Las personas pueden confundir un aneurisma con un dolor de cabeza tipo migraña, retrasando la atención médica y posiblemente llevando a un daño significativo. Es importante aprender las diferencias y qué hacer cuando los signos de un aneurisma están presentes.

Si usted experimenta un dolor de cabeza severo (algunos lo describen como el peor dolor de cabeza de su vida) y viene de repente, llame al 911.

Un aneurisma cerebral es un área abultada débil en una arteria en el cerebro. Esto es similar a un punto débil en el tubo interior de una llanta. Dado que la pared de un aneurisma es delgada y débil, el aneurisma se puede roturar. La rotura del aneurisma es una de las emergencias médicas más devastadoras. Resultando en el sangrado dentro del cerebro y puede causar daño cerebral significativo e incluso la muerte.

El dolor de un aneurisma cerebral que está sangrando a veces puede confundirse con un dolor de cabeza tipo migraña. Incorrectamente percibir un dolor de cabeza severo como migraña que eventualmente se resolverá por su cuenta puede retrasar el tratamiento y puede tener consecuencias desastrosas.

Por lo tanto, es muy importante aprender las diferencias y qué hacer si usted experimenta los signos de advertencia de un sangrado de un aneurisma cerebral.

Resumen de Síntomas de una Migraña

Según la National Headache Foundation (Fundación Nacional de Cefaleas), los síntomas de la migraña varían de persona en persona, pero a continuación se encuentran las más comunes:

• Dolor de cabeza recurrente, durando de cuatro a 72 horas
• Dolor moderado a severo de un lado y pulsante
• Habilidad reducida para funcionar
• Náusea y/o vómito
• Sensibilidad a la luz
• Sensibilidad al ruido

Otros síntomas menos comunes de las migrañas pueden incluir sudoraciones o manos heladas, diarrea, color de la piel pálida y sensibilidad del cuero cabelludo, o dolor al tacto o presión (tal como una cadena tocando la piel, el cepillarse el pelo o afeitarse).

Resumen de Síntomas de Aneurisma

Para entender cómo la experiencia de un aneurisma cerebral roturado es diferente de una migraña, aquí están los síntomas, según la Brain Aneurysm Foundation (Fundación de Aneurisma Cerebral):

• Dolor de cabeza repentino y severo, usualmente descrito como “el peor dolor de cabeza de mi vida”
• Náusea/vómito
• Cuello rígido
• Visión borrosa o doble
• Sensibilidad a la luz
• Convulsiones
• Párpado caído
• Una pupila dilatada
• Dolor arriba y detrás del ojo
• Pérdida de la conciencia
• Confusión
• Debilidad y/o entumecimiento

Diferencias Importantes Entre los Síntomas de una Migraña y Aneurisma

Hay definitivamente cierto cruce entre los síntomas de las migrañas y un aneurisma cerebral roturado. Los síntomas tal como náusea y vómito, visión borrosa o doble y sensibilidad a la luz ocurren en ambas condiciones.

Éstas son, sin embargo, algunas diferencias importantes. El dolor de un aneurisma cerebral roturado es usualmente descrito como el peor dolor de cabeza de la vida de una persona. El dolor viene más repentinamente y más severo que cualquier otro previo dolor de cabeza o migraña.

En contraste, los dolores de cabeza tipo migraña usualmente vienen de forma gradual. Las migrañas usualmente causan un dolor de cabeza palpitante o una sensación pulsante en un lado de la cabeza. Estos pueden incluir un aura, lo cual es usualmente un signo de advertencia que la migraña está a punto de empezar. Las auras pueden incluir perturbaciones visuales o destellos de luz.

“Los doctores pueden encontrar un aneurisma sin roturar dado que un paciente se presenta con un dolor de cabeza sin relacionar, o después de un trama en la cabeza, llevando a que el doctor ordene una TC [escaneo de tomografía computarizada] o un RM [escaneo de resonancia magnética],” dice Shervin R. Dashti, M.D., Ph.D., neurocirujano con Norton Neuroscience Institute.

El tipo y el tamaño del aneurisma y cualquier factor de riesgo determina qué tan peligroso es un aneurisma en particular. Los aneurismas cerebrales roturados siempre requieren un tratamiento de emergencia. Con un aneurisma no roturado, solo aquellos que se encuentran en alto riesgo de rotura son tratados.

Tratamiento de Aneurisma

El tratamiento usualmente involucra métodos mínimamente invasivos para poder ‘enhebrar’ un catéter especial desde el abrazo del paciente, a través de la arteria radial hasta las arterias del cerebro y hasta el saco del aneurisma, según el Dr. Dashti. El método permite que el doctor bloquee el aneurisma desde adentro.

Ocasionalmente, puede ser necesario de abrir quirúrgicamente el cráneo y colocar un clip de titanio a lo largo del cuello del aneurisma para tratarlo.

Cualquiera de los dos procedimientos tiene la intención de prevenir que el aneurisma vuelva a sangrar o de causar más daño cerebral.

En Norton Brownsboro Hospital, los neurocirujanos endovasculares y cerebrovasculares entrenados por un Centro Integral de Accidentes Cerebrovasculares realizan más de 150 tratamientos de aneurismas cada año.

Si sus dolores de cabeza o migrañas no son repentinos y severamente terribles, hable con su proveedor de cuidado primario o aprenda más sobre nuestros especialistas en dolores de cabeza certificados por la junta.

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Duke, 89, was in his yard splitting wood the week before his stroke. He’d had triple-bypass surgery nearly 30 years ago but otherwise showed no signs of any major health issues. On March 30, Duke sat down in his living room to do a puzzle. He fell to the ground.

“I don’t remember anything that happened,” Duke said.

Fortunately, Duke’s wife called a neighbor who rushed over. The neighbor found Duke on the ground. He was unresponsive, and one side of his face was sagging. An emergency medical services team quickly arrived at the scene to transport him to Norton Brownsboro Hospital.

“There’s another hospital that’s closer to his [Duke’s] home,” said Karen Nichter, Duke’s daughter. “But the EMT recommended going to Norton Brownsboro Hospital because it’s a designated Comprehensive Stroke Center. And I’m glad they did.”

Duke was fading fast when he arrived at Norton Brownsboro Hospital. He immediately came under the care of Mahan Ghiassi, M.D., neurosurgeon with Norton Neuroscience Institute.

“Duke had very little brain activity on one side,” Dr. Ghiassi said. “We needed to get blood flow quickly or the brain would die out.

Dr. Ghiassi performed a mechanical thrombectomy, a minimally-invasive procedure using specialized equipment to remove a clot from a patient’s artery. He went through the artery in Duke’s leg. Within about 20 minutes, blood flow was restored to Duke’s brain.

“Once he woke up, he was pretty much back to being dad,” Karen said. “He’s passed all the walking and strength and cognitive tests and only needed a little physical therapy. He was barely in the hospital for two days.”

Nephew experiences same type of stroke

Even though Duke was home, he needed care while he continued to recover. Paul, 61, stayed with Duke one afternoon in early April. What Paul didn’t know then was that he was about to experience a stroke just days later.

“I was at home talking to some friends who came by the house,” Paul said. “Apparently I was slurring my words.”

After the friends left, Paul went to his garage to work. The friends suspected something was up and went back to tell Paul’s wife, Linda. They then walked into the garage to find Paul on the floor. He was conscious but couldn’t move the left side of his body. Knowing what Duke had gone through weeks before, they knew immediately that Paul was having a stroke.

Like Duke, Paul was transported to Norton Brownsboro Hospital. There waiting for him was Dr. Ghiassi. The scans revealed Paul had a clot in the same artery as Duke, but on the opposite side of the brain. Paul was losing blood flow every second.

“You see patients who refer family members, but they are for elective procedures, not emergency procedures. I’ve never had family members present with acute strokes, especially not within a couple of weeks of each other,” Dr. Ghiassi said.

Dr. Ghiassi performed a mechanical thrombectomy on Paul, but unlike with Duke, he went through the artery in Paul’s wrist. Brain function returned almost immediately.

“There are advantages of treating a stroke radially [though the arm], as it’s less invasive and allows for quicker recovery time,” Dr. Ghiassi said. “Due to Duke’s age, we needed to go in through the leg, but both procedures are very effective.”

After two days, Paul left the hospital. He and Duke continue to deal with minor effects from their strokes, but for the most part they’re back to life as usual.

“I feel incredibly fortunate,” Paul said.

What caused their strokes?

According to Dr. Ghiassi, genetics likely played a role in both Paul’s and Duke’s strokes, as well as a family history of heart issues. However, he also attributed the timing of both as likely the product of bad luck.

“The positive is that because of Duke’s stroke, the family knew what to do when Paul had his stroke,” Dr. Ghiassi said. “That quick action very well could have saved his life.”

Paul and Duke also credit Dr. Ghiassi and the team at Norton Brownsboro Hospital.

“If you’re having a stroke, get to Norton Brownsboro,” Duke said.[templatera id=”89477″]

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Using new biplane X-ray technology, Norton Neuroscience Institute specialists are better able to identify and analyze these diseases. The equipment, which provides high-resolution imaging and computational ability, not only allows surgeons to see the vessels better but also simulates how medical devices will fit before they’re ever used in the patient.

“The image quality of the machine is an integral piece of patient safety, because the higher the resolution of the blood vessels, the more efficiently and effectively we can operate on patients,” said Tom L. Yao, M.D., endovascular neurosurgeon with Norton Neuroscience Institute. “The technology allows us to see and understand the vessels that are less than one millimeter in diameter. We can redraw and analyze the vessels in a virtual 3D space. Not only does it help with ischemic strokes, but it also helps with the hemorrhagic strokes as well, which are caused by aneurysms, AVMs [arteriovenous malformations] and fistulas.”

The biplane X-ray tubes and computer software recently received Food and Drug Administration approval and represent the newest iteration of virtual and 3D modeling. Norton Brownsboro Hospital is the eighth in the country to receive the equipment. It is the only hospital in the nation to install two of this type in biplane rooms in one facility.

Biplane rooms give doctors options for the best treatment

The biplane equipment uses two X-ray tubes — each rotating around the patient — capturing images simultaneously. When combined digitally, the two sets of images form a 3D picture of the area in fine detail while the patient is on the operating room table. It also allows for simulations that can determine the best course of treatment.

The new imaging equipment is installed in Norton Brownsboro Hospital’s two hybrid biplane rooms. In these hybrid rooms, doctors can perform interventional procedures — treating a clot or bleed through an artery in the leg or wrist — or open up the skull if necessary, without the delay and stress of moving the patient to a separate area for surgery.

“Being able to do both types of procedures in the same room gives us a big advantage in the fight against time,” Dr. Yao said. “We lose about five to seven million neurons a minute in a stroke, so each minute that passes greatly affects what we can get back. The fact that we have two of these setups allows us to handle multiple cases at the same time as well.”

Advanced stroke treatment requires big investment

Norton Healthcare operates the area’s largest stroke system. Norton Brownsboro Hospital is Norton Healthcare’s flagship neurosurgical hospital, which is certified as a Comprehensive Stroke Center by The Joint Commission and the American Heart Association/American Stroke Association. Norton Brownsboro Hospital uses advanced technology and a specialized team to care for the most severe of stroke cases, which can lead to better outcomes, according to the certification.

Norton Healthcare has provided the latest technology/software, multiple hybrid operating rooms to provide care, and health care teams to fully support the surgeons, which will greatly benefit the community, according to Dr. Yao.

“By building these rooms and getting this equipment, Norton Healthcare has shown its continued commitment to providing excellent stroke care,” Dr. Yao said. “It’s a major investment, but it’s what’s best for the community. Thanks to the investment, we can treat patients with complicated neurological issues better than ever before.”

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If you experience a severe headache (some describe it as the worst headache of their life) and it comes on suddenly, call 911.

A brain aneurysm is a weak, bulging area in an artery in the brain. This is similar to a weak spot on a tire’s inner tube. Because the wall of the aneurysm is thin and weak, the aneurysm can rupture. Aneurysm rupture is one of the most devastating medical emergencies. The resulting bleeding in the brain can cause significant brain damage and even death.

Pain from a bleeding brain aneurysm sometimes can be confused with a migraine headache. Wrongly perceiving a severe headache as a migraine that will eventually resolve on its own can delay treatment and can have disastrous consequences.

Therefore, it’s very important to learn the differences and what to do if you experience the warning signs of a brain aneurysm bleed.

Migraine Symptoms Summary

According to the National Headache Foundation, migraine symptoms vary from person to person, but the following are the most common:

• Recurrent headaches, lasting four to 72 hours
• One-sided, pulsating, moderate-to-severe pain
• Decreased ability to function
• Nausea and/or vomiting
• Sensitivity to light
• Sensitivity to noise

Other, less common migraine symptoms may include sweating or cold hands, diarrhea, pale skin color and scalp tenderness, or pain from touch or pressure (such as a necklace touching skin, hair brushing or shaving).

Aneurysm Symptoms Summary

To understand how the experience of a ruptured brain aneurysm is different from that of a migraine, here’s a look at symptoms, according to the Brain Aneurysm Foundation:

• Sudden and severe headache, often described as “the worst headache of my life”
• Nausea/vomiting
• Stiff neck
• Blurred or double vision
• Sensitivity to light
• Seizure
• Drooping eyelid
• A dilated pupil
• Pain above and behind the eye
• Loss of consciousness
• Confusion
• Weakness and/or numbness

Related Content: New device is big advancement in brain aneurysm treatment

Important Differences Between Migraine and Aneurysm Symptoms

There is definitely some crossover in the symptoms of migraines and ruptured brain aneurysms.  Symptoms such as nausea and vomiting, blurred or double vision, and sensitivity to light occur in both conditions.

There are, however, some important differences. The pain from a ruptured brain aneurysm is often described as the worst headache of a person’s life. The pain comes on more suddenly and is more severe than any previous headaches or migraines.

In contrast, migraine headaches usually come on gradually. Migraines often cause moderate to severe throbbing pain or a pulsating sensation on one side of the head. They can include an aura, which is usually a warning sign that the migraine is about to start. Auras can include visual disturbances or flashes of light.

The type and the size of the aneurysm and any risk factors determine how dangerous a particular aneurysm is. Ruptured brain aneurysms always require emergency treatment. With unruptured aneurysms, only those deemed to be at relatively high risk of rupture are treated.

Aneurysm Treatment

Treatment usually involves minimally invasive methods to thread a special catheter from the patient’s arm, through the radial artery into the arteries of the brain and into the aneurysm sac, according to Dr. Dashti. The method allows the doctor to block off the aneurysm from the inside.

Occasionally, it may be necessary to surgically open the skull and place a titanium clip across the neck of the aneurysm to treat it.

Insert aneurysm-illo from images task

Either procedure is intended to prevent the aneurysm from rebleeding and causing more brain damage.

At Norton Brownsboro Hospital, a Comprehensive Stroke Center, fellowship-trained endovascular and cerebrovascular neurosurgeons perform over 150 aneurysm treatments each year.

If your headaches or migraines are not sudden and terribly severe, talk to your primary care provider or learn more about our board-certified headache specialists.

The post Migraine vs. aneurysm: The differences and the dangers appeared first on Norton Healthcare.

But now doctors at Norton Neuroscience Institute are using a new approach. Instead of going through the groin, Mahan Ghiassi, M.D., and Mayshan Ghiassi, M.D., brothers and endovascular neurosurgeons with Norton Neuroscience Institute, are accessing the brain through the patient’s wrist.

“Heart physicians have used this wrist, or radial, approach for years,” said Dr. Mayshan Ghiassi. “The artery in the wrist connects to the brain, which also makes this a viable option for stroke and aneurysm treatment.”

The surgeons with Norton Neuroscience Institute are among only a handful in the country using the radial approach, which takes its name from its use of the radial artery in the forearm.

“It’s a more complex procedure that requires more expertise,” Dr. Mayshan Ghiassi said. “But the benefits are worth it.”

Faster recovery without general anesthesia

The wrist approach can allow for a quicker recovery from stroke or aneurysm. With the radial approach — unlike going through the groin — patients aren’t put under anesthesia. This alone makes the procedure safer.

Even though the patient is awake, the procedure is painless. Drs. Ghiassi even use a special injector so the patient doesn’t feel the needle prick into the wrist.

Another benefit is that patients can get up and move around right after the procedure. With the groin approach, patients must remain on their backs for several hours after treatment.

“There’s also less pain during recovery, and no scarring,” said Dr. Mayshan Ghiassi. “Patients love it.”

Patient drives across the state to get radial treatment

Tina Terrell had an aneurysm rupture in 2012. The massage therapist from Paducah, Kentucky, first sought treatment in Tennessee, where doctors used the groin approach. When she needed additional treatment last year, doctors referred her to Norton Neuroscience Institute.

“I was told the expertise and service at Norton rivaled the best hospitals around,” Tina said. “And they were right.”

Tina needed a special stent that allowed the body to eliminate the aneurysm. Typically, placing the stent required invasive, and risky, brain surgery. She met with Drs. Ghiassi, who recommended the radial approach. She’s glad they did.

“I went home the day after the procedure and was back at work several days after that,” she said. “The recovery was great. As a massage therapist I use my wrists a lot, and the procedure didn’t slow me down. I’m feeling great and was so pleased with the compassionate care I received from everyone.”

‘The future of treatment’

Drs. Ghiassi are using the treatment for both emergency and nonemergency strokes and aneurysms. Right now, they’re doing the radial approach on about half their patients, but Dr. Mayshan Ghiassi expects that number to grow.

“Unless they’ve had a previous surgery on the arm, radial artery surgery, or are just too anxious to hold still, going through the wrist is likely an option,” he said. “We think this is the future of treatment.”

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“The WEB device potentially represents one of the next big shifts in aneurysm treatment,” Dr. Yao said. “It will be an excellent tool to complement the treatment options we have available now. We have three endovascular neurosurgeons who will be able to implant these devices to offer a full complement of treatment options, including Mahan Ghiassi, M.D., and myself.”

How the WEB device works to treat brain aneurysms

A brain aneurysm is a weak area in the wall of a blood vessel that bulges or balloons out from the normal vessel wall. Because the wall integrity is compromised, the weakened wall can burst, causing a brain bleed. According to Dr. Yao, the goal of aneurysm treatment is to prevent blood from getting to the weak part of the aneurysm.

The WEB device is a sphere of woven wires that is inserted into an artery in the groin, then threaded up into the aneurysm. It forms to the shape of the aneurysm and holds in place so that it can prevent blood flow into the aneurysm and allow healing of the vessel wall.

Dr. Yao said the WEB device combines methods of two other aneurysm treatments — coiling and flow-diverting stents.

“Coiling an aneurysm involves placing little wires inside the aneurysm to prevent blood from going in,” Dr. Yao said. “A flow-diverting stent allows us to direct blood flow out of the aneurysm. The new WEB device makes use of both of these methods.”

The WEB device is designed to custom-fit the aneurysm, eliminating the need to insert coil after coil until it is filled. It works similar to a flow-diverting stent by preventing blood flow into the aneurysm.

Advantages of the WEB device to treat brain aneurysms

According to Dr. Yao, the new WEB device provides several advantages for treating brain aneurysms:

• It’s easier to place because the WEB device is designed to fit the aneurysm.
• It simplifies treatment by decreasing the length of surgery.
• It’s safer because patients don’t have to be placed on as many blood thinners.
• It decreases the patient’s stroke risk because nothing is placed inside the main artery where the aneurysm is located.

Brain aneurysm signs and symptoms

Brain aneurysms are typically found in two ways, according to Dr. Yao:

• After the aneurysm has ruptured and the patient is in the emergency room with the worst headache of his or her, or the patient is in a coma, has lost consciousness or has suffered a stroke
• When a patient has a scan because of a neurologic issue that is unrelated to the aneurysm such as headache, numbness or tingling, or the patient is screened because he or she is at high risk for aneurysm due to family history or diseases such as polycystic kidney disease

Although the WEB device may not be right for all patients, Dr. Yao is encouraged to have a new option for brain aneurysm treatment.

“There are multiple procedures we can use to treat brain aneurysms, and this is a new option that has shown good results,” said Dr. Yao. “Norton Neuroscience Institute continues to be on the cutting edge of offering new treatments when they become available.”

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We’ve all heard “time is money” and “time heals all wounds.” What about this one? “Time lost is brain lost.”

Treating a stroke quickly can mean the difference between recovery and irreversible brain damage, or even death, according to Bryan J. Eckerle, M.D., neurologist with Norton Neurology Services, and Tom L. Yao, M.D., endovascular neurosurgeon with Norton Neuroscience Institute.

Once someone has a stroke, the single most important factor in avoiding or reducing the chance of brain damage is the time it takes to start treatment, according to Dr. Eckerle.

As soon as a patient enters a Norton Healthcare emergency department with stroke symptoms such as facial weakness, difficulty talking or trouble moving one side of the body, Norton Healthcare doctors and others know what to do. They move quickly to use cutting-edge tools to determine the type of stroke and the right treatment.

Spotting different kinds of strokes

There are two types of strokes: ischemic and hemorrhagic. About 90 percent of strokes are ischemic strokes, when there’s a disruption of brain function caused by a blockage in a blood vessel that flows to the brain. Hemorrhagic strokes occur when blood pools in or around the brain due to a ruptured aneurysm or vessel, or other condition. Treatment is very different for each type.

In order to determine whether an individual has suffered an ischemic or hemorrhagic stroke, a treating physician traditionally employs diagnostics such as a standard computed tomography (CT) scan, magnetic resonance imaging (MRI) or a CT angiogram (which involves injecting dye into blood vessels to evaluate blood flow). These traditional diagnostic methods are limited, however, because they only show the physical abnormality. More advanced technology, in the form of a CT perfusion scan, now enables doctors to distinguish between portions of the brain which have suffered irreversible damage versus other portions which are still at risk for brain death.

“That helps us make decisions about which patients should be rushed to the operating room,” Dr. Eckerle said.

Time is still the biggest factor

Traditionally, stroke treatment was strictly based on how quickly they were treated. The first-line treatment for an ischemic stroke is tPA (tissue plasminogen activator) to dissolve clots within the first 4½ hours of the first symptoms. Mechanical thrombectomy, a procedure in which a surgeon inserts a catheter into the blocked blood vessel from the groin to remove the clot, works best if performed within 12 hours of the first symptoms.

Although time is still critical, advanced imaging (like CT perfusion) allows doctors to expand the potential number of patients who can benefit from advanced intervention, such as thrombectomy.

“Because scans can identify how much brain is already dead or about to die, we can then individualize treatment to optimize each patient outcome and better quantitate the risk of surgery versus medical treatment,” Dr. Yao said. “Obviously the more at-risk brain there is, the more potential brain we can save. In all cases, when at-risk brain is identified, it’s important we move as fast as possible to save that brain before it dies.”

In a bleeding stroke, it’s essential to stabilize the patient as soon as possible, according to Dr. Eckerle. This may require emergency surgery to stop the bleeding.

Comprehensive Stroke Center care at the hub

Norton Healthcare is the region’s largest stroke system, with diagnosis and treatment response times faster than the national average.

The American Heart Association and The Joint Commission have certified Norton Brownsboro Hospital as a Comprehensive Stroke Center. With the system’s most advanced diagnostic technology, it serves as Norton Healthcare’s hub for stroke care and supports its other hospitals, which are certified Primary Stroke Centers. Norton Women’s & Children’s Hospital is certified as an Acute Stroke Ready hospital.

“We make sure all our hospitals are fully trained to handle any stroke patient,” Dr. Yao said. “It doesn’t matter where they land in our system” to get the best care available.

Dr. Eckerle encouraged everyone to be vigilant about the warning signs of stroke.

“It’s frustrating when we see a patient who thought they might be having a stroke but ignores it and come in hours or days later when there is nothing we can do,” Dr. Eckerle said. “We would rather people overreact to their symptoms than ignore them.”

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