Friday, May 13, 2022

How To Prevent Brain Aneurysm

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What’s The Difference Between A Ruptured And An Unruptured Brain Aneurysm

Can you prevent brain aneurysms?

A ruptured aneurysm, sometimes called a brain bleed, is when blood breaks through the aneurysm’s wall and starts bleeding. This causes severe symptoms, such as a very painful headache like you’ve never felt before, and requires immediate medical care. With rapid, expert treatment, patients can often recover fully.

An unruptured brain aneurysm may cause zero symptoms. People can live with them for years before detection. If a brain aneurysm is unruptured, no blood has broken through the blood vessel walls. This means the “balloon” in your blood vessel remains intact.

For unruptured brain aneurysms, doctors will treat aneurysms that are more likely to bleed and leave certain others alone.

Once a brain aneurysm bleeds, or ruptures, it requires immediate medical care in a medical center designed to handle emergencies. If you think you are experiencing a ruptured brain aneurysm, dial 911 immediately.

Neurosurgeons use specialized procedures to treat ruptured and unruptured brain aneurysms, when appropriate:

  • Microsurgical clipping: Neurosurgeons make a small opening in the skull and then place a titanium clip over the aneurysm to stop blood flow into the aneurysm.
  • Endovascular coiling/stenting: In this newer approach, neurosurgeons place a stent, or tube, or other devices, such as coils, inside a blood vessel or aneurysm to divert blood flow away from an aneurysm.

How Are Brain Aneurysms Treated

Surgery and/or endovascular therapy are the treatment for brain aneurysms, whether they are ruptured or unruptured.

Open surgical clipping

During this procedure, your surgeon cuts a small opening in your skull to access the aneurysm. Using a tiny microscope and instruments, your surgeon attaches a small metal clip at the base of the aneurysm to pinch it off. This blocks blood from flowing into the aneurysm. The surgery can stop a brain bleed or keep an intact aneurysm from breaking open. Recovery time is different for ruptured and unruptured aneurysms. This procedure is considered to be durable with a low recurrence rate.

Endovascular therapy

For this procedure, your surgeon doesnt need to create an opening in your skull. Instead, a doctor inserts a catheter in a blood vessel, usually in the groin or wrist, and threads it to your brain.

Through the catheter, your doctor places a ball of wires , most often made of platinum, in the aneurysm, sometimes with the help of small stents or balloons. Recently another small device , which looks like a mesh ball, made of nickel titanium, also became available, and works in a similar fashion as coils. Both methods result in blood clot formation around and inside the wire ball or web device, and block blood flow into the aneurysm, reducing or eliminating the risk of rupture.

Treatment For An Aneurysm

Treatment for an aneurysm depends on its location and severity, but may include:

  • Cerebral aneurysm is repaired either by coils or stent insertion, or by surgery where the aneurysm has been clipped. If the aneurysm has ruptured, then you will need to stay in hospital for up to 21 days because of potential complications, including vasospasm and hydrocephalus. Around one third of all people who experience a ruptured cerebral aneurysm die, and less than 30 per cent get back to a pre-rupture state.
  • Thoracic aortic aneurysm requires drugs to control high blood pressure and surgery to repair the aneurysm if necessary. Sometimes, the nearby heart valve may also need fixing during the operation. Most people with a ruptured thoracic aortic aneurysm die within minutes.
  • Abdominal aortic aneurysm requires drugs to control high blood pressure and surgery to repair the aneurysm if necessary. The mortality rate is more than 50 per cent if the aneurysm ruptures.

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Aortic Aneurysm Treatment Options

The doctor may monitor an unruptured aortic aneurysm, if no symptoms are evident. Medications and preventive measures may form part of conservative management, or they may accompany active surgical treatment.

A ruptured aneurysm needs emergency surgery. Without immediate repair, patients have a low chance of survival.

The decision to operate on an unruptured aneurysm in the aorta depends on a number of factors related to the individual patient and features of the aneurysm.

These include:

  • the age, general health, coexisting conditions and personal choice of the patient
  • the size of the aneurysm relative to its location in the thorax or abdomen, and the aneurysms rate of growth
  • the presence of chronic abdominal pain or risk of thromboembolism, as these may also necessitate surgery

A large or rapidly growing aortic aneurysm is more likely to need surgery. There are two options for surgery:

  • open surgery to fit a synthetic or stent graft
  • endovascular stent-graft surgery.

In endovascular surgery, the surgeon accesses the blood vessels through a small incision near the hip. Stent-graft surgery inserts an endovascular graft through this incision using a catheter. The graft is then positioned in the aorta to seal off the aneurysm.

In an open AAA repair, a large incision is made in the abdomen to expose the aorta. A graft can then be applied to repair the aneurysm.

Endovascular surgery for the repair of aortic aneurysms carries the following risks:

Continue Learning About Brain Aneurysms

How Do You Prevent a Brain Aneurysm?

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.

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How Is Brain Aneurysm Treated

Treatment of an unruptured aneurysm may depend on its size and location. If the aneurysm is very small, you will probably be recommended to have regular scans to monitor it, and treatment for any other conditions, such as high blood pressure.

If you have had a burst aneurysm, you will be told to stay in bed and to take pain relief medication for any pain you might have. You will then have surgery to clip the aneurysm so that it does not bleed again.

Another type of surgery involves threading a thin tube through the artery from the groin and using it to insert a tiny metal coil into the aneurysm. This causes a blood clot, which prevents the aneurysm from bursting.

If the aneurysm caused a brain haemorrhage, you may need other treatments for complications, such as reduced blood flow to the brain or fluid on the brain.

Surgical Repair Of Aneurysms

If the aortic aneurysm is less than five cm wide, it is usually left untreated, but closely monitored . If it is larger than five cm, the aneurysm is surgically repaired. In most cases, the aneurysm is cut out and the hole is plugged with an artificial graft.Depending on the location of the cerebral aneurysm, it will be treated either surgically with clipping, or by using fine platinum coils inserted in the aneurysm via an angiogram, which is a radiological procedure used, in this case, to close the aneurysm and preserve the normal flow of blood in the brain.Treatment of a ruptured cerebral aneurysm is an urgent procedure, but treatment of an unruptured aneurysm can be performed semi-electively.

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Contact The Center For Cerebrovascular Disease

The Center for Cerebrovascular Diseases is home to six neurosurgeons among them world leaders in the treatment of brain aneurysms. In additional to their exceptional technical skill, our neurosurgeons are known for their clear communication, compassion, ample time spent with patients, and personal care and attention.

We understand that confronting an aneurysm can be frightening for many patients and families, and we are aware of the challenges this presents. Our guiding principle is to put the patient and family first. We emphasize healing in a comfortable, relaxed environment. Your physicians are accessible to you throughout your care before, during and after the treatment period.

Our team of neurosurgeons with deep expertise in treating aneurysms includes:

What Are The Symptoms

Brain Aneurysm Symptoms — Know the Signs to Prevent Serious Damage!

Unruptured aneurysm Most cerebral aneurysms do not show symptoms until they either become very large or rupture. Small unchanging aneurysms generally will not produce symptoms.

A larger aneurysm that is steadily growing may press on tissues and nerves causing:

  • pain above and behind the eye
  • numbness
  • paralysis on one side of the face
  • a dilated pupil in the eye
  • vision changes or double vision.

Ruptured aneurysmWhen an aneurysm ruptures , one always experiences a sudden and extremely severe headache and may also develop:

  • double vision

TypeThere are three types of cerebral aneurysms:

  • Saccular aneurysm. A saccular aneurysm is a rounded sac containing blood, that is attached to a main artery or one of its branches. Also known as a berry aneurysm , this is the most common form of cerebral aneurysm. It is typically found on arteries at the base of the brain. Saccular aneurysms occur most often in adults.
  • Fusiform aneurysm. A fusiform aneurysm balloons or bulges out on all sides of the artery.
  • Mycotic aneurysm. A mycotic aneurysm occurs as the result of an infection that can sometimes affect the arteries in the brain. The infection weakens the artery wall, causing a bulging aneurysm to form.

SizeAneurysms are also classified by size: small, large, and giant.

  • Small aneurysms are less than 11 millimeters in diameter .
  • Large aneurysms are 11 to 25 millimeters .
  • Giant aneurysms are greater than 25 millimeters in diameter .

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What Is The Outcome Of Brain Aneurysm

Brain aneurysms are deadly. About 10% of patients with a ruptured aneurysm die before receiving medical care. If untreated, another 50% will die within a month, with a 20% risk of rebleed by the end of the first two weeks. Aside from the bleeding issues, there is significant risk of artery spasm leading to stroke.

Survival rates are increased in patients who present early to the hospital. Early diagnosis, aneursym repair, and control of blood vessel spasms with appropriate medications are all associated with increased survival.

Brain Aneurysm: 4 Things You Need To Know

    When part of a blood vessel in your brain bulges, or balloons, it’s called an aneurysm. Every brain aneurysm is unique in location, shape and size. These particulars guide your doctor in determining how and whether to treat a brain aneurysm.

    Neurosurgeon Judy Huang, M.D., of the Johns Hopkins Department of Neurosurgery, provides insight into some of the most common questions behind brain aneurysm diagnosis and treatment.

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    Who Should Get Treatment For A Brain Aneurysm

    A leaking or ruptured brain aneurysm requires emergency surgery. But you might only find out about a brain aneurysm when you have an imaging test for an unrelated condition.

    If you have a small brain aneurysm that isnt causing symptoms, and you do not have other relevant risk factors, your healthcare provider may recommend not treating it. Instead, your provider will order regular imaging tests to rule out any change or growth over time. They will also recommend you quit smoking and require that your blood pressure control is under control. Youll need to get help right away if you develop symptoms, or aneurysm change/growth occurs on follow-up imaging.

    If you have symptoms, positive risk factors, and/or the aneurysm is large, you and your healthcare provider will discuss the benefits, risks and alternatives of surgical and/or endovascular treatment. The decision depends on several factors, including but not limited to your:

    • Age
    • Risk of a brain bleed

    Rupture Signs And Symptoms

    How to Avoid an Aneurysm: 14 Steps (with Pictures)

    The most common symptom is the worst headache of your life, or what Crawford calls the “W-H-O-L.”

    “People describe it as like being struck by a bolt of lightning,” Riina says. That headache could be accompanied by the neck stiffness, face tingling, and light sensitivity Colagrossi experienced. Some people also report hearing a gunshot or boom when their rupture occurs.

    Seizures, a feeling of weakness in the limbs, blurry or double vision, and extreme tiredness are all associated symptoms.

    But a sudden, excruciating headache is really the hallmark of a rupture, Riina says. “The headache could be anywhere or all over, but patients usually describe it as being focused behind the eyes,” he adds.

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    How Can A Brain Aneurysm Growth Or New Aneurysm Formation Be Prevented

    Once an aneurysm is found, it is not expected to resolve on its own. However, aneurysm growth, change, risk of aneurysm rupture, or new aneurysm formation can be reduced by having a healthy lifestyle. Steps you can take include:

    • Exercise regularly without excessive heavy lifting.
    • Eat a balanced diet.
    • Get help for alcohol or drug use disorder and dont use cocaine or other stimulant drugs.
    • Control high blood pressure with medications and lifestyle changes.

    How Are Cerebral Aneurysms Treated

    Not all cerebral aneurysms require treatment. Some very small unruptured aneurysms that are not associated with any factors suggesting a higher risk of rupture may be safely left alone and monitored with MRA or CTA to detect any growth. It is important to aggressively treat any coexisting medical problems and risk factors.

    Treatments for unruptured cerebral aneurysms that have not shown symptoms have some potentially serious complications and should be carefully weighed against the predicted rupture risk.

    Treatment considerations for unruptured aneurysms A doctor will consider a variety of factors when determining the best option for treating an unruptured aneurysm, including:

    • type, size, and location of the aneurysm
    • risk of rupture
    • the persons age and health
    • personal and family medical history
    • risk of treatment.

    Individuals should also take the following steps to reduce the risk of aneurysm rupture:

    • carefully control blood pressure
    • avoid cocaine use or other stimulant drugs.

    Treatments for unruptured and ruptured cerebral aneurysms Surgery, endovascular treatments, or other therapies are often recommended to manage symptoms and prevent damage from unruptured and ruptured aneurysms.SurgeryThere are a few surgical options available for treating cerebral aneurysms. These procedures carry some risk such as possible damage to other blood vessels, the potential for aneurysm recurrence and rebleeding, and a risk of stroke.

    Endovascular treatment

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    Risk Factors For Rupture Of A Brain Aneurysm

    All brain aneurysms are at risk of bleeding. If you have a brain aneurysm, it is not possible to know which path it will follow over the course of the next few years or over the course of your life.

    There are several factors associated with a higher chance of brain aneurysm rupture:

    • Increase in size of the aneurysm
    • Seizures
    • Alcohol use

    How Do I Decide What Procedure To Have If I Have A Cerebral Aneurysm

    Brain Aneurysm Diagnosis, Prevention and Treatment

    The treatment of choice for an intracranial aneurysm, like all medical decisions, should be agreed upon by both the physician and the patient. In the case of either ruptured or un-ruptured intracranial aneurysms, the treating physician should discuss the risks and benefits of each available treatment option. The physician will usually make recommendations for one treatment over another, depending on the facts of each individual case. Seeking a second opinion, when possible, is usually advisable.

    Although unresolved controversies remain as to what the best treatment option is for an individual patient, both surgical clipping and endovascular coiling/stenting are considered to be viable treatment options in the management of cerebral aneurysms today.

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    Will I Need Surgery To Treat An Unruptured Brain Aneurysm

    For an unruptured brain aneurysm, your doctor will decide whether it’s better to treat the aneurysm now or monitor you carefully .

    Certain aneurysms are more likely to bleed, or rupture. A rupture is a critical and potentially life-threatening situation. Your care team will determine how likely the aneurysm is to rupture so it can plan your treatment.

    If treatment is necessary, your doctor will consider which treatment is best for your circumstances. The two most effective treatments for brain aneurysms today are:

    • Microsurgical clipping: Neurosurgeons make a small opening in the skull and place a titanium clip to prevent blood from flowing into an aneurysm.
    • Endovascular coiling: In this newer approach, neurosurgeons place a stent, or tube, or other devices, such as coils, inside a blood vessel or aneurysm to divert blood flow away from an aneurysm.

    How Will I Know If A Brain Aneurysm Has Ruptured

    When an aneurysm ruptures, it causes a severe headache like no other you’ve ever felt.

    If a brain aneurysm has ruptured, time is of the essence. Rapid medical care is critical to getting the necessary treatment for a successful recovery. With immediate, expert care, a full recovery is often possible.

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    Afraid Of Having A Brain Aneurysm How Can I Prevent This

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    I Was Diagnosed With An Unruptured Brain Aneurysm What Do I Do Next

    How to Avoid an Aneurysm: 14 Steps (with Pictures)

    First, you need to get more information. You should seek out care at a specialized center for brain aneurysm treatment.

    It’s important to choose a medical team that knows brain aneurysms. The more surgeries a center performs on brain aneurysms, the better it is at ensuring safe and effective results.

    At Johns Hopkins, our expert neurosurgery team uses the most advanced techniques to perform more than 4,000 surgeries each year more than 300 of those are for brain aneurysms alone.

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