Cerebral Aneurysms: The timebomb in your head
Cerebral aneurysms, also called intracerebral or intracranial aneurysms, are balloon-like outpouchings of the arteries in the brain. They arise from a weak point in the wall of a brain artery and enlarge over time. Aneurysms have very thin walls which lack the normal structure of the surrounding arterial walls. The walls are very weak in comparison to the normal arteries. The major danger is that and aneurysm may rupture and bleed directly into the brain or into the spinal fluid surrounding the brain. Either even is associated with potentially disastrous consequences: paralysis, coma and sudden death.
This type of bleeding is known as subarachnoid hemorrhage
Aneurysms are caused by a focal weakening in the wall of an artery, usually at a branch point, called a bifurcation. This area of weakness is probably present at birth. From the constant force of the blood pressure throughout life, an aneurysm develops and enlarge during a person's lifetime. Other causes of aneurysms include the deposit of infectious material from the heart into brain artery walls, trauma, brain tumor, and brain arteriovenous malformation (AVM).
The average age of aneurysm rupture is about 50 years of age although this can occur at any age. Approximately 50% of these ruptures are ultimately fatal. Patients who do survive are at risk for neurologic and cognitive deficits.
Several factors are known to increase the chances of aneurysm development and rupture: cigarette smoking, excess alcohol consumption, and atherosclerotic heart disease. Some families have a definite genetic predisposition. In such families aneurysms may run as high as 10%.
The prevalence of cerebral aneurysms in the population is estimated to be as high as 5%. That means there could be as many as 900,000 people in the greater New York Metropolitan area walking around with aneurysms! However, not all of them rupture: the incidence of aneurysm rupture in the U.S. each year is about 10 per 100,000 persons. In New York there about 200 cases of aneurysm rupture each year. About half of them never reach treatment and die before they ever reach the surgery necessary to stop the aneurysm from bleeding again.
The risk of surgery increases in relationship to the severity of the aneurysm rupture. But why wait for one of these to rupture? Most aneurysms can be detected by MRI. Modern surgical and endovascular techniques have very significantly reduced to almost nil the risk of treating and curing unruptured aneurysms.
We have no way of knowing when an aneurysm will rupture. If you had a time bomb ticking in your head wouldn't you want to know about it and have it defused before it kills or cripples you?
