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The initiative was taken by an interventional radiologist, Audrius Širvinskas, Head of the Department of Interventional Radiology at the Vilnius Republican University Hospital (RVUL). After a recent case of a ruptured brain aneurysm ended in death, a 72-year-old woman died and another, a 47-year-old woman, was barely rescued by a hair.
The risk is low, the damage is enormous
“Brain aneurysm is a disease that is probably not as likely as other cardiovascular diseases that Lithuanians suffer from, but its damage is one of the greatest. When an aneurysm ruptures in the head, the probability that a person will survive is only about 50 percent. 80 percent of survivors suffer permanent phenomena, which often mean disability, loss of independence, inability to work, inability to take care of themselves, “says A. Širvinskas.
About 5% have an aneurysm in Lithuania. people, the risk of it breaking is about 1.5 percent.
A brain aneurysm is defined as a weakened or thinned area of the wall of the cerebral artery that expands and assumes the shape of a balloon when blood pressure is applied. In this way it becomes a bomb that is aimed at the head because it can explode at any moment. About 5% have an aneurysm in Lithuania. people, the risk of rupture is about 1.5 percent, which is about 300 cases per year in Lithuania. Still, most breakups have tragic consequences.
Says Know But Doesn’t Check
According to the survey, up to three out of five people have no idea what a brain aneurysm is. Of the remaining 40 percent. a third (34%) of those surveyed who say they know the disease believe that it is dangerous only because of the high probability of death from ruptured aneurysms. 7 percent. – that the risk of an aneurysm is due to the fact that it normally does not present symptoms. Slightly more than half (55%) of those surveyed said an aneurysm was dangerous for the two reasons listed.
Interventional radiologist A.Širvinskas comments that the correct answer is the last one: an aneurysm is dangerous for both reasons: people who have it do not feel any health problems or symptoms. One day the aneurysm just ruptures and blood flows to the brain. “
According to the doctor, it is for this reason that the fact that only 9% of who knows what controlled a brain aneurysm for their health – 1 percent. examined regularly, 8 percent. examined at least once. Another 9 percent. respondents are not sure they have done the research. And the vast majority (81%) have never had a health test for a brain aneurysm.
An aneurysm is not visible on a plain CT scan.
“Obviously, even those people who know about the disease and how dangerous it is don’t come to check it out. It is important to know that an aneurysm does not go away on its own, it is not treated with any medicine. The only way to prevent a rupture is to “shut off” the aneurysm from the bloodstream. There are two ways to do this: open surgery by a neurosurgeon with a titanium “clip” placed on the aneurysm, a special clip to protect it from rupture, and a minimally invasive treatment method through the inguinal artery – brain aneurysm embolism radiologist.
Of course, you first need to know if you have an aneurysm, because an undiagnosed disease cannot be treated, ”says interventional radiologist A. Širvinskas.
The way to discover an aneurysm is magnetic resonance imaging
According to the RVUL doctor, an accidental aneurysm is not found by accident, it is necessary to have a health check by MRI. However, according to the survey, only one in three (35%) is aware of the diagnosis of the disease. Slightly more (37%) believe that an aneurysm is detected by CT scan.
“It is not entirely true: an aneurysm is not visible on a simple CT scan. This requires a special injection of contrast to highlight the blood vessels in the brain. This specific test is called CT angiography,” says A.Širvinskas.
The rest, about a quarter, are completely unaware of the methods for diagnosing brain aneurysms. Probably the main risk factor for brain aneurysm is genetic predisposition.
“Those with first-line relatives are more likely to have an aneurysm in the brain. The risk of having an aneurysm doubles if there are two or more relatives who have had it,” says the doctor.
Other risk factors include high blood pressure and smoking. Still, the interventional radiologist remembers that some people with brain aneurysms do not necessarily fall into the risk group and do not feel any signs of the disease. Most aneurysms occur in people over the age of 35, more often in women. A ruptured aneurysm usually occurs between the ages of 40 and 60.
Results and practice are out of date
According to Dr. A.Širvinskas, a surprising result of the survey: almost a third of those who know what a brain aneurysm is, say they know both forms of treatment.
Both the surgical treatment performed by the neurosurgeon by opening the scalp and compressing the aneurysm with special titanium clips and endovascular embolization of the aneurysm without opening the head while the interventional radiologist “travels” through the groin to the aneurysm in the brain and embolizes the brain.
In the latter method, the brain aneurysm is treated by A. Širvinskas, the head of the RVUL Department of Interventional Radiology, and his colleagues, but he feels from practice that the knowledge of this method is much less than that of open surgery and therefore insufficient.
However, very few people are aware of endovascular aneurysm embolization by interventional radiology.
These two summer stories, one of which ended in death and the other, happiness, a woman survived, showed that very few people are aware of endovascular embolization of aneurysms by interventional radiology, even those who hear a positive diagnosis after a magnetic resonance. I would say that practice and statistics are somewhat out of place here.
It is already becoming a trend that I often see patients who, after diagnosis, had only heard of treating an aneurysm using traditional open surgery, and it took them several years to learn about groin embolization. Opening her head is often scared, she doesn’t dare to do it, so she just lives with an aneurysm and hopes it won’t rupture, ”shared A. Širvinskas.
The doctor who performed the most endovascular aneurysm embolizations in the Vilnius region, more than 250, believes that knowing this treatment method would definitely decide to seek treatment, so more people are likely to survive. This is fully compensated for with a minimally invasive procedure that maximizes the patient’s body and helps prevent complicated head surgery.
About the study:
Spinter Research Study on Brain Aneurysm, Its Diagnosis and Treatment in 2020 In September, it surveyed 1,008 respondents aged 18-75 from all over Lithuania. Almost 40 percent. of those surveyed, aged 35 to 55, nearly a third aged 56 or over. 2 out of 3 respondents have higher, secondary or special secondary education and work as specialists, civil servants, workers or technicians, they have formed a family.
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