CHENNAI : According to the Brain Aneurysm Foundation, one in 50 people in the United States have an unruptured brain aneurysm. There are almost 500,000 deaths worldwide each year caused by brain aneurysms, and half the victims are younger than 50. A brain aneurysm is a bulge or ballooning in a blood vessel in the brain. CE speaks to Dr Jos Jasper, HOD, Kauvery Brain and Spine Centre, Kauvery Hospital, Cantonment Tiruchy.
“A brain aneurysm starts off as a bulge. It keeps on ballooning and at one point, the balloon bursts causing bleeding in the brain. The ballooning out is known as aneurysm. A ruptured aneurysm can also cause death. Therefore, a brain aneurysm is always life threatening,” says Dr Jasper.
Symptoms
Throbbing headache with loss of consciousness
Severe headache associated with vomiting
Loss of consciousness and seizure
Headache in the morning or when one does some strenuous activity
It seems like the worst headache of your life
Neck pain with limited neck movement
Causes
There are no specific causes of brain aneurysms. Some people have a genetic predisposition. The Japanese have high chances of getting brain aneurysms because of the genes.
Diagnosis
There are two types of brain aneurysms — ruptured and unruptured. In a ruptured aneurysm, blood leaks into the brain and it can damage the brain. In some cases, the blood degenerates in the brain and becomes toxic. If not treated aggressively, it can lead to death. Unruptured aneurysm is easier to treat as blood doesn’t leak into the brain.
“In Japan, screening angiograms are done where they find an aneurysm even before it ruptures. In India, we find patients only after they rupture. We don’t have preventive angios. It’s very rare that we find unruptured aneurysms,” says Dr Jasper, adding: “If a patient comes with headache, we check for neck stiffness. It’s almost sure that there is blood in the brain if there is neck stiffness with headache.”
A CT brain with CT angiogram is done to check for an aneurysm. The angiogram shows the aneurysm separately. If more details are required, a Digital Subtraction Angiography (DSA) of the brain is performed.
Treatment
There are two main treatment options:
Clipping: In this method, the surgeon opens the skull and puts a clip where the blood vessel is ruptured. This technique is known as clipping of the aneurysm. It is an open surgery.
Coiling: This method is like the stenting of the heart. The surgeon takes the catheter to the aneurysm in the brain and inserts a special coil. The coil obliterates the aneurysm.
Risk factors
Unhealthy lifestyle, hypertension,
diabetes, bad fat like cholesterol, increased stress, familial tendencies.
Prevention
The disease can be prevented by following a healthy lifestyle and diet, maintaining blood pressure and sugar, exercising regularly and not taking stress.
Post-treatment care
A patient can go back to work within two months if there are no other complications. Patients do have to follow up and take repeat angiograms as per their doctor’s instruction.