Monday, September 17, 2012

Aneurysm 'a high-pressured fire hose inside the brain'

Often illnesses or medical issues gain attention when famous people are afflicted with them.

Many people around the world learned about Parkinson's disease after Michael J. Fox announced his diagnosis.

More locally, many people became more informed about brain aneurysms when Rochester City Council President Dennis Hanson died following a brain aneurysm.

Here are some facts about brain aneurysms:

Misconceptions

A common misperception is that a brain aneurysm is a rupture of a blood vessel in the brain, but that's not exactly the case. Brain aneurysms alone don't kill or harm people.

"A brain aneurysm is a small, balloon-shaped bubble that forms on the side of an artery," said Dr. Robert Brown, a Mayo Clinic neurologist.

The bubble is the aneurysm, but the trouble doesn't happen until that bubble bursts. When the bubble ruptures blood can shoot out into the brain.

"It's like a high-pressured fire hose inside the brain," said Mayo Clinic Neurosurgeon Dr. Giuseppe Lanzino. The blood leak can either destroy the brain, or harm it enough to dramatically impact a person's mental and physical capacities, Lanzino said.

Life and death

 "It's a relatively uncommon, but still important cause of death," Brown said.

There are 25,000 to 30,000 reported brain aneurysm ruptures in the United States every year. Brown says about one-third of those, or about 10,000, cause death, but the number of brain aneurysm ruptures is a tiny fraction of the number of brain aneurysms people have. Some 2 percent of the U.S. population, or about 6 million people, have a brain aneurysm that has not ruptured.

"Many people have them and don't even know it," Brown said.

Many patients don't even require treatment, Lanzino said. Between 60 percent and 70 percent of people who've had burst aneurysms and been treated at Mayo Clinic do very well. The other 30 percent either die or have severe mental or physical impairment, Lanzino said.

The chief determinant of life or death is the amount of damage already done to the brain by the time the patient comes in.

"If the brain has already been irreversibly damaged by the bleed, those are patient's beyond our ability to help," Lanzino said.

Brown said he doesn't think the rate of brain aneurysms is increasing — rather, medical technology has just made it easier to spot them.

"The frequency with which we're identifying brain aneurysms that haven't burst is due to more CT and MRI scans being done, typically for symptoms completely unrelated to the aneurysm that is seen on the scan," he said.

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