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Routine MRI leads to discovery of Aneurysms

Bill Swearingen's Medical Story on an Aneurysms of the Carotid Arteries.

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Compendium Information about Aneurysms of the Carotid Arteries is provided in the tables below.

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713-467-3025 Fax 713-467-3192
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You can find this site again by typing in the Google search engine the very unique word " 1smsyruenA " which is " Aneurysms1 backwards.

Article Word Count 10,481 MSW 172

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1Read Bill Swearingen's Medical Story on an Aneurysms of the Carotid Arteries.

Compendium Information about Aneurysms of the Carotid Arteries is provided in the tables below.

2 Back about Thanksgiving, 2005 we were in Clovis, NM visiting with my wife's Cousin and her family. Prior to our trip my wife noticed that I shuffled my feet and walked "fully". She suggested that I go to the doctor and see if I'd suffered a stroke. I thought that I just had "Lazy Legs" and was reluctant to waste money on an MRI. But Mary, Kathryn's Cousin in New Mexico also noticed my "Lazy Legs" and also suggested that I have an MRI.

When we got back home to Bellville, TX, I made an appointment with our Family Doctor, Dr. Weldon Hill, for Monday 5-Dec-05. He recommended an MRI and it was done in Bellville on Wednesday, 7-Dec-05 in the a.m. and a Doppler on 12-Dec-05 in the p.m. in Brenham - to check for any artery blockages (there was none).

On Thursday, 14-Dec-05, Dr. Hill's office called and told me that the MRI found what looked like aneurysms on the Carotid Arteries and they scheduled an MRA in Bryan-College Station for Friday,16-Dec-05.

Dr. Hill's office called and said they wanted to see me
and had an opening on 26-Dec-05 at 1:15 p.m. He had a large pile of x-ray film and from it he recommended that I set up an appointment in Houston with a Neurosurgeon, Dr. Marabi at Herman-Memorial Hospital off I-10 at Gessner.

The appointment
was scheduled for Monday 2-Jan-06 and based on his findings he recommended yet another test - one said to be on the "Gold Standard"
T
his was to be an Angeogram. This was scheduled for Wednesday, 4-Jan-06. The Right-side Artery in the groin area was cut half way in to and a tube was inserted. This was pushed through me, through
my heart and into my brain. At various places they would inject a dye and snap a picture. All in all they took about 20 photos. The dye gave me the "mother of all headaches" and I was in recovery about 6 hours allowing my artery to begin to grow back together and some of the "killer dye" effects to ware off.

I was scheduled for an office visit on Friday 6-Jan-06. At the O.V. I learned that YES, I had two aneurysms - one on the Right - about 9 mm long and one on the Left - about 5 mm long. Neither were considered to be initially life threatening. BUT - he recommended surgical removal of the one on the Right side with the possibility of getting the Left-side at the same time IF we Got Lucky. He also recommended that I do 4 things :
1. Loose 20 - 30 lbs weight
2. Get in better physical shape to tolerate a 5 - 6 hr operation
3. Get my Cholesterol under 200
4. Seek & get a second opinion

I've begun working on the fab-four and hope to have more info soon.

Contact me if I can help you.
Bill Swearingen bswear@hal-pc.org 1-10-06

3 Write your Medical Story on this website free. Share all of your unique pain, agony and treatment situations with others. It will make a difference in their lives. They will contact you to share medical illness information. Click here to e-mail me. Brian Nelson 713-467-3025

4 Misspelled words on this page medical, meical, medcal, medicl, mdical, medycal, medicar, medycar, metical, meticar, medial, medail, medyal, mediar, medyar, medair, metial, metiar, medear, medeal, medica, medyca, metica, ned1ca1, ned1cal, nedical, medicla, mediacl, medcial, meidcal, mdeical, emdical, edical,story, storie, stolie, stoly, stery, sterie, storey, stroie, stloie, stroy, stloy, stoyr, sotry, tsory, aneurysm, aneurycsim, ainulysm, ainurycsim, eineurysm, eineurycsim, eineulysm, aneurym, aneulycsim, aneuryscim, aneursm, ainulycsim, ainuryscim, aneuysm, eineulycsim, eineuryscim, anerysm, aneulyscim, anurysm, ainulyscim, aeurysm, eineulyscim, ainurysm, aneulysm, aneurysms, ameurysms, aneuryssm, aneurymss, aneursyms, aneuyrsms, aneruysms, anuerysms, aenurysms, naeurysms, aneuryss, aneuryms, aneursms, aneuysms, anerysms, anurysms, aeurysms, neurysms, carotid, carotd, caotid, crotid, caroid, cartid, calotid, carot1d, carotdi, caroitd, cartoid, caortid, craotid, acrotid, caroti, arotid, alterius, arteleis, arteries, alturius, altelies, artereis, artelius, alteleis, arturies, altelius, artureis, alteries, altereis, alturies, arterius, altureis, arturius, artelies, artorius, ardurius, altoreis, arderius, altories, ardeleis, arteies, artoreis, ardelies, ardorius, artries, artories, ardureis, ardoreis, areries, arduries, arteris, ateries, ardereis, arteres, arderies, ardories, altorius, ardelius, arter1es, arterise, arteires, artreies, aretries, atreries, rateries, arterie, rteries, bill, bull, byll, birl, bil, byl, bul, bir, b11, b1l, blil, ibll

5 Cerebral Aneurysms

John Pile-Spellman, M.D.
Director of Interventional Neuroradiology
Professor of Radiology and Neurosurgery
Columbia Univesity College of Physicians and Surgeons
New York, New York
T:212-305-6515
F:212-305-5476
EMail: jp59@cunixf.cc.columbia.edu

How do they develop? It is not clear why a person develops a cerebral aneurysm. They are very uncommon in patients below 20 years of age and are increasingly common in older patients. In people over 65, they may be found in as high a 5% of the population. It appears they are related to an absence of a muscular layer that makes up part of the blood vessels that over time stretches and thins and creates the aneurysm. Smoking appears to markedly increase the chance that one will develop a cerebral aneurysm. Click on pictures for a larger view.

Click on pictures for a larger view.

What are the dangers?

Aneurysms can break open and bleed into the brain causing a stroke or even death. This is called a hemorrhage, or rupture. These are usually quite serious. It is estimated that approximately 30,000 people in the United States suffer an aneurysm rupture. The results from these bleeds are quite bad. It has been estimated that if 5 people suffer a bleed today, in one year, only one person will be alive and well. One person will be disabled and three will be dead. Aneurysms, once they bleed, have a high incidence of recurrent bleeding in the days following. There are also delayed problems of water on the brain, (hydrocephalus), and narrowing of the blood vessels because of the irritation of the blood on the blood vessels known as Vasospasm. Rebleeding, hydrocephalus, and vasospasm can happen days to weeks after the initial bleed. Aneurysms can and do grow. If they reach a certain size, usually over 25 mm, (one inch), they can start putting pressure on the surrounding brain and cause progressive problems. These are called Giant aneurysms.

Taken together, all aneurysms appear to bleed at about a 4 % per year rate, or a 1/25 chance of bleeding. It should be noted that most small aneurysms under 6 mm (1/4 inch) are very unlikely to bleed.

How is an aneurysm diagnosed?

If an aneurysm bleeds, the patient almost always has a severe headache that prompts the patient to seek medical attention. A CT scan of the brain or a Lumbar puncture usually identifies the blood outside the blood vessel and is called a Subarachnoid Hemorrhage (SAH). An angiogram is usually performed to identify the exact blood vessel that has bled and the detailed anatomy of the aneurysm.

Occasionally, aneurysms grow and press on the surrounding area around the brain and cause other symptoms such as headache or double vision. This may prompt an MRI / MRA that may identify an aneurysm that has not bled.

Why should it be treated?

Treatment of the aneurysms can be used to

(1) keep them from rebleeding
(2) treating the hydrocephalus
(3) treating the vasospasm.

The major danger is from rebleeding in the days to weeks following the initial bleed.

What are the treatment options?

To avoid rebleeding, aneurysms can be treated with Direct Surgery or Embolization (Endovascular). Direct surgery is usually the preferred method of treatment since it is highly effective and relatively safe. Under general anesthesia, surgery is performed to open the skull and identify the neck of the aneurysm. This is the junction between the good strong blood vessel and the weakened ballooned aneurysm. A clip is put across this area. In those patients where direct surgery is believed to have a higher risk, or be less effective, embolization may be offered.

Endovascular surgery is performed by navigating a small tube or catheter into the aneurysm from the blood vessel in the leg artery under X-Ray guidance. Tiny platinum coils or tiny latex or Silicone balloons are used to fill the aneurysm. The materials that are used to treat aneurysms are new and considered investigational, and require a special consent. Patient selection is based on the individual patient and aneurysm anatomy. Occasionally, a number of operations must be performed to safely obliterate the aneurysm.

Additional Information

A group of patients and family members who have much knowledge and experience with aneurysm have formed an Aneurysm support group nationally with regional chapters. Any member of our team would be glad to answer any questions you might have. Below is a list of phone numbers that may be of use for your reference.

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Aneurysms

An aneurysm is a balloon-like bulge in an artery. Aneurysms can form in arteries of all sizes. An aneurysm occurs when the pressure of blood passing through part of a weakened artery forces the vessel to bulge outward, forming what you might think of as a blister. Not all aneurysms are life-threatening. But if the bulging stretches the artery too far, this vessel may burst, causing a person to bleed to death. An aneurysm that bleeds into the brain can lead to stroke or death.

Picture is before surgery.

Where do aneurysms occur in the body?

In the arteries that supply blood to the brain. This is called a cerebral aneurysm.
In parts of the aorta. The aorta is the large vessel that carries blood from the heart to other parts of the body. Aortic aneurysms can occur in the area below the stomach (abdominal aneurysm) or in the chest (thoracic aneurysm). An abdominal aortic aneurysm (AAA) is usually located below the kidneys.
In the heart's main pumping chamber (the left ventricle). If a section of the heart wall becomes damaged after a heart attack, it causes scarring and the heart wall grows thinner and weaker. This may cause a ventricular aneurysm to form. The weakened area of aneurysm does not work well, which makes your heart work harder to pump blood to the rest of your body. Ventricular aneurysms may cause shortness of breath, chest pain, or an irregular heart beat (arrhythmia). If a ventricular aneurysm leads to congestive heart failure, left ventricular heart failure, or arrhythmia, your doctor may want you to have surgery.

How do aneurysms happen, and who is at risk?

Any condition that causes the walls of the arteries to weaken can lead to an aneurysm. The following increase the risk of an aneurysm:

Atherosclerosis (a build-up of fatty plaque in the arteries).
High blood pressure.
Smoking.
Deep wounds, injuries, or infections of the blood vessels.
A congenital abnormality (a condition that you are born with).
Inherited diseases. An inherited disease such as Marfan syndrome, which affects the body's connective tissue, causes people to have long bones and very flexible joints. People with this syndrome often have aneurysms.

How are aneurysms detected?

Aneurysms can be detected by physical exam, on a basic chest or stomach x-ray, or by using ultrasound. The size and location can be found through echocardiography or radiological imaging, such as arteriography, magnetic resonance imaging (MRI), and computed tomography (CT) scanning.

A CT scan gets a number of images that your doctor can look at one by one. New computer technology now lets technicians stack the images on top of each other to get a 3-D image that can be rotated and viewed from any angle. The red arrows in the images above point to a large aneurysm of the abdominal aorta seen from the front (left picture) and the side (right picture).

What are the symptoms?

Symptoms are different depending on the type and location of the aneurysm. Symptoms result from the pressure caused by an aneurysm's pressing against nearby organs, nerves, and other blood vessels. For example,

Aortic aneurysms may cause shortness of breath, a croaky or raspy voice, backache, or pain in your left shoulder or between your shoulder blades. Sometimes, an aortic aneurysm can "dissect". When this happens, the pain may be sudden and severe. Patients often feel like something is ripping or tearing inside of them.
Abdominal aortic aneurysms may cause pain or tenderness below your stomach, make you less hungry, or give you an upset stomach.
Cerebral (brain) aneurysms may have no symptoms, although you may have headaches, pain in your neck and face, or trouble seeing and talking.

How are aneurysms treated?

Treatment depends on the size and location of the aneurysm and your overall health. Aneurysms in the upper chest (the ascending aorta) are usually operated on right away. Aneurysms in the lower chest and the area below your stomach (the descending thoracic and abdominal parts of the aorta) may not be as life-threatening. Aneurysms in these locations are watched regularly. If they become about 5 centimeters (almost 2 inches) in diameter, continue to grow, or begin to cause symptoms, your doctor may want you to have surgery to stop the aneurysm from bursting.

For aortic aneurysms or aneurysms that happen in the vessels that supply blood to your arms, legs, and head (the peripheral vessels), surgery involves replacing the weakened section of the vessel with an artificial tube, called a graft.

For patients with smaller or stable aneurysms in the descending aorta or abdominal parts of the aorta—those farthest from the heart, doctors usually ask patients to come in for regular check-ups so they can follow the growth of the aneurysm. If the aneurysm does not grow much, patients may live with the aneurysm for years. Doctors may also prescribe medicine, especially medicine like a beta blocker that lowers blood pressure, to relieve the stress on the aortic walls. Medicine to lower blood pressure is especially useful for patients where the risk of surgery may be greater than the risk of the aneurysm itself.

Nonsurgical Procedure for Treatment of AAAs

Cardiologists at the Texas Heart Institute were among the first to use a nonsurgical technique to treat high-risk patients with abdominal aortic aneurysms. This technique is useful for patients who cannot have surgery because their overall health would make it too dangerous.

The procedure uses a catheter to insert a device called a stent graft. The stent graft is placed within the artery at the site of the aneurysm. The blood flows through the stent graft, decreasing the pressure on the wall of the weakened artery. This decrease in pressure can prevent the aneurysm from bursting.

Benefits of the procedure include no general anesthesia (you are awake for the procedure), a shorter hospital stay (about 24 hours), a faster recovery, and no large scars. Time and experience will prove whether this procedure will eliminate the long-term risk of an aneurysm's bursting.

7 Routine MRI leads to discovery of Aneurysms

Bill Swearingen's Medical Story on an Aneurysms of the Carotid Arteries.
Compendium Information about Aneurysms of the Carotid Arteries is provided in the tables below.