Brown Vertical Stripe in Child’s Fingernail plus Cuticle
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Best Solutions for Dry, Cracked Winter Knuckles that Bleed
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Car Pool Etiquette for Work: Don’t Honk and Wake People Up!
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Why Aren’t There Routine MRI Screenings for Brain Aneurysms?
An MRI can easily detect a brain aneurysm (aka “time bomb”), so why isn’t the MRI a standard screening tool for this often fatal condition?
How often have you heard of a famous person, celebrity or media personality who died from a ruptured brain aneurysm?
It’s rare, but when it happens, it’s shocking. It also makes you think, Gee, had they known they had an aneurysm in the brain, it could have been treated.
“Magnetic resonance angiography (a type of MRI) can be used to search for un-ruptured brain aneurysms,” says Resham Mendi, MD, a renowned expert in the field of medical imaging, and the medical director of Bright Light Medical Imaging.
“Some studies have shown that one to six percent of the population have an aneurysm,” continues Dr. Mendi.
“Depending on the size, some are at higher risk of rupture than others.”
Notable People Who Died from Ruptured Cerebral Aneurysm
Brain aneurysm rupture. Shutterstock/OpenStax College
• Guy Williams (John Robinson on “Lost in Space”)
• Laura Branigan (made “Gloria” a hit song in the early ‘80s)
• Lisa Colagrossi (TV news anchor/reporter)
There’ve been many more over the years. It’s not that famous people are more important than “regular” people, but let’s face it:
When a media personality dies from a ruptured brain aneurysm that nobody knew existed prior, it’s quite a shocker.
Aneurysms can be managed with clipping, coiling or serial observation. Otherwise, the risk is that over time they grow so big that they burst, causing massive bleeding in the brain known as a hemorrhagic stroke.
- One-third of victims will die.
- One-third will be left with brain damage.
- Only one-third will recover well.
When people go to emergency rooms with symptoms suspicious for a leaking or ruptured aneurysm, they are given a CT scan (radiation), because this is far faster than an MRI (no radiation).
But imagine the lives, over the years, that would have been saved had MRI screenings for cerebral aneurysms been routine for apparently healthy people.
Alarming Facts
“Most cerebral aneurysms go unnoticed until they rupture or are detected by brain imaging that may have been obtained for another condition.”
This statement comes from the National Institute of Neurological Disorders and Stroke.
There’s no routine screening protocol for brain aneurysms and it’s unlikely that this will be a reality soon.
“At the current time, the guidelines for screening indicate that patients who are at high risk for aneurysm should be screened,” says Dr. Mendi. But not the general population.
Why? The NHS online states that it’s “because researchers have calculated routine screening would do little to prevent deaths,” but would place enormous drain on NHS resources.
The NHS is a United Kingdom entity, but the reasoning behind that statement — the enormous drain on resources — is the same reason why there’s no routine screening for brain aneurysms in the United States.
People who have significant risk are urged to get regular screenings.
“This includes patients who have smoked cigarettes, with family history of aneurysm in close relatives, high blood pressure, history of cocaine or amphetamine use, or history of rare diseases such as polycystic kidney disease, Ehler’s Danlos syndrome and Marfan syndrome,” says Dr. Mendi.
Other Possible Reasons There’s No Routine Screening for Brain Aneurysm
• Distress at learning one has a cerebral aneurysm that’s not suitable for surgical treatment.
Risk of rupture is actually small, but such patients may then live the rest of their lives thinking they’re a “walking time bomb.” They will regret the screening.
• MRIs are very expensive.
• CT scans, though a lot cheaper, emit radiation.
• Not enough people in the population have asymptomatic cerebral aneurysms to justify routine screening.
• Risks of surgical treatment (which include triggering a rupture) outweigh the risk of an asymptomatic aneurysm ever rupturing.
Medical technology isn’t advanced enough to surgically treat (coiling or clipping) every single aneurysm that shows on an MRI. Some are deemed unsuitable for this.
As long as the rate of rupture is actually quite low in non-symptomatic people, and the rate of surgical complication is relatively high, there will not be any routine screenings for brain aneurysms – even if MRI were dirt cheap.
Dr. Mendi has published several articles in radiology journals and has expertise in MRI, women’s imaging, musculoskeletal, neurological and body imaging.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Freepik/wayhomestudio
Sources:
ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Cerebral-Aneurysms-Fact-Sheet#3098_7
nhs.uk/Conditions/Aneurysm/Pages/Diagnosis.aspx
uptodate.com/contents/screening-for-intracranial-aneurysm
Can Getting Hit in Head Rupture a PRE-EXISTING Aneurysm?
If a person has a brain aneurysm, would getting “bonked” in the head, from the activities of daily living, necessarily rupture it? (more…)
Can a Lump ON the Collarbone Mean Lymphoma Cancer ?
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Is It Okay to Lift Weights with a Winged Scapula?
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If a person has a winged scapula – an actual diagnosis rather than just an assumption based on what it looks like – would there be any reason to avoid lifting weights? (more…)
Can a Scapula Tumor Be Misdiagnosed As Benign Winging?
“Scapular winging could be mistaken for a tumor, or vice versa,” says John-Paul H. Rue, MD. This is precisely what you were hoping NOT to hear: a cancer can be mistaken for a benign winging of the scapula bone. (more…)
Head Very Sensitive to Touch Post-Concussion: Cause, Solutions
Head sensitivity to touch after a concussion can be quite significant, causing alarm to the patient.
You may think that this means brain injury, bleeding in the brain or some other serious problem due to the extreme tenderness and sensitivity just from the lightest touching.
Even lightly brushing or combing your hair may really hurt your head.
Why can the head be very sensitive to touch after a concussion?
“The area of the head where the impact happened is innervated by the skin nerves,” says neurosurgeon Charles Park, MD, Director of The Minimally Invasive Brain and Spine Center at Mercy Medical Center in Baltimore. “These nerves can then become very sensitive, especially to touch.”
The job of a nerve is to get innervated. This simply means that the nerve receives an electrochemical impulse.
The impulse may be motor and coming from the brain (to command muscle contraction) or sensory and coming from the skin (to forward on to the brain for interpretation).
So if you’ve had a concussion and then touch your head, or something touches it like a shirt that you’re putting on, the sensory nerves in the skin of your scalp receive this stimulus.
The skin they serve is wounded and hurting, and the electrical impulses they send to the brain, when the skin is touched or rubbed, are interpreted as extreme sensitivity, tenderness or soreness.
In short, your skin took a blow and it hurts as a result. It’s like getting whacked in your knee.
Though you can walk afterwards, it hurts to high heaven when you lightly press on it.
The degree of skin sensitivity is not telling of the degree of concussion. In fact, a concussion isn’t even necessary to sustain a high degree of skin sensitivy on the head – or what is actually the skin there.
You can get hit hard in the head – no concussion, no neurological symptoms – and still suffer quite a bit of sensitivity, tenderness and soreness in the spot that got hit.
Again, this does not mean a brain injury. It means a benign skin injury (assuming there’s no gash) that can even start showing a bruise.
It can take many days for the sensitivity to wear off.
Dr. Park explains, “Patients can be assured that this will become less and less and eventually resolve with time. Usually an ice pack will bring symptomatic relief.”
