Fast fix for a brain aneurysm – while wide awake


Surgeons can now perform complex operations to repair damaged blood vessels in the brain while patients are wide awake.

The delicate procedure could be a lifeline for the 5,000 Britons who have a ruptured brain aneurysm every year – where a weakness in the blood vessels in the skull leads to catastrophic internal bleeding.

About two percent of the population is thought to have such weakness, and it does not usually cause everyday problems.

But in half the cases, a fracture, which can happen without warning, means near-instant death. And many of those who survive sustain permanent brain damage.

A graph shows how the delicate procedure, which could be a lifeline for 5,000 Britons a year, will work

A graph shows how the delicate procedure, which could be a lifeline for 5,000 Britons a year, will work

If an aneurysm is picked up in scans before there is a rupture, surgeons usually use a small metal implant to support the blood vessels and prevent major bleeding. In the past, the surgery had to be done under general anesthesia, but now they can do it with just local anesthesia and sedation.

Celine Dawes, a 64-year-old housewife from Chingford, North East London, had the operation last winter and was out of bed an hour after the procedure. She felt ‘small tingling’ in her head during the operation, but no pain. “I know it saved my life and I’m glad others will get it now,” she says.

Worryingly, aneurysms don’t usually cause symptoms until they rupture. They can cause everything from severe headaches and vision problems to a potentially fatal stroke.

Despite years of research, scientists still don’t know what causes it, but they are known to run in families. Smoking and high blood pressure also increase the risk.

Fractures are most commonly seen in adults between the ages of 30 and 60, and are more common in women than men. However, it is believed that they can develop at any age. Game Of Thrones star Emilia Clarke, 33, revealed last year that she had suffered two in her twenties.

To repair an aneurysm, surgeons insert tiny metal coils into the damaged blood vessels, or a gauze ball known as a cerebral aneurysm embolization device, or both. They work by blocking blood flow to the aneurysm, occluding it, and preventing rupture. The implants are placed through a catheter, normally inserted into a vein in the thigh or wrist and passed to the brain.

Celine became the first patient in the UK to undergo the surgery while wide awake when surgeons realized that her lung condition meant that the use of general anesthetics would not be possible.

She developed a ruptured aneurysm for the first time just before Christmas.

Celine says: “I was standing in my kitchen when I suddenly started to feel dizzy. Everything started to spin. ‘

She thought it was the flu and stayed in bed for two days. But the pain in her head was so bad that she didn’t sleep and was constantly throwing up.

Surgeons can now perform complex operations to repair damaged blood vessels in the brain while patients are wide awake

Surgeons can now perform complex operations to repair damaged blood vessels in the brain while patients are wide awake

Surgeons can now perform complex operations to repair damaged blood vessels in the brain while patients are wide awake

When Celine’s daughter came by, she begged her mother to go to the hospital. Brain scans showed that Celine had a ruptured aneurysm in the back of her brain. “The doctors looked at the scan and told me I was very lucky to be there,” she adds. She was immediately transferred to the Royal London Hospital neurosurgery team, but as she also suffers from a lung condition, it would have been very risky to use a general anesthetic to repair the damage caused by the aneurysm.

Neurosurgeon Dr. Paul Bhogal explained to Celine that they were going to try something new – she would be awake operating her brain.

During the procedure, which took just 35 minutes, her head was placed between two wooden blocks and told to remain completely still. Celine literally followed the instruction: “I was still clenched, I even held my breath at certain points.”

The neurosurgery team injected Celine with a dye that an advanced X-ray could use to provide a real-time picture of the fracture. A local anesthetic was then applied and a catheter threaded through a vein in Celine’s right wrist.

“This is a major operation to perform while the patient is awake because one wrong movement can spell disaster,” Bhogal says. “Fortunately, Celine hasn’t moved a muscle.”

Celine was followed in hospital for seven days, but Mr. Bhogal says it is possible in the future for patients to be able to go home the same day.

A year later, Celine has had no more problems.

Mr. Bhogal has since published a study on the procedure and hopes his research will encourage surgeons to perform awake brain aneurysm surgery on patients at risk from general anesthetics.

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The post Fast fix for a brain aneurysm – while wide awake appeared first on WhatsNew2Day.

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