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Minimally invasive aneurysm surgery saves lives

April 6, 2012
Dr. Michael Brant-Zawadzki

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 aneuroradiologist. 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 survivors.
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 health.
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 Hoag.
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 Neurosciences Institute
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