It’s known as a silent killer. Although there are no warning signs in the majority of cases, more than half of people who suffer from a ruptured brain artery each year will die and only a third will recover without any disabilities.
A new study published in BMJ Open has determined for the first time a link between variations in the size of the brain’s arteries and the possibility of developing an aneurysm. The study provides scientists with a new screening tool to monitor people at risk.
Lead researcher, University of South Australia neuroanatomist, Dr Arjun Burlakoti, says that imaging tests of 145 patients revealed that people with asymmetric brain arteries have an increased risk of developing an aneurysm, a ballooned vessel in the brain that could rupture and cause a haemorrhagic stroke.
Subarachnoid hemorrhage is the most dangerous type of stroke. It happens when the artery in the brain ruptures or leaks, causing bleeding to the brain. This can result in brain death that is greater than 50 percent.
Many small, unruptured and undiagnosed aneurysms aren’t detected by the commonly used imaging techniques. They are not always diagnosed until they are large enough to cause symptoms or rupture, typically when it is too late.
We looked at brain pictures of people with aneurysms and discovered that the four arteries entering the brain box, dividing into multiple segments and providing blood to the brain, were not proportional to each other, thus increasing the blood pressure, and exposing them to ballooning blood vessels.”
Dr Arjun Burlakoti, Lead Researcher, University of South Australia
Where the front part of the brain arterial network (the anterior cerebral artery, also known as the A1) differs in the left and right diameter ratios by up to 1.4 individuals are at risk of having an 80 per cent risk of developing aneurysms in that region, which is the most prevalent location of ruptured aneurysms. A 7.8 percent risk of an equivalent risk is for those with symmetrical ratios lower than 1.4.
Cerebral aneurysms are responsible for nearly 500 000 deaths each year around the world and half of them occur in those under 50 and women are at greater risk.
Aneurysms that rupture can trigger severe headaches nausea, double vision vomiting stiff neck, muscle weakness and confusion, as well as seizures and cardiac arrest.
If detected early, aneurysms are able to be monitored and controlled by regulating blood pressure using medications and lifestyle adjustments. They can be surgically clipped or removed, but this has the potential for brain damage or stroke and is only recommended if there is a significant risk of rupture.
Dr Burlakoti says that MRI and CT angiograms are able to determine whether people have asymmetrical cerebral arteries according to their findings. If so it is recommended to screen for cerebral aneurysms regularly.
Burlakoti A., and others. (2021). Relationship between cerebral aneurysms, variations in cerebral basal arterial network: a morphometric cross sectional study in Computed Tomography Angiograms from a neurointerventional Unit. BMJ Open. doi.org/10.1136/bmjopen-2021-051028.
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