vessels to the brain —there has been a lot of curiosity about the a potentially life-threatening condition.
The incidence of brain aneurysms is relatively higher in Japan and Finland where it is around 20-25 cases per one lakh people. The exact reason for this is not known but is often attributed to the genetic make-up. Worldwide, the incidence is almost 3% in the population (3 out of 100) above the age of 50 years. The death rate among patients affected by cerebral aneurysm is around five out of 200 patients. Below the age of 50, almost equal instances of aneurysms are found in both males and females, but in the 50 plus age group, it is found more among the females, mainly due to weakened blood vessels owing to menopausal hormonal changes, say experts.
CEREBRAL ANEURYSM EXPLAINED
An aneurysm is a bulge or balloon-like outpouching from blood vessels/arteries that carry blood, and a cerebral aneurism is one occurring in a vessel from the heart to the brain. Usually, a defect develops in one of the three layers of the thick blood vessels and blood will be pushed from the point of the defect in the arterial wall, causing a pouch. Over time, this pouch will grow and someday may rupture (causing bleeding in the brain). It can even be fatal. Though aneurysms can form anywhere in the brain, usually, they are found in arteries at the base of the brain. If the rupture happens, around 30% people die immediately, 30% fall unconscious following a severe headache while another
30% suffer from a mild headache but more or less remain okay,” says Dr B J Rajesh, senior neurosurgeon from Yashoda Hospital. Repeat ruptures are common in those patients who survive and the second rupture is more likely to be fatal.
UNEXPLAINED HEADACHE - A WARNING SIGN
“Cerebral aneurysms do not have prominent symptoms but patients who have survived the rupture say that prior to the incident, they experienced sudden severe headaches. They refer to the ‘thunderclap’ headache as the worst headache ever. The severity varies according to the degree of the rupture,” says Dr Rajesh.
Risk factors
Though the specific causes of brain aneurysms are not known, it is often seen in patients with hypertension and the habit of smoking. The risk factors include uncontrolled hig blood pressure, smoking and sub stance abuse, family history of cer bral aneurysms, genetic factor older age, vasculitis (inflammatio of the blood vessels), infection and high fat content i blood etc. Therefor an active, health lifestyle, good die and abstainin from smokin are required t cut down th
risk factors.
ANEURYSM IS A BULGE OR BAL- LOON-LIKE OUT-POUCHING FROM BLOOD VESSELS/ARTERIES THAT CARRY BLOOD, AND A CEREBRAL ANEURISM IS ONE OCCURRING IN A VESSEL FROM THE HEART TO THE BRAIN. USUALLY, A DEFECT DEVELOPS IN ONE OF THE THREE LAYERS OF THE THICK BLOOD VESSELS AND BLOOD WILL BE PUSHED FROM THE POINT OF THE DEFECT IN THE ARTERIAL WALL, CAUSING A POUCH. OVER TIME, THIS POUCH WILL GROW AND SOMEDAY MAY RUPTURE. IT CAN BE FATAL.
DIAGNOSIS
Screening i advisable if yo experience sud den unexplaine headaches. Diagnosi can be done throug MRI or CT scan combine with a cerebral angiogram. This wi help detect the point of rupture an its shape and structure and th blood vessel from which it is arisin and also help in determining th treatment.
MODE OF TREATMENT
“There are two aspects of treatmen The first is identifying the affecte blood vessels and parameters of th aneurysm and provide emergenc care to prevent a repeat ruptur This treatment can be either the les invasive endovascular coiling (with out opening the skull) or surgical (b opening the skull) and clipping a the neck (opening) of th aneurysm to prevent any furthe blood flow. The disadvantage o the endovascular coiling metho is that if a rupture suddenly hap pens during the coiling, becomes very difficult to save th patient, whereas if rupture hap
pens during an open sku surgery, saving the life is easie Nowadays, with advanced tech nology, complications of endova cular intervention are fewer an safer and many patients prefe this,” elaborates Dr Rajesh.
“The second aspect is treating th patients for the effects of ruptur such as swelling in the brain seizures, loss of consciou ness, nausea, blurre vision, weakening o hand and legs, an hearing or speec problems depend ing on the are where the bleed ing happens an the blood vesse affected” add the neurosu
geon.