A 60-year-old patient presented with left hemiparesis some months ago.
This was what was found on the CT scan of the Brain, which was extended to a CT Angiography …
There is a humongous aneurysm involving the entire Posterior Communicating artery. All the arteries making up the circle of Willis are larger than normal (or ectatic in our jargon). There are smaller aneurysms in the Middle Cerebral arteries on both sides.
The humongous aneurysm measures about 60mm in the longest dimension, the two smaller aneurysms measure 25mm & 15mm.
An aneurysm of greater than 40mm size in the Aorta (the largest artery in the body) is considered dangerous, i.e., it could rupture at any time.
Any aneurysm, even one as small as 5mm, in the brain is dangerous and a rupture could be life-threatening.
There are many ways to treat cerebral aneurysms.
But if an aneurysm of this size ruptures, it would mean almost instantaneous death. It is as good as one of those explosive-tipped bullets or mini-bombs that we read about in spy novels or see in Hollywood movies.
This patient has had two CT scans in my department over a period of eight months or so. The very first time I saw his scan I thought he was living on borrowed time.
He still is. With a pulsating bomb at the base of his brain.
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Wow! It’s amazing how much beating the body can take…and still go on!
Two questions:
1. I only see endovascular coiling and surgery. Is it not possible to have a stent-graft (Ok, I have a one-track mind, I agree.. but it seems like a possibility, right?)
2. Won’t the aneurysm and related pressure cause problems with the brain cells/nerves, and therefore affect normal activities?
Ancillary question:
How did you NOT faint when you saw that one? I feel queer just looking at that picture.
That’s a Scary site to see when scanning!!
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