Tag Archives: Brain aneurysm

Depression following a Brain Aneurysm

Dealing with the new you….

Brain Aneurysm is a life-changing event that affects the life of a person in every aspect. How does it feel like to go from “ normal” to being called a “survivor”? The feeling of coming to terms with the new you and letting go of the old you is what traps most survivors and wraps them around the depression face during recovery.

Depression becomes almost like a virus consuming the individual from inside out. You sought of loose yourself for a while in an identity crisis dilemma that your mind has and continues to create. You are basically existing in your own world debating on whether you are better off alive or dead.

While you are being consumed from the inside out, the people around you start to be affected as well. They feel like they have reached a burn out point and underappreciated. This is the point where things start to fall apart. Relationships break, new health concerns arise, finances become a challenge and suicide dominates the mind of the “weak.” This is the saturation point for both parties affected and intervention is a must. While most people don’t get to this point, those who do should try to seek the help of a professional immediately.

Similar to the nature of depression, healing starts from the inside and spreads to the outside. The survivor needs to discover and believe in the reason why he/she is alive. Maybe you’re alive to raise your children or perhaps your grandchildren depend on you or maybe you’re the inspiration that your church needs or the role model that your workplace looks up to or you’re simply the one that touch and changes people’s lives or you’re the reason for someone else’s happiness or maybe your story is what the world is waiting on…whatever the reason might be, try to find it. There is so much joy that comes with that feeling when you know that your life is not a mistake but a miracle and a testimony.

Recovering from a brain aneurysm or any major life-changing event is a journey with a lot of changes along the way. Like we all know, change is hard but the only key to ensure a smooth transition is choosing to concentrate your energy on what matter the most. You must focus on the positives and make the best of every moment because before you know it, that moment will soon be a mere footnote in your life’s story. So please, make it memorable.

Sometimes I look back and try to reflect on all of the changes that I have experienced in life and the reality is, nothing is meant to last forever. We go through seasons in life.

Of all the changes that I have gone through so far, the one that takes the trophy is child birth. The moment before life happens and the baby’s first cry is heard, a woman goes through intense pain. What’s so interesting is that before the baby is delivered, a woman has to experience all the stages of labor until her cervix is ready to let the baby out. It’s that magical moment that the pain is intolerable that the baby makes its victorious entrance into the world. Shortly after that, all the pain is literally replaced with joy. How magical is that!

No matter how many lemons life will throw at you during recovery, make the best of every moment by focusing on the lemonade!

Brain Aneurysm: Diagnosis

Can you spot the 2 aneurysms? The big balloon was the largest and below it was the smallest one that is still intact. This is one of the pictures from my angio showing the aneurysm before the embolization. Zoom in close for details.
This scan compares the brain pre-embolization (top half) and post-embolization (bottom half). Zoom in close for a clear view and details.

Most brain aneurysms go unnoticed until they rupture or are detected during medical imaging tests for another condition. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Cerebral-Aneurysms-Fact-Sheet#5

If you have experienced a severe headache or have any other symptoms related to a ruptured aneurysm your doctor will order tests to determine if blood has leaked into the space between the skull bone and brain. 

Several tests are available to diagnose brain aneurysms and determine the best treatment. These include: 

  • Computed tomography (CT)This fast and painless scan is often the first test a physician will order to determine if blood has leaked into the brain.  CT uses x-rays to create two-dimensional images, or “slices,” of the brain and skull.  Occasionally a contrast dye is injected into the bloodstream prior to scanning to assess the arteries, and look for a possible aneurysm.  This process, called CT angiography (CTA), produces sharper, more detailed images of blood flow in the brain arteries.  CTA can show the size, location, and shape of an unruptured or a ruptured aneurysm. 
  • Magnetic resonance imaging (MRI).   An MRI uses computer-generated radio waves and a magnetic field to create two- and three-dimensional detailed images of the brain and can determine if there has been bleeding into the brain.  Magnetic resonance angiography (MRA) produces detailed images of the brain arteries and can show the size, location, and shape of an aneurysm. 
  • Cerebral angiography.  This imaging technique can find blockages in arteries in the brain or neck.  It also can identify weak spots in an artery, like an aneurysm.  The test is used to determine the cause of the bleeding in the brain and the exact location, size, and shape of an aneurysm.  Your doctor will pass a catheter (long, flexible tube) typically from the groin arteries to inject a small amount of contrast dye into your neck and brain arteries.  The contrast dye helps the X-ray create a detailed picture of the appearance of an aneurysm and a clear picture of any blockage in the arteries. 
  • Cerebrospinal fluid (CSF) analysis.  This test measures the chemicals in the fluid that cushions and protects the brain and spinal cord (cerebrospinal fluid).  Most often a doctor will collect the CSF by performing a spinal tap (lumbar puncture), in which a thin needle is inserted into the lower back (lumbar spine) and a small amount of fluid is removed and tested.   The results will help detect any bleeding around the brain.  If bleeding is detected, additional tests would be needed to identify the exact cause of the bleeding. 

In the next segment, I will talk about treatment.

Brain Aneurysm: Risk Factors/causes

Brain aneurysms/cerebral aneurysms form when the walls of the arteries in the brain become thin and weaken.  Aneurysms typically form at branch points in arteries because these sections are the weakest.  Occasionally, cerebral aneurysms may be present from birth, usually resulting from an abnormality in an artery wall. Reference          

Risk factors for developing an aneurysm

Sometimes cerebral aneurysms are the result of inherited risk factors, including:

  • genetic connective tissue disorders that weaken artery walls
  • polycystic kidney disease (in which numerous cysts form in the kidneys)
  • arteriovenous malformations (snarled tangles of arteries and veins in the brain that disrupt blood flow.  Some AVMs develop sporadically, or on their own.)
  • history of aneurysm in a first-degree family member (child, sibling, or parent).

Other risk factors develop over time and include:

  • untreated high blood pressure
  • cigarette smoking
  • drug abuse, especially cocaine or amphetamines, which raise blood pressure to dangerous levels. Intravenous drug abuse is a cause of infectious mycotic aneurysms.
  • age over 40.

Less common risk factors include:

  • head trauma
  • brain tumor
  • infection in the arterial wall (mycotic aneurysm).

Additionally, high blood pressure, cigarette smoking, diabetes, and high cholesterol puts one at risk of atherosclerosis (a blood vessel disease in which fats build up on the inside of artery walls), which can increase the risk of developing a fusiform aneurysm.

Risk factors for an aneurysm to rupture

Not all aneurysms will rupture.  Aneurysm characteristics such as size, location, and growth during follow-up evaluation may affect the risk that an aneurysm will rupture. In addition, medical conditions may influence aneurysm rupture.

Risk factors include:

  • Smoking.  Smoking is linked to both the development and rupture of cerebral aneurysms. Smoking may even cause multiple aneurysms to form in the brain.
  • High blood pressure.  High blood pressure damages and weakens arteries, making them more likely to form and to rupture. 
  • Size.  The largest aneurysms are the ones most likely to rupture in a person who previously did not show symptoms.
  • Location.  Aneurysms located on the posterior communicating arteries (a pair of arteries in the back part of the brain) and possibly those on the anterior communicating artery (a single artery in the front of the brain) have a higher risk of rupturing than those at other locations in the brain.
  • Growth.  Aneurysms that grow, even if they are small, are at increased risk of rupture.
  • Family history.  A family history of aneurysm rupture suggests a higher risk of rupture for aneurysms detected in family members.
  • The greatest risk occurs in individuals with multiple aneurysms who have already suffered a previous rupture or sentinel bleed.

For my case, I had been diagnosed with high blood pressure in the first trimester of my second pregnancy and the condition was being managed when I suffered the brain aneurysm. No family history of brain aneurysms that I am aware of. No smoking, no alcohol abuse, and absolutely no drug use except for the ones for BP and vitamins. My take from this is that we are all pretty much at risk. I have heard stories of completely healthy people, very athletic, and with no family history get them. The more information we know about brain aneurysms, the more lives we can help save.

Brain Aneurysm: Definition

Let’s be honest, how many people are familiar with brain aneurysm? Even with a background in healthcare, I did not know what brain aneurysms were all about except for the definition. Often, we find ourselves becoming quite familiar with a condition once we experience it either directly or indirectly.

According to WebMD, https://www.webmd.com/brain/brain-aneurysm#1 , brain aneurysm is defined as below:

Think of a weak spot in a balloon and how it feels stretched out and thin. A brain aneurysm is like that. It’s a weak spot in the wall of a blood vessel inside the brain.

That area of the blood vessel gets worn out from constant flow of blood and bulges out, almost like a bubble. It can grow to the size of a small berry.

Although brain aneurysms sound alarming, most don’t cause symptoms or health problems. You can enjoy a long life without ever realizing that you have a brain aneurysm.

But in rare cases, aneurysms can grow big, leak, or explode. Bleeding in the brain, known as hemorrhagic stroke, is very serious and requires urgent medical care.

A ruptured brain aneurysm can be life-threatening and lead to:


Brain Aneurysm: Symptoms

From a Distance by Bette Midler.
https://www.youtube.com/watch?v=hLHE9jrb_N4

I remember having a constant headache for 2 days or so prior to the rupture. The pain wasn’t overwhelming and I could tolerate it. I would rate it a 2 on the scale of 1-10 with 10 being the worst. New mothers, me being one of them, tend to ignore little things that their bodies are trying to communicate. We give excuses in order to make ourselves feel better. It is very true we are tired most of the time with little to no adequate rest most of the time. We prioritize the needs of our children and our loved ones. The question that still ponders my mind is – ‘was the aneurysm ruptured already prior to my hospital admission and the bleeding just got worse or did it rupture on that hectic night?’ The doctors that I have met with haven’t given me a conclusive answer yet. They tend to say…..in so many words——“we just don’t know”

So what are the actual symptoms of a brain aneurysm?

Please do not sit and start guessing what could be wrong with you or your loved one. Get emergency care if you suddenly get an intensely painful headache, lose consciousness, or have some of these other symptoms of an aneurysm that has ruptured: I cannot emphasize enough to you how critical it is to get that medical care urgently. Get help if you think something is wrong with your body. DO NOT WAIT.

Although brain aneurysms usually don’t show symptoms, they can press on the brain and nerves as they get bigger. See a doctor at once if you’re having the following symptoms of an unruptured aneurysm:

  • Headache
  • Dilated pupils
  • Blurred or double vision
  • Pain above and behind an eye
  • Drooping eyelid
  • Hard time speaking
  • Weakness and numbness in one side of your face

Please remember that no matter what you are going through or how things turn out, you are not alone. God is with you and He has everything under control. He will lead you to where you need be at the right time. He will bring the right people to your case. God is watching us from a distance. You are a very special child of Him. Have faith and trust in nothing else but in Him. https://www.youtube.com/watch?v=hLHE9jrb_N4

Diminished Sense of Smell and/or Taste

During recovery, a good number of brain aneurysm survivors complain of having a diminished sense of smell or taste. This can be irritating and unfortunately, it does not help reduce the anxiety that you are already suffering from. You want to be normal, you want to be able to smell that coffee and enjoy your steak without having to load it up with salt!

We know that the brain is very complex and controls just about all the functions in the body. When a brain aneurysm ruptures, the blood starts leaking into the brain. Depending on the location, quantity and duration of the blood that is leaking, several functions that the brain controls in the body becomes affected.

Diminished sense of smell and/or taste occurs due to the leaking blood that irritates the nerves that control these senses. If the aneurysm did not rupture, smell and taste deficits can occur if the aneurysm compresses the surrounding nerves. Unfortunately, these deficits may not get better with time.

The complexity of the Brain

About a week ago, I was going through my medical records of when I was first admitted to the hospital following the rupture of my aneurysm. Something caught my attention that has led me to a new conversation… or perhaps just digging deeper into the complexity of life. This was on my neuro checks at the section where they had to record my level of consciousness. At one point, it was indicated that I was unconscious and the other times, it was indicated that I was semi-conscious. It got me thinking…what is the difference/relationship between brain and mind, alert and conscious? Does the brain control the mind? If you are alert, can we assume that you are also conscious?

In Biology, we are told that the brain is part of the tangible and visible world of the body. You can see it and you can feel it. The mind, however, is the part of the invisible, transcendent world of thought, feeling, imagination, and attitude. In other words, the mind is the devil’s right hand. It is responsible for all the negativity, laziness, restlessness, doubtfulness…etc. The mind cannot manipulate the brain but the brain can manipulate the mind by what we commonly refer to as intuition. Intuition can only be successful at influencing the brain if the person if fully conscious.

From the healthcare standpoint, to be alert, you only need to be awake and responsive. To be conscious, you need to be: alert, attentive, able to follow commands and be aware of your surroundings.

Doctor Jacob Sage, a neurologist and one of the well-known bloggers, defines conscious as nothing more than the ability of our brain to acquire information (which is the state of being awake)  AND all the content that the information contains AND the ability to get all that information into and out of memory. The key word is “ALL”. If you have all that, you are conscious of the blue sky and the red sun. Nothing more is needed to be conscious of that beautiful sky.

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