Crystal Ball for Brain Aneurysms

December 15, 2008 9:29:45 AM PST
Brain aneurysms occur when an artery in the brain abnormally bulges outwards. According to the American Society of Interventional and Therapeutic Neuroradiology, one in 15 people in the United States will develop the condition in their lifetime. Women are more susceptible to aneurysms than men. An aneurysm often goes undetected until it ruptures and causes bleeding in the brain, or a subarachnoid hemorrhage. Such hemorrhages can cause stroke, brain damage and even death. More than 30,000 people across the nation suffer these types of hemorrhages. The prognosis is grim. According to Satoshi Tateshima, M.D., an interventional neuroradiologist at the Ronald Reagan University of California, Los Angeles Medical Center, around one-third die before reaching the hospital and another third die within the first 30 days after the rupture. Many of those who survive are left with permanent brain damage.

TREATMENT: After an aneurysm ruptures, the main goal of treatment is to stop the bleeding and damage to the brain, and reduce the likelihood of recurrence. Sometimes aneurysms are detected and treated before they rupture using one of two treatment options: surgery or minimally-invasive endovascular coiling.

Surgical treatment of aneurysms involves a craniotomy, or removing a portion of the skull. Brain tissue is moved aside and surgeons stop blood flow to the aneurysm using a tiny metal clip. The bone is then replaced and the incision is closed. The endovascular option is a minimally-invasive procedure. The aneurysm is accessed by inserting a catheter into the femoral artery in a patient's leg and up to the head. Tiny platinum coils are threaded through the catheter and into the aneurysm until all of the space inside it is full. This blocks blood flow and prevents a rupture from occurring. More than 125,000 patients around the world have been treated with this method. Studies have found many benefits of the minimally-invasive treatment over the surgical method. For example, it cuts hospital time in half, reduces the likelihood of new symptoms and disability following treatment, and shortens recovery time from one year to, in some instances, just 27 days.

A WINDOW INTO THE BRAIN: Sometimes treating an aneurysm that hasn't ruptured is risky, but a new technology is allowing surgeons to assess a patient's condition before they decide their course of action. The computer modeling software creates a vivid color, 3-D image of the brain. Doctors are able to measure the friction of blood flow against the weakened artery and plan a treatment approach in advance. After evaluating the aneurysm with the software, doctors sometimes decide not to treat it because the risks of the procedure outweigh the benefits. "We run the simulation and we see the flow pattern, and we evaluate them and decide the best option; whether we should observe it or treat it," Dr. Tateshima told Ivanhoe. According to him, the software has been an invaluable tool. "The more we know about the enemy, the better fight we can make," he explained.

FOR MORE INFORMATION, PLEASE CONTACT:
Satoshi Tateshima, MD, stateshima@mednet.ucla.edu
Elaine Schmidt, Public Relations, (310) 794-2272
http://www.uclahealth.org


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