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Related Topics-Aneurysms Etc

Related Topics-Aneurysms Etc

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Published by: james garcia on Sep 28, 2009
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What is a Brain Aneurysm?
A brain aneurysm, also called a cerebral or intracranial aneurysm, is an abnormal bulgingoutward of one of the arteries in the brain. It is estimated that up to one in 15 people inthe United States will develop a brain aneurysm during their lifetime.Brain aneurysms are often discovered when they rupture, causing bleeding into the brainor the space closely surrounding the brain called the subarachnoid space, causing asubarachnoid hemorrhage. Subarachnoid hemorrhage from a ruptured brain aneurysm canlead to a hemorrhagic stroke, brain damage and death.The main goals of treatment once an aneurysm has ruptured are to stop the bleeding and potential permanent damage to the brain and to reduce the risk of recurrence. Unruptured brain aneurysms are sometimes treated to prevent rupture. Learn more abouttreatmentoptions for a brain aneurysm.
Incidence Rates of Brain Aneurysms
Approximately 0.2 to 3 percent of people with a brain aneurysm may suffer from bleeding per year 
The annual incidence of aneurysmal subarachnoid hemorrhage in the U.S.exceeds 30,000 people. Ten to 15 percent of these patients will die beforereaching the hospital and over 50 percent will die within the first thirty days after rupture. Of those who survive, about half suffer some permanent neurologicaldeficit
Brain aneurysms can occur in people of all ages, but are most commonly detectedin those ages 35 to 60
Women are actually more likely to get a brain aneurysm than men, with a ratio of 3:2
Symptoms of Brain Aneurysms
Ruptured Cerebral Aneurysm Symptoms
Sometimes patients describing "the worst headache in my life" are actually experiencingone of the symptoms of brain aneurysms related to having a rupture. Other rupturedcerebral aneurysm symptoms include:
 Nausea and vomiting
Stiff neck or neck pain
Blurred vision or double vision
Pain above and behind the eye
Dilated pupils
Sensitivity to light
Loss of sensation
 
Unruptured Cerebral Aneurysm Symptoms
Before an aneurysm ruptures, patients often experience no symptoms of brain aneurysms.In about 40 percent of cases, people with unruptured aneurysms will experience some or all of the following cerebral aneurysm symptoms:
Peripheral vision deficits
Thinking or processing problems
Speech complications
Perceptual problems
Sudden changes in behavior 
Loss of balance and coordination
Decreased concentration
Short-term memory difficulty
FatigueBecause the symptoms of brain aneurysms can also be associated with other medicalconditions, diagnostic neuroradiology is regularly used to identify both ruptured andunruptured brain aneurysms.
Diagnosis of Brain Aneurysms
Diagnosis of a ruptured cerebral aneurysm is commonly made by finding signs of subarachnoid hemorrhage on a CT scan (Computerized Tomography, sometimes called aCAT scan). The CT scan is a computerized test that rapidly X-rays the body in cross-sections, or slices, as the body is moved through a large, circular machine. If the CT scanis negative but a ruptured aneurysm is still suspected, a lumbar puncture is performed todetect blood in the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord.To determine the exact location, size and shape of an aneurysm (ruptured or unruptured),neuroradiologists will use either cerebral angiography or tomographic angiography.Cerebral angiography, the traditional method, involves introducing a catheter (small plastic tube) into an artery (usually in the leg) and steering it through the blood vessels of the body to the artery involved by the aneurysm. A special dye, called a contract agent, isinjected into the patient's artery and its distribution is shown on X-ray projections. Thismethod may not detect some aneurysms due to overlapping structures or spasm.Computed Tomographic Angiography (CTA) is an alternative to the traditional methodand can be performed without the need for arterial catheterization. This test combines aregular CT scan with a contrast dye injected into a vein. Once the dye is injected into avein, it travels to the brain arteries, and images are created using a CT scan. These imagesshow exactly how blood flows into the brain arteries.
 
Treatment of Brain Aneurysms
Surgery or minimally-invasive endovascular coiling techniques can be used in thetreatment of brain aneurysms. It is important to note, however, that not all aneurysms aretreated at the time of diagnosis or are amenable to both forms of treatment. Patients needto consult a neurovascular specialist to determine if they are candidates for either treatment.
Surgical Treatment
To get to the aneurysm, surgeons must first remove a section of the skull, a procedurecalled a craniotomy. The surgeon then spreads the brain tissue apart and places a tinymetal clip across the neck to stop blood flow into the aneurysm. After clipping theaneurysm, the bone is secured in its original place, and the wound is closed.
Minimally-Invasive Treatment Coil Embolization or Endovascular Coiling 
Endovascular therapy is a minimally invasive procedure thataccesses the treatment area from within the blood vessel. Inthe case of aneurysms, this treatment is called coilembolization, or "coiling". In contrast to surgery,endovascular coiling does not require open surgery. Instead, physicians use real-time X-ray technology, calledfluoroscopic imaging, to visualize the patient's vascular system and treat the disease from inside the blood vessel.Endovascular treatment of brain aneurysms involves insertionof a catheter (small plastic tube) into the femoral artery in the patient's leg and navigating it through the vascular system,into the head and into the aneurysm. Tiny platinum coils arethreaded through the catheter and deployed into theaneurysm, blocking blood flow into the aneurysm and preventing rupture. The coils are made of platinum so thatthey can be visible via X-ray and be flexible enough toconform to the aneurysm shape. This endovascular coiling, or filling, of the aneurysm is called embolization and can be performed under general anesthesia or light sedation. Morethan 125,000 patients worldwide have been treated withdetachable platinum coils 

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