Lifewatch: Aneurysms

Reported by Claire Hosmann - email
Posted by Debra Worley - email

LOS ANGELES, CA (WECT) - AT least 1/15 Americans will develop an aneurysm at some point in their lifetime.

Now, 3-D computer software is helping doctors see into the future to learn if an aneurysm will burst.

Rebecca Gadberry lives a fairy tale life.  Her family includes a devoted husband, Mark, and son, Kyle, who rarely leaves his mom's side.

But, Rebecca's story suddenly changed.  She had a brain aneurysm, a bulging blood vessel in her brain.

"First day we were in shock, kind of numb. Second day, I think we cried all day," said Mark.

"I had a bomb in my head that could go off at any minute," said Rebecca.

If an aneurysm ruptures, 1/3 of patients die immediately.  Another 1/3 die within a month, and survivors may face neurological problems.

Now, computer software can get rid of some of the guessing and gives neurosurgeons a glimpse into the future.

"We can reconstruct 3-D aneurysms in a virtual space," said Dr. Satoshi Tateshima with the Ronald Reagan UCLA Medical Center.

The program simulates blood flow direction, speed, and friction in an aneurysm.  The more friction, the greater chance for disaster.

In Rebecca's case, the model predicted her aneurysm was in danger of bursting.  It helped her make a decision to have surgery immediately.

Six months after surgery, Rebecca went back to the doctor who saved her life and saw what could have happened in her brain.

Doctors say the software gives them more control.

"The more we know about the enemy, the better fight we can make," said Tateshima.

The Gadberry's now have a second chance for a happy ending.

Women between the ages of 35 and 60 are more likely to have a brain aneurysm than men.

UCLA and George Mason University are the only centers using the software under a federal grant.

It will likely be available to all hospitals within the next two years.

Satoshi Tateshima, MD,
Schmidt, Public Relations, (310) 794-2272

BACKGROUND: 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.