Videos from Clinical Neuroscience Institute

A brain aneurysm is a weak spot in the artery in the brain. It can be located on any of the arteries that do supply the brain with its blood supply. That weak spot will tend to expand over time, and eventually can rupture if not treated.

The symptoms that would concern us for a brain aneurysm would be as follows. If somebody had the worst headache of their life, that is a clearly classic description of an aneurysm. It may have leaked or even bled. Again, these patients often times have had headaches, of course, in the past, but this would be something different. This would be, again, most people say the worst headache of your life. Often comes with nausea, vomiting. It can be sometimes related to even being comatose or knocking the person unconscious.

In addition to just the worst headache of your life, there are other subtle symptoms that can come along with a brain aneurysm that are a bit more rare, but need to be mentioned, which are everything from nerves not working quite right, meaning you have facial droop or you may have double vision, or any of the signs of classic stroke, where one side of the body's not working quite as well as the other side. In an aneurysm situation, that usually comes with also headache of some sort. If it's a stroke that is a low blood flow stroke, where an artery's been blocked and it's not supplying blood and they're having symptoms from it, headache is usually not associate with those. It's a little bit of a separator between a low blood flow stroke and a bleeding stroke. Headache is almost always associated with the bleeding strokes. Again, they tend to have some nausea and feeling sick to their stomach. It can be, again, associated with exertion. It may come with other nerve findings that are unusual, but all those should be taken seriously and get evaluated immediately.

An aneurysm can be caused by family history of having brain aneurysms, meaning you're more predisposed to having arteries that are a bit weaker, that may eventually develop into a ballooning or a sacular type aneurysm. It also can be aided by people who smoke cigarettes. Blood pressure and hypertension, specifically, can also be a risk factor for someone to have an aneurysm rupture, or even develop an aneurysm.”

One is, if you do have a family history of a brain aneurysm in a first degree relative, especially a ruptured brain aneurysm in someone that's a first degree relative, it's probably not unreasonable to have a screening done to make sure you're not also harboring an aneurysm, because again, if we can catch it early and treat it electively, the overall complication rates and prognosis are very, very good.

The second thing I tell most people is if you're a smoker, stop smoking. That's just the standard advice most doctors are saying, of course. Third thing is if you do have high blood pressure, try to control your blood pressure into a range that's considered normal. Work with your doctor, primary care doc to help with that process. Then exercise and just eating right, taking care of yourself also has been shown to be somewhat protective for just about any arterial problem in the body. Beyond that, there's not a whole host of things someone can do, necessarily, to try to ward off a brain aneurysm, and I think the most important next step in my advice is, there are treatments for it, and there are things we can do about it. If it's caught early, the prognosis is not as doom and gloom as most people associate with the word brain aneurysm, and that you've got a great team and you've got a good group of individuals from both preop to postoperative care, right here in Dayton that can take care of all these problems and have very good success with it.

There are actually several options for treating brain aneurysms. They range from open surgical techniques, meaning you actually go in, opening the skull and removing the aneurysm by using a clip, to wait and watch, and surveillance of this, because some aneurysms inside the brain, strangely enough, don't need to be treated. It's actually more risky if you were to opt for a treatment plan, with certain categories of brain aneurysm, and that's why it's so important to have these patients come and talk to us, and go through the various options.

The one option we actually use most frequently now, because research and literature certainly support this type of care, is the minimally invasive treatment of an aneurysm, using what's called endovascular techniques, or similar models to what cardiologists do for the heart now, where they use wires and catheters through the arterial system instead of opening the chest and being directly involved with the heart, you use the already existing arterial system to allow you to transport your tools to the location in which you need them.

For our procedures, we tend to go through the arteries starting in the leg, all the way up into the head. Many patients are confused why we would take that route. The reason for that is safety. It's actually one of the easiest places to get into the arterial system in the body. It's a safe and well studied region of the body to both get in and get out without bleeding or an infection rate that's very high, so these are ideal situations for us, because we can then treat an aneurysm with making a tiny little incision just down at the leg and repair an aneurysm inside the head, and that's really all the patient has to show for it is this little tiny incision, it's less than a centimeter in length.

Sometimes it's difficult to identify triggers or define them. We know commonly that sleep deprivation can lead to seizure, but seizure may not be happening each time they are sleep deprived. Now, the threshold at which these trigger could cause seizure can be variable, so that's why it's difficult to identify them. But once they are identified, if patient have seen a pattern that when they are sleep deprived each time they have been having seizure, then avoiding those situation can be very helpful for them to avoid seizure.

Maintaining a seizure diary can be very effective for their seizure management. Patient can track the frequency and duration of their seizure, and that can be helpful for physician to plan the treatment.

Maintaining an epilepsy diary is a very effective way for seizure management. The information which can be documented there is seizure type, the frequency, and duration. Some patients, they have multiple seizure types, so identifying which one is common can be helpful to curve the treatment accordingly. It can be helpful to document the seizure medication, its dosing, if there were any changes made in existing medication dosing, or if there are any new medication added there, did it help in decreasing the frequency and duration of the seizure. Those things can be tracked.

Females of childbearing age can track their menstrual cycle and identify if their seizures are getting more frequent around that time so that that can be helpful for physician to plan treatment accordingly for them. Documenting any lifestyle modification around the seizure time, like missing dose of seizure medication, or stress, or sleep deprivation can be helpful for understanding their triggers. So those are the things which they can document to help the physician planning their epilepsy treatment.

There are several online resources available. There are apps, which can be downloaded on a smart phone for example. Epilepsy Foundation offers an app, which can be downloaded, known as My Seizure Diary. That app offers patient to document the seizure description, frequency, duration, the days they are seizure free, if it's too frequent for them. They can also enter their seizure medication dosing. Not just seizure medication, they can enter other medication they're on so that the physician can understand if there is interaction going on between those medication and the seizure medication.

They can also set a reminder for themselves to remember taking their medication. This information can be shared with a caregiver, so some kind of a reminder can be set up for them to help seizure patients. They can also set up a reminder for themselves to refill their medication, so that's always helpful. This information can be shared with their healthcare provider online, and this app can be used offline more too and it can be synchronized later when the internet is available. So a patient can always use those resources, and that's always helpful for physician to plan their treatment for them.