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What are brain aneurysms?
Aneurysms are swellings on the walls of blood vessels. They are
like balloons with thin walls. They can grow larger and rupture,
spilling out blood into the brain at high pressure. Some
aneurysms produce effects such as weakness and numbness as a
result of compression of the adjacent brain and nerves.
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What
happens when an aneurysm ruptures inside the brain?
Bleeding inside the brain is the most devastating complication
of an aneurysm. This is diagnosed with a Computed Tomography
(CT) scan. About 15% of patients with bleeding due to a ruptured
aneurysm do not survive to reach the hospital. About 40% will
not survive over the next 6 months due to complications from the
initial bleed.
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What
is coil treatment for brain aneurysms?
Brain aneurysms can be treated by open surgery or by inserting
fine platinum coils into the aneurysm itself. Coil treatment is a minimally invasive technique of reliably treating brain
aneurysms through a small puncture of an artery in the groin.
From there, a fine tube (microcatheter) is pushed within the blood
vessels and navigated into the aneurysm. Extremely soft, flexible
platinum coils are then deposited within the aneurysm. The final
result is filling of the aneurysm sac with clots mixed with coils.
This was made possible through the invention of an electrolytically
detachable coil device invented by an Italian neuroscientist in the
University of California Los Angeles. The coil, named as the Guglielmi
Detachable Coil (GDC) after its inventor revolutionised treatment of
brain aneurysms after it was introduced in 1992.
In September 1995, this device was approved by the FDA for use in
treatment of brain aneurysms. Now, there are several different types
of coils from various companies that can be used to treat aneurysms in
this manner.
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When
was coil embolisation first performed in South East Asia?
The first case of a patient with a brain aneurysm treated by
this coil technique in South East Asia was a 56 year old Indian
man with a ruptured basilar artery aneurysm which presented with
subarachnoid haemorrhage. This was carried out in February 1996.
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How
are stents used in the treatment of patients with brain
aneurysms?
In some patients, the aneurysm has a wide opening into the main
artery. Coils deposited within such aneurysms can fall back into
the main artery. A stent can be placed across the opening of the
aneurysm to prevent the coils from any shift in position.
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A stent is
meant to prevent the coils from falling into the main artery
in cases where the opening of the aneurysm is too wide. |
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How
do brain aneurysms form?
Aneurysms usually form as a result of a weakness of the wall of
the brain artery. This is especially likely at the site of
branching of a major brain artery. It starts as a small blister
and then grow into a balloon like structure. The walls of the
aneurysm are very thin, making them prone to rupture.
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What
are the risk factors for developing aneurysms?
High blood pressure, smoking and certain pre-existing blood
vessel diseases of the brain are risk factors favouring the
development of an aneurysm. Aneurysms are also more likely to
develop in the elderly. In many patients, however, it can form
even when no risk factors are present.
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