A time bomb in the head, brain aneurysm, with a family history, is four times more likely to develop
Oct 09, 2024
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◇Family history increases the risk of developing disease four times higher
The size of the brain aneurysm varies from as small as 2 mm to as large as 50 mm or more. It is commonly found between 40s and 70s, and the exact cause is not yet known, but it is presumed to occur due to cracks in the blood vessel wall due to hemodynamic causes. It may occur when the blood vessel wall is damaged by inflammation or trauma in the blood vessel, and may be accompanied by cerebrovascular diseases such as cerebral arteriovenous malformations or moyamoya disease. Smoking and high blood pressure increase the risk of developing brain aneurysms, and it is reported that the risk of developing brain aneurysms in the family is about four times higher.
Professor Won-ki Yoon of neurosurgery at Korea University Guro Hospital said "Brain aneurysm usually has no symptoms. However, when the brain aneurysm ruptures, you feel extreme pain and headaches, such as being hit by a hammer, to a degree never experienced in your life. It is accompanied by nausea, vomiting, or stiff back neck, and in severe cases, as pressure in the skull rises, it can lead to unconsciousness or coma, so if you experience any suspicious symptoms, you should visit the emergency room quickly," he stressed.
Treatment methods are divided into 'Clip Ligation', an operation in which the head is opened and the swollen blood vessel area is clip-bound, and 'Coil Embolization', an endovascular operation that prevents blood from entering the brain aneurysm by inserting a thin platinum coil of less than 1 mm through the thigh femoral artery without opening the head.
Treatment is applied according to the patient's condition, and the two methods have distinct advantages and disadvantages. 'Clip ligation' is performed when there is a high probability of recurrence or complications, when the patient is young, and when there is a brain aneurysm in the epidermis of the brain, the recurrence rate is low, but there is a burden of having to open the brain and operate. On the other hand, 'coil embolization' is often performed on elderly patients due to less burden and faster recovery compared to clip ligation, but has the disadvantage of relapse rate being relatively high.
◇We are developing the latest surgical methods that minimize incision and lower recurrence rates
Recently, various surgeries and procedures optimized for high-level lesions according to the type of brain aneurysm have been developed to compensate for these shortcomings. 'Clip ligation' is performed as a 'mini craniotomy' that makes a small hole of less than 3 cm in the eyebrows or temples to minimize the incision. In the treatment of brain aneurysms that are difficult to treat with 'coil embolization' or macrobrain aneurysms larger than 25mm, a 'blood flow conversion stent procedure' is also actively performed by inserting a stent instead of a coil into the brain aneurysm to change the direction of blood flow.
Furthermore, if the brain aneurysm occurs in areas where blood vessels overlap and the difficulty of the procedure is high, 'blood flow conversion stent procedure through balloons' is performed, and the difficulty of the procedure is high due to the simultaneous balloon and stent procedure, but more sophisticated procedures are possible and safety is high.
Professor Won-ki Yoon explained, "The branched brain aneurysm that occurs at the point where blood vessels diverge is not enough because the neck is wide, and in this case, the procedure is performed by filling the brain aneurysm with a tightly woven metal net called 'Woven EndoBridge (WEB)'. As such, new treatments that compensate for the shortcomings of existing ligation and coil embolization but increase the effectiveness of treatment are taking place.'
◇High-risk groups should be examined in advance
Brain aneurysm is not the end of a procedure or surgery. No matter how well you treat it, it can happen again in other places over time, so you should thoroughly manage factors that can affect you, such as high blood pressure. Patients who have undergone coil embolization or stenting should take antiplatelet drugs steadily and follow up periodically.
Professor Won-ki Yoon advised, "There is no way to prevent the outbreak itself because the clear cause has not been identified.". "However, if detected early, brain bleeding can be prevented before rupture, so if you have a family history or are at high risk such as smoking or high blood pressure, you should get tested during a medical examination."
bellho@sportschosun.com
