St. Peter's Hospital: "Preemptive cerebral aneurysm screening matters after 40"
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Gangnam St. Peter's Hospital 26-06-23 09:21Main content
Advice has been issued that people in middle age and older, from their 40s on, need to take pre-emptive care over cerebral aneurysm, which usually causes no particular symptoms but can lead to fatal cerebral hemorrhage if it ruptures. In summer especially, heat waves and air conditioning can widen swings in blood pressure, so caution is required of high-risk groups.
St. Peter's Hospital said on the 23rd that cerebral aneurysm, in which part of a cerebral vessel wall balloons out, mostly progresses without symptoms but can lead to serious cerebral hemorrhage such as subarachnoid hemorrhage if it ruptures.
Cerebral aneurysm is regarded as an emergency condition that can cause death or leave neurological sequelae if it ruptures. In fact, about 15% of patients are known to die before reaching hospital when an aneurysm ruptures, and of the remaining patients about 28% die during treatment.
The problem is that in many cases there are no particular warning signs before rupture. Most unruptured cerebral aneurysms cause no symptoms, and only about 10-15% are known to be accompanied by symptoms.
Because they are hard to detect yet so dangerous if they rupture, some high-risk cerebral aneurysms are called ‘silent time bombs’.
For this reason, it is important with cerebral aneurysm to look at and manage the risk factors before symptoms appear. People in middle age and older, from their 40s on, who have risk factors that can raise blood pressure or whose risk of cardio-cerebrovascular disease is rising are advised to consult a specialist about whether testing is needed, even if they have no symptoms.
Professor SUH, Dae Chul of Interventional Neuroradiology at St. Peter's Hospital explained, "An unruptured cerebral aneurysm causes no symptoms, so it is hard for patients to detect it early on their own," adding, "In summer in particular, seasonal factors such as heat waves and air conditioning make swings in blood pressure large, so people at high risk of cerebral aneurysm need to take a more active interest in their cerebrovascular health."
A cerebral aneurysm is a state in which part of the wall of an artery inside the brain balloons out abnormally, like a balloon. It is most often found in the circle of Willis, the large cerebral arteries at the base of the brain.
Most are 10 mm or smaller, but giant cerebral aneurysms of 25 mm or more also occur. By shape and cause they are classified as saccular, shaped like a pouch; fusiform, in which the artery is dilated all around; and dissecting, in which a hematoma forms between the inner and outer layers of the vessel wall.
Prevalence is about 2–4% of the population, and most cases are found in people in their 40s to 60s.
Professor Suh said, “The exact mechanism by which cerebral aneurysms develop is still not clearly understood, but the main cause is thought to be damage to the vessel wall and loss of elasticity as blood flow pressure is applied steadily to an already weakened wall.”
When a cerebral aneurysm ruptures and causes a cerebral hemorrhage, a severe headache like a bolt of lightning can appear. It may be accompanied by nausea, vomiting and a stiff neck, and in severe cases can lead to seizures, reduced consciousness and even cardiac arrest.
Rupture of a cerebral aneurysm is also cited as a common cause of subarachnoid hemorrhage. It occurs in about 10 people per 100,000 each year, and the danger is such that one third of patients die the moment the hemorrhage occurs.
If a ruptured cerebral aneurysm is suspected, it is important to get to the emergency room quickly. In patients with a ruptured aneurysm, rebleeding frequently occurs within 24 hours of the first hemorrhage, and if it does the mortality rate can reach 70%. Complications such as vasospasm and hydrocephalus can also follow, so prompt diagnosis and treatment are needed.
Unruptured cerebral aneurysms mostly cause no clear symptoms. People over 40 who have risk factors such as hypertension, a family history or a history of smoking can consider brain CT, MRI or MRA after consulting a specialist.
In summer, blood pressure management and fluid intake also need attention, because intense heat, dehydration and abrupt temperature changes can all combine to affect blood pressure. Repeated exposure to these factors can widen swings in blood pressure and increase the burden on the blood vessels.
Recently, more unruptured cerebral aneurysms are being diagnosed and treated in advance. According to the Health Insurance Review and Assessment Service, there were 209,242 patients with unruptured cerebral aneurysm last year, about 69% more than the 123,579 recorded in 2020.
Once an unruptured cerebral aneurysm is diagnosed, whether to operate or to perform an endovascular procedure is decided according to the patient's condition.
In the past, aneurysm neck clipping — opening the skull with a craniotomy and closing the neck of the aneurysm with a clip — was mainly performed. More recently, embolization is also carried out, reaching the cerebral artery through the femoral artery in the groin without an incision and blocking off the aneurysm with platinum coils and similar devices.
Embolization, in which a device is inserted into the blood vessel to block the flow inside the aneurysm and lower the risk of rupture, is also advancing. Among these techniques, embolization using WEB, a mesh-shaped flow disruptor, is drawing attention as a treatment that makes up for the limitations of coil embolization.
The team of Professor SUH, Dae Chul in Interventional Neuroradiology at St. Peter's Hospital is also continuing related research, including analysis of WEB strategies by cerebral aneurysm shape.
Professor Suh said, "What matters most with a cerebral aneurysm is managing it while it is still unruptured," adding, "If an unruptured aneurysm is found in advance, a treatment strategy suited to the patient's condition — follow-up imaging, surgery or an endovascular procedure — can be set to lower the risk of rupture, so it is well worth considering active, pre-emptive management."
Source: MediPana News (https://www.medipana.com)
St. Peter's Hospital said on the 23rd that cerebral aneurysm, in which part of a cerebral vessel wall balloons out, mostly progresses without symptoms but can lead to serious cerebral hemorrhage such as subarachnoid hemorrhage if it ruptures.
Cerebral aneurysm is regarded as an emergency condition that can cause death or leave neurological sequelae if it ruptures. In fact, about 15% of patients are known to die before reaching hospital when an aneurysm ruptures, and of the remaining patients about 28% die during treatment.
The problem is that in many cases there are no particular warning signs before rupture. Most unruptured cerebral aneurysms cause no symptoms, and only about 10-15% are known to be accompanied by symptoms.
Because they are hard to detect yet so dangerous if they rupture, some high-risk cerebral aneurysms are called ‘silent time bombs’.
For this reason, it is important with cerebral aneurysm to look at and manage the risk factors before symptoms appear. People in middle age and older, from their 40s on, who have risk factors that can raise blood pressure or whose risk of cardio-cerebrovascular disease is rising are advised to consult a specialist about whether testing is needed, even if they have no symptoms.
Professor SUH, Dae Chul of Interventional Neuroradiology at St. Peter's Hospital explained, "An unruptured cerebral aneurysm causes no symptoms, so it is hard for patients to detect it early on their own," adding, "In summer in particular, seasonal factors such as heat waves and air conditioning make swings in blood pressure large, so people at high risk of cerebral aneurysm need to take a more active interest in their cerebrovascular health."
A cerebral aneurysm is a state in which part of the wall of an artery inside the brain balloons out abnormally, like a balloon. It is most often found in the circle of Willis, the large cerebral arteries at the base of the brain.
Most are 10 mm or smaller, but giant cerebral aneurysms of 25 mm or more also occur. By shape and cause they are classified as saccular, shaped like a pouch; fusiform, in which the artery is dilated all around; and dissecting, in which a hematoma forms between the inner and outer layers of the vessel wall.
Prevalence is about 2–4% of the population, and most cases are found in people in their 40s to 60s.
Professor Suh said, “The exact mechanism by which cerebral aneurysms develop is still not clearly understood, but the main cause is thought to be damage to the vessel wall and loss of elasticity as blood flow pressure is applied steadily to an already weakened wall.”
When a cerebral aneurysm ruptures and causes a cerebral hemorrhage, a severe headache like a bolt of lightning can appear. It may be accompanied by nausea, vomiting and a stiff neck, and in severe cases can lead to seizures, reduced consciousness and even cardiac arrest.
Rupture of a cerebral aneurysm is also cited as a common cause of subarachnoid hemorrhage. It occurs in about 10 people per 100,000 each year, and the danger is such that one third of patients die the moment the hemorrhage occurs.
If a ruptured cerebral aneurysm is suspected, it is important to get to the emergency room quickly. In patients with a ruptured aneurysm, rebleeding frequently occurs within 24 hours of the first hemorrhage, and if it does the mortality rate can reach 70%. Complications such as vasospasm and hydrocephalus can also follow, so prompt diagnosis and treatment are needed.
Unruptured cerebral aneurysms mostly cause no clear symptoms. People over 40 who have risk factors such as hypertension, a family history or a history of smoking can consider brain CT, MRI or MRA after consulting a specialist.
In summer, blood pressure management and fluid intake also need attention, because intense heat, dehydration and abrupt temperature changes can all combine to affect blood pressure. Repeated exposure to these factors can widen swings in blood pressure and increase the burden on the blood vessels.
Recently, more unruptured cerebral aneurysms are being diagnosed and treated in advance. According to the Health Insurance Review and Assessment Service, there were 209,242 patients with unruptured cerebral aneurysm last year, about 69% more than the 123,579 recorded in 2020.
Once an unruptured cerebral aneurysm is diagnosed, whether to operate or to perform an endovascular procedure is decided according to the patient's condition.
In the past, aneurysm neck clipping — opening the skull with a craniotomy and closing the neck of the aneurysm with a clip — was mainly performed. More recently, embolization is also carried out, reaching the cerebral artery through the femoral artery in the groin without an incision and blocking off the aneurysm with platinum coils and similar devices.
Embolization, in which a device is inserted into the blood vessel to block the flow inside the aneurysm and lower the risk of rupture, is also advancing. Among these techniques, embolization using WEB, a mesh-shaped flow disruptor, is drawing attention as a treatment that makes up for the limitations of coil embolization.
The team of Professor SUH, Dae Chul in Interventional Neuroradiology at St. Peter's Hospital is also continuing related research, including analysis of WEB strategies by cerebral aneurysm shape.
Professor Suh said, "What matters most with a cerebral aneurysm is managing it while it is still unruptured," adding, "If an unruptured aneurysm is found in advance, a treatment strategy suited to the patient's condition — follow-up imaging, surgery or an endovascular procedure — can be set to lower the risk of rupture, so it is well worth considering active, pre-emptive management."
Source: MediPana News (https://www.medipana.com)