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Symptom-less 'Ticking Time Bomb in My Brain': watching out for risk factors only to bleed [증상 없는 ‘머릿속의 시한폭탄’ 위험인자 방치하다간 뇌출혈]

Mr. A, a man in his 50's who works for facility management, fell down and was taken to the emergency room. The diagnostic result was a cerebral aneurysm. Although Mr. A usually had high blood pressure, he was a relatively healthy man. Bu if Mr. A arrived a little later to the hospital, the hemorrhage would have reached severely dangerous stages.
# Asymptomatic cerebral aneurysms can be fatal

A cerebral aneurysm is when a portion of the vessel wall swells like a balloon due to the weakening and deficiency of the structures that make up its vessel wall. Most cerebral aneurysms are less than 10 mm in size, but some larger than 25 mm have been reported and are called giant aneurysms.

In most cases, cerebral aneurysms do not have any symptoms before rupturing, but some people have visual impairment or tinnitus. Once the cerebral aneurysm ruptures, it can lead to head-breaking headaches, loss of consciousness, and even coma. Cerebral aneurysm rupture is a serious disease that can lead to continues bleeding ranging from hours to days and can lead to neurological disorders and death.

# Aneurysm ligation, coil embolization

Cerebral aneurysms are determined based on the size, shape, and location of the aneurysm seen in cerebrovascular examinations, such as computed tomography (CT), brain magnetic resonance imaging (MRI), and cerebral angiography. Most cerebral aneurysms are diagnosed with MRA, and cerebrovascular angiography is the most accurate test for diagnosing cerebrovascular disease.

Treatment of cerebral aneurysms depends on their shape and location. There are two major types of treatment known as surgical clipping (closing off blood vessels around the cerebral aneurysm) and coil embolization (filling the aneurysm with platinum or alloy polymer coils through the vessel). Coil embolization is a treatment that prevents blood from entering the aneurysm, and is preferred by patients visiting Nasaret International Hospital because of the shorter hospital stay and faster recovery than the opening of their skull during surgery.

Once the cerebral aneurysm is treated, the chance of it bursting again is less than 1%. However, it is important to manage the disease by having cerebrovascular examinations once a year because it may recur at the same location or another site.

# Regular checkups are the best way to prevent cerebral aneurysm rupture

Cerebral aneurysms is a scary disease that can cause cerebral hemorrhage, and they are called time bombs in your head because they have no prognostic symptoms.

To prevent cerebral aneurysm ruptures, risk factors such as hypertension, smoking, drinking, and obesity should be managed. In addition, it is important to detect cerebral aneurysm early by brain CT or brain MRI, which includes angiography, even if there is no special symptom. If you have a family history of cerebral hemorrhage due to vascular malformations, it is highly recommended to get tested.

If the test reveals a cerebral aneurysm, you should regularly check with your doctor to determine if the cerebral aneurysm changes or grows.

Written with the help of Dr. Choi Jong Won, Neurosurgery Dept., Nasaret International Hospital
Original article by Kiho Ilbo
Published 2019 Jun 12


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