Your brain is where you live, where you tuck away your memories. It
moves you, both figuratively – with your aspirations and big ideas – and
literally, by directing you to place one foot in front of the other.
But what's really going on up there?
I'm a neuroradiologist. I have studied the brain on X-rays, angiograms
(where dye is injected into its pipes), and on CT and MRI scans for decades.
I've snaked tiny tubules into the deepest crevices of brain matter to seal
leaking blood vessels, and unclog others. I've stuck needles into the spinal
canal to study and treat patients, listened to their complaints, experienced
their disabilities, and worked closely with the neurologists, psychiatrists and
neurosurgeons who take care of their complex conditions.
I now help coordinate the people, the facilities and the technology
focused on brain (and spine) matters at the Hoag Neurosciences Institute.
From addiction to brain tumors, seizures, stroke and dementia, defects
in our brains can fundamentally change who we are. I will help readers navigate
and understand those changes, explain the latest research and debunk some
myths. And, when possible, I will show how we can slow or reverse damage – or
even prevent disaster.
Just recently, for instance, a 60-year-old woman with a history of
headaches came to the emergency room. She was experiencing a much worse
headache than usual (headaches, "mind" you, are one of the most
common complaints seen in our ERs).
A brain scan uncovered three aneurysms, weak bubble-like outpouchings of
the pipes providing blood flow to the brain. Sharon Stone and Vice President
Joe Biden both survived aneurysm rupture and emerged unimpaired. They were the
lucky ones. When those brain bubbles pop, massive bleeding can occur, killing
33 percent of those afflicted and permanently damaging the brains of many
Sealing the bubble and reinforcing the wall of the pipe can prevent the
devastation a "blow-out" would produce. In the past, intricate
surgery to remove the skull, navigate deep into the brain and place a
clothesline-type clip on the bubble was the standard approach. The lucky ones
whose aneurysms were caught in time could then face weeks-long hospital stays
and sky-high medical bills.
Today, highly skilled neuroradiologists guide tiny tubes from the groin
artery under X-ray guidance into the brain without even touching the patient's
head. It's like a real life, high intensity video game.
They seal up the bubble from inside and deposit an inner sleeve in the
pipe to reinforce it.
Avoiding rupture by intervening proactively is what high-resolution
brain scans and modern minimally invasive techniques are all about: better
Like Sharon Stone and an increasingly growing number of aneurysm
patients, the woman in our ER went home healthy and happy after just one day at
Does everyone with headaches require a brain scan? Of course not. Who
decides? Highly trained headache experts. Armed with the best technology, we
can do wonders.
And that should give everyone some peace of mind.
Dr. Brant-Zawadzki is the executive medical director of Hoag's
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