Q&A with Babu Welch, M.D., Associate Professor of Neurosurgery and Radiology, Director of the UT Southwestern Microvascular Laboratory, and Director of the Cerebrovascular Fellowship.
What is a brain aneurysm? This is a weakness of a blood vessel in the brain. The main concern with this weakness is that it may tear or rupture and cause blood to cover the brain. This is frequently life-threatening.
What symptoms should someone look out for? Many brain aneurysms are found without symptoms while another complaint is being investigated. A sudden and new headache is a common presenting complaint in a person with an aneurysm that has bled.
When and why should someone seek immediate medical care? A new and severe headache requires an evaluation in the emergency room. Many times the family of the patient brings the patient to the ER because the patient is not able to speak about their pain.
What can be done to prevent an aneurysm? Establishing good health habits and a steady exercise routine are the best ways to improve your outcome even if an aneurysm does bleed.
What can be done to treat an aneurysm? Aneurysms can be treated very well by traditional surgical or endovascular (see below) options. It is important that any patient with a ruptured or unruptured aneurysm be evaluated by an individual or team of individuals who have the ability to determine which option is best for the patient's long term benefit. A common misconception is that the endovascular option is the lower risk option. The value of an opportunity to have a cerebrovascular specialist explain your options to you cannot be underestimated.
What is endovascular surgery? This is a minimally invasive technique to treat aneurysms, arteriovenous malformations (AVMs), stroke, and carotid artery disease. In addition to achieving effective outcomes, patients may benefit from shorter hospital stays and recovery times.
With endovascular surgery, the neurosurgeon can enter the femoral artery and reach the brain to treat the problem. It can be sealed, with any further bleeding stopped. For AVMs, endovascular techniques are used to inject material into abnormal vessels using microcatheters. Dangerous components of the AVM can be eliminated to make other therapies safer or more effective.
Endovascular surgery has revolutionized the treatment of stroke and the causes of stroke. Through a similar approach through the artery in the leg, surgeons now have the ability to open vessels in the neck and brain to restore blood flow within minutes. The results can be very dramatic.
Is less-invasive surgery just as effective as traditional surgeries in resolving aneurysms? For many patients, the results are similar. We can now resolve more brain aneurysms with less-invasive procedures while achieving the same outcomes as a more extensive surgical intervention, such as craniotomy.
Can genetic factors help predict the likelihood of someone developing a brain aneurysm? Some studies show that some people with immediate family members (mothers, father, grandparents, and first-degree aunts and uncles) are at greater risk for developing aneurysms. MRA (magnetic resonance angiogram) studies are the most effective and safe screening method for those patients who are considered more likely to have an aneurysm. UT Southwestern Neurosurgery has built one of the largest databases on aneurysms in the world, evaluating the pathology of the disorder as well as effective neurosurgical treatments. By evaluating how we treat each patient, we make things better for the next patient.