Kauvery Hospital Chennai, has 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.
"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 5mm 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,” said Dr Bhuvaneshwari Rajendran, Consultant Neurology and Neurophysiology, Kauvery Hospital.
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,” explained 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 the 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," Dr Bhuvaneshwari added.