Monday, February 28, 2011

A Brain Aneurysm – as I understand it.

A brain aneurysm is a disorder in which weakness in the wall of an artery or vein in the brain causes a localized ballooning of the blood vessel there.

This weakness in the wall is supposed to be a congenital problem -something you are born with. High blood pressure, stress and time cause blood to push against this weak wall and one fine day a sneeze, a fall or a stressful situation can cause it to burst. Then you have a brain hemorrhage. Blood leaks into the brain. Depending on the amount of blood leaking you can end up with a terrible headache or a stroke or death.

Once you have an aneurysm – and it is detected due to a cautionary angiogram or a leak - it needs to be blocked/sealed so it cannot seep blood or burst. There are two ways to go about it – a brain surgery or endovascular coiling. Brain surgery – is surgery, they cut your skull and brain and get to the aneurysm and take care of it. A more recent – since 1991- method is coiling where a catheter is inserted up an artery and used to fill the aneurysm with platinum coils. It is less intrusive and has a faster recovery period. However this procedure is not available everywhere and is more expensive. In certain situations a surgery is the only way to go.

My mother had a brain hemorrhage but many stars lined up to ensure that the leak was very little – she was lying down when it happened ensuring she did not hit her head in a fall, her blood clots easily thus reducing blood flow, she was in a house with doctors so she was not moved around much and above all at 51 she is very young. She was in terrible pain for days and on steroids and pain killers for even more.
The pain after the aneurysm burst can be unbearable and spasms continue for 21 days after, until the blood is absorbed and the pressure in the brain released. The blood in the brain causes pressure and irritation. It is the amount of blood that determines your long term prognosis. Lesser the leakage the better it is.

Brain aneurysm can be detected by a brain angiogram but it is not cost effective (in India it costs about Rs 30K or $600 but I am sure it is way higher in the US) and can have medical complications. However I do hope that the cost and the risks associated with the procedure come down. As at this point I feel that if one has a family history of this issue and faces migraines scheduling a brain angiogram might not be a bad idea.


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