September is National Brain Aneurysm Awareness Month
Most people understand that a brain aneurysm can be deadly. But the statistics supporting this fact can still be surprising: about 30,000 people in the United States suffer a brain aneurysm rupture each year, and the prognosis can be grim if not treated immediately. However, three neuro-endovascular surgery specialists at White Plains Hospital say that the presence of an unruptured brain aneurysm is not always an immediate concern.
“First, we need to understand just what a brain aneurysm is,” says Dr. Rafael A. Ortiz, White Plains Hospital’s Executive Director of Neurosciences. “To put it most plainly, it is a bulge in a weak area of a blood vessel in or around your brain. Most aneurysms are very small and undetectable even by a physician, unless they are specifically running imaging tests of your head, possibly for another condition.”
“It is possible for someone to live with a brain aneurysm for years without even knowing they have one,” agrees neuro-endovascular surgeon Dr. Ivo Bach. “But that is not the case if the aneurysm has ruptured. When that happens, patients often report a sudden onset of severe headache that can be accompanied by altered mental status, blurred vision, or weakness. Those patients should seek medical treatment immediately, as a ruptured brain aneurysm can be life-threatening.”
Even then, says neurosurgeon Dr. Jared Cooper, “With immediate, expert care, a full recovery is often possible.” Treatments may consist of open microsurgical clipping as well as a variety of minimally invasive endovascular techniques. Most commonly, endovascular treatment involves placing tiny platinum wires, called coils, into the aneurysm to stop blood flow into it. Other endovascular techniques may involve the placement of flow diverting stents or intrasaccular devices. Open microsurgical clipping, on the other hand, involves creating a small opening in the skull and placing a titanium clip across the aneurysm neck to prevent further blood flow into the aneurysm. In the setting of an aneurysm rupture, both operations require at least a few weeks of rest, both at the hospital and at home, Dr. Cooper adds.
Brain Aneurysm Prevention
Sometimes there is no clear cause for developing a brain aneurysm; in fact, Dr. Ortiz says, they may develop after someone is in their 20s. “Even so,” he adds, “we know that the risk of developing one increases as we age. Women over 40 are the most common segment of the population to develop one.
“Genetics can play a role,” he continues. “Family history of aneurysm in a first-degree family member – a parent, sibling, or even child – can certainly be something to keep in mind. There are also several specific genetic conditions that can lead to developing an aneurysm, including fibromuscular dysplasia (a condition where the blood vessels become twisted throughout the body), polycystic kidney disease (involving a mutation that may be inherited from one’s parents), and Marfan syndrome (a disorder that negatively affects the body’s connective tissue), among others.”
Many patients with a family history will be referred to a vascular neurologist or a neurosurgical specialist who can determine what type of treatment is necessary.
Absent such conditions, people can make lifestyle changes to reduce their chances of developing an aneurysm. “High blood pressure is a major risk factor,” says Dr. Cooper. Maintaining a healthy diet is always recommended, as is avoiding cigarette smoking, heavy alcohol drinking, and abusing drugs.”
In some cases, suffering head trauma or the presence of a brain tumor may also lead to developing an aneurysm, Dr. Bach says, though such instances are relatively rare.
Even without medical confirmation that you have an unruptured brain aneurysm, there are signs to watch out for. Symptoms of an unruptured brain aneurysm may include:
- Pain above and behind one eye
- A dilated pupil
- Double vision
- Numbness on one side of the face
- Unruptured aneurysms rarely cause headaches, however a change in headache pattern or severity may be cause to reach out to your healthcare provider
“Several of those symptoms are common with a stroke as well,” says Dr. Ortiz. “In any case, you should consult with a medical provider as soon as you can.”
Depending on a patient’s circumstances, microsurgical clipping or endovascular coiling/stenting may be used to treat an unruptured aneurysm as well as one that has ruptured. “If we find them before they start bleeding, we have the opportunity to provide a preventive treatment to make sure they don’t rupture in the future,” says Dr. Bach. Otherwise, some aneurysms may simply be regularly monitored by a patient’s neurosurgical team.
With a preventive procedure to address an unruptured aneurysm, the patient is treated and usually can return home within 24 hours, Dr. Bach notes. In an emergency, a longer stay in the ICU is required and depends on the severity of the ruptured aneurysm and the post-operative situation.
“It can be highly variable,” Dr. Ortiz remarks. “Some people come in with a small bleed, get treated and return to baseline quickly, while more severe cases may need further attention and extensive rehabilitation at a center like Burke Rehabilitation Hospital (an affiliate of the Montefiore Health System, also located in White Plains).”
Regardless of their diagnosis, patients in the region now have access to life-saving neurological care, delivered by highly-trained subspecialists, close to home.
“Aneurysms are never to be taken lightly, and access to advanced care can make a significant difference in patient outcomes,” Dr. Bach says. “We are proud to bring these services to our community.”
To find a neurologist, neuro-endovascular, or neurosurgical specialist, call 914-WPH-MIND (974-6463). Learn more about White Plains Hospital's Neurosciences Program.
Dr. Rafael Alexander Ortiz is Executive Director of Neurosciences at White Plains Hospital, with offices in our WPHPA Neurosurgery & Neuro-Endovascular Surgery location in White Plains. To make an appointment, call 914.849.5300.
Dr. Jared Cooper is a neurosurgeon and neuro-endovascular surgeon with White Plains Hospital Physician Associates (WPHPA), with offices in our WPHPA Neurosurgery & Neuro-Endovascular Surgery location in White Plains. To make an appointment, call 914.849.7593.
Dr. Ivo Bach is a neuro-endovascular surgeon and vascular neurologist with White Plains Hospital Physician Associates (WPHPA), with offices in our WPHPA Neurosurgery & Neuro-Endovascular Surgery location in White Plains. To make an appointment, call 914.849.5300.