Every 18 minutes in the United States, a brain aneurysm ruptures – and nearly half are fatal. Of those who survive, many suffer some permanent neurological deficit.
Brain aneurysms, a bulge or ballooning of a blood vessel in the brain, can be treated if caught in time. The two most common treatments are open brain surgery or endovascular coiling, a less invasive procedure developed in the 1990s in which a wire is inserted via catheter into the aneurysm, disrupting blood flow and causing the blood to clot. Both procedures can be risky – and they cannot be used to treat aneurysms in hard to reach, vulnerable areas of the brain.
In April 2011, the U.S. Food and Drug Administration approved the new Pipeline Embolization Device, which provides neurointerventional surgeons with another tool to treat brain aneurysms without open brain surgery.
University of Miami/Jackson Memorial Medical Center neurosurgeon Ali Aziz-Sultan, M.D., who specializes in minimally invasive aneurysm techniques, was among the first doctors in the United States – and the only doctor in South Florida – to use this new treatment.
“This is the latest technological advancement in aneurysm treatment,” Dr. Sultan said. “It’s a revolutionary jump in what we do.”
The Pipeline Embolization Device is a flexible mesh tube that is delivered through the lumen of a catheter, inserted into an artery in the leg and threaded to the area in the brain where the aneurysm is located. The pipeline stent is then expanded against the walls of the artery and across the neck of the aneurysm, cutting off its blood flow, and ultimately shrinking it. The procedure – a major technological advance from other aneurysm treatment options like coiling or open brain surgery – can take as little as one hour to perform, and patients are usually discharged home after two days.
The University of Miami/Jackson Memorial Medical Center is one of the first of 10 medical centers in the United States to treat aneurysm patients by implanting the Pipeline Embolization Device.
Dr. Sultan first used the Pipeline stent in June 2011 to treat Bernadette Fields, a 72-year-old waitress from Sunrise. For nearly four years, Bernadette was constantly bothered by an annoying drip from her nose. She thought it was a sinus problem, but a CT scan determined that it was much more serious – a large brain aneurysm behind her eye that was pressing on her sinus cavity. Two doctors in Broward County saw Bernadette before she was thankfully referred to Dr. Sultan at Jackson Memorial Hospital.
The timing was right.
Dr. Sultan was already scheduled to begin performing the new procedure using the Pipeline device, and Bernadette was the perfect candidate because of the size and location of her aneurysm.
“She had a very complex aneurysm, and if it had ruptured, she could have bled to death,” Dr. Sultan said.
Six months after Bernadette’s procedure, scans showed her aneurysm was almost completely gone. “I feel so blessed that it never ruptured and that it didn’t appear a few years ago, when this procedure wasn’t an option,” said Bernadette, who is back to work and feeling great.
Another patient of Dr. Sultan’s, Maria Gestro, suffered headaches and dizzy spells for years. Medical tests revealed two brain aneurysms. In August 2011, Dr. Sultan implanted two Pipeline stents in Maria’s brain. Since then, her aneurysms have completely shrunk, her headaches are gone and her life is back to normal.
Often aneurysms go undiagnosed until they rupture. Common signs and symptoms of a ruptured aneurysm are:
• A sudden, severe headache, often described as the "worst headache" ever experienced
• Nausea and vomiting
• Stiff neck
• Blurred or double vision
• Sensitivity to light
• Seizure
• A drooping eyelid
• Loss of consciousness
• Confusion
Doctors advise, that in all cases, you should seek immediate medical attention if you develop a sudden, extremely severe headache.
