Hypertension, Diabetes and lifestyle habits such as smoking can be major risk factors
Aneurysms in adults are often undiagnosed due to their asymptomatic nature
Kauvery Hospital Chennai, a unit of Kauvery Hospitals, a leading healthcare chain in Tamil Nadu, successfully treated a 59-year-old man for multiple neurological disorders – Aneurysm, Seizures and Thrombus.
The patient had presented with difficulty in speech, along with a pulling sensation in the right hand, and tongue which was folding inwards. The abnormal sensations were diagnosed to be part of a seizure, later clinically confirmed with EEG.
Speaking on the case, Dr. Bhuvaneshwari Rajendran, Consultant Neurology and Neurophysiology, Kauvery Hospital Chennai, says, “The patient was initially diagnosed for seizures and underwent an MRI scan, when we identified an aneurysm in the brain. This was a cerebral aneurysm (a bulging or weakening in the walls of main blood vessel) that measured more than 5 mm in size. We also identified a thrombus (clot in the vessel) in a major artery feeding the left brain. Hence we had to take a multi-pronged approach in treating the patient.”
The patient was treated with a minimally invasive coiling procedure, a method where a coil is inserted to the aneurysm, to block the blood flow into the area, thus avoiding rupturing of the aneurysm. “Generally, this minimally invasive procedure is done with a catheter and the coil is filled into the aneurysm sac, to prevent blood flow. In this case, the patient had a thrombus in one of the blood vessels too. We had to treat that with blood thinners, after the patient was deemed fit for blood thinners, post endovascular coiling procedure,” explains Dr. Bhuvaneshwari.
The patient was carefully monitored for any new neurological deficits. He was alright and thus discharged on the fourth day without any complications. He was able to speak and move his hands with ease.
Brain aneurysms are more common in adults, and in most cases they remain undiagnosed. The problem occurs when the aneurysm ruptures or begins to leak which leads to symptoms like severe headache, drooping of eyelids, difficulty in mobility, seizures, stiffness in neck, numbness on one side of face etc. Sometimes aneurysmal bleeds can be catastrophic for the patient and large bleeds have high mortality rate.
The prevalence of an aneurysm in general population is around 2%. The vast majority of these aneurysms are small (measuring less than 10 mm) and have an annual risk of rupture of approximately 0.7%. “Many risk factors contribute to this condition such as age, diabetes, Hypertension, lifestyle habits such as smoking, elasticity of vessel wall etc. If the patient is a younger person then there could be a strong family history and we screen family members to confirm the same. In this case, the patient was an active smoker and had hypertension,” she adds.
This case highlights the need to have a multi-dimensional approach to patients who present with multiple problems at the same time. It gives us utmost satisfaction to think that we could achieve this level of success during the height of the COVID pandemic and lockdown.
Speaking on the same, Dr. Aravindan Selvaraj, Co-founder and Executive Director Kauvery Hospital Chennai says, “Treating aneurysms require a team of well qualified neurosurgeons, interventional radiologist and well equipped infrastructure for diagnosis and dedicated post-operative care. Since the brain is a very delicate organ, it needs utmost attention and care during the procedure. Our Centre of excellence for Neurology offers best-in-class treatment options for people with any neurological complication and the Neuro Intensive care unit with state of the art facilities, provides utmost care and rehabilitation for patients. I congratulate Dr. Bhuvaneshwari and team for the timely diagnosis and treatment given to the patient, helping him get out of danger.”