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Learn the Latest Treatments for Aneurysms

July 16, 2013

Washington Hospital Seminar Highlights High Tech Surgery Options

Imagine having brain surgery through a tiny artery in your leg. Sound far off? Actually this type of endovascular neurosurgery is currently being performed at Washington Hospital to treat brain aneurysms and other disorders.

"Advances in technology have dramatically changed the way we do brain surgery," said Dr. Jeffrey Thomas, a cerebrovascular neurosurgeon and the medical director of Interventional Neuroradiology at Washington Hospital. He is one of only about 120 neurosurgeons in the United States with dual expertise in microscopic brain surgery and interventional neuroradiology. "Today we can perform brain surgery without ever cutting open the skull."

Dr. Thomas will talk about this relatively new type of surgery as well as other treatment options available today for brain aneurysms at a free seminar scheduled for Tuesday, July 30, from 1 to 2:30 p.m. "Learn the Latest Treatment Options for Aneurysms" will be held at the Conrad E. Anderson, M.D. Auditorium, located at 2500 Mowry Avenue (Washington West) in Fremont. Register online at www.whhs.com/seminars or call (800) 963-7070 for more information.

A brain aneurysm is an abnormal bulge on the side of the artery wall. The artery carries oxygen-rich blood and pressure on the wall can cause the bulge to burst, allowing blood to flow out of the vessel into the brain.

Rupture Can be Deadly

About 15 percent of people with a ruptured brain aneurysm die before they even make it to the hospital and ruptured brain aneurysms are ultimately deadly in about 40 percent of cases, according to the Brain Aneurysm Foundation. Of those who survive, 66 percent suffer some permanent neurological disability.

"Generally you don't know you have a brain aneurysm until it ruptures," Dr. Thomas explained. "A brain aneurysm can be detected by an MRI, but most people are not routinely screened for them. Usually if they are discovered before they burst, it's during an MRI for something unrelated like migraine headaches or after a head injury."

Symptoms of a ruptured aneurysm include a sudden and severe headache (the worst headache you have ever experienced), loss of consciousness, nausea and vomiting, stiff neck, seizure, sudden blurred or double vision, sudden pain above or behind the eye, sudden change in mental status or awareness, dizziness, trouble walking, sudden weakness or numbness, and drooping eyelid.

"It's imperative that you seek immediate medical attention after an aneurysm ruptures," he said. "The blood can damage brain cells and cause pressure to build up on the brain. It's very dangerous. Even days after a successful surgery, patients are not out of the woods. They can still die as a result of complications from so much blood flowing abnormally into the brain."

Clipping vs. Coiling

Dr. Thomas will talk about the two surgical procedures used today to treat brain aneurysms: clipping and coiling. Clipping is the traditional surgical treatment. The neurosurgeon removes part of the skull, locates the blood vessel that feeds the aneurysm, and places a titanium clip on the neck of the aneurism. The clip stops blood from continuing to flow into the brain, he explained.

The newer coiling technique uses a tiny microcatheter that is introduced into the leg and guided through a series of blood vessels into the chest, through the aorta, and into the head and brain, he said. A soft platinum wire is pushed through the microcatheter and into the aneurysm. The wire coils up inside the aneurysm, stops the blood flow, and causes the blood to clot.

With the help of advanced interventional neuroradiology equipment, including biplane cerebral angiography, Dr. Thomas performs the delicate neurosurgical procedure while watching his movements on a high-resolution monitor in Washington Hospital's new advanced surgical suite.

"The first human aneurysm was coiled in 1991," he added. "Since the mid-90s, angiographic imaging technology has improved steadily and pretty magnificently."

Case Studies

Dr. Thomas will provide case studies of some of his patients who have given their consent. He said that is the best way to understand some of the complications related to treating aneurysms that have ruptured.

For example, he will talk about the case of Maria Ramirez, who suffered a ruptured brain aneurysm last year while living in Modesto. She was flown to Washington Hospital, where she was met by Dr. Thomas and a team of specialists.

Maria had suffered a very large hemorrhage and a lot of blood had surrounded her brain, he said. He determined that the best course of action was to repair the rupture with conventional microscopic brain surgery rather than the newer coiling method.

"When you have a patient with this much hemorrhaging, pressure builds up in the brain," Dr. Thomas explained. "The pressure can cause the brain to swell. But by removing part of the skull, it helped to alleviate the pressure, and Maria never got terribly sick."

He will also talk about the difference between treating an aneurysm that has ruptured and one that is diagnosed while it is still intact. With a rupture, a hospital stay can last several weeks followed by a long period of rehabilitation.

"If we perform the coiling method, the patient is out of the hospital the next day when there is no rupture," Dr. Thomas said. "Using the clipping method, the patient is discharged within three to four days."

Register For This Class Online

To learn more about aneurysms, attend the upcoming seminar by registering at www.whhs.com/seminars. To learn about other programs and services offered at Washington Hospital that can help you stay healthy, visit www.whhs.com.