i.v drrug abuse – a cause of multiple aneurysms in brain
DESCRIPTION
Dr Vineet Saggar is an alumnus of D.A.V Chandigarh. After MBBS from (M.A.M.C) New Delhi in 2002, he did his P.G. in General Surgery from Safdarjung Hospital (2002-05). He went for his training in MCh Neuro Surgery at S.M.S Medical College Jaipur. After completing his MCh in July 2009, he trained under Prof. S.R. Dharker one of the pioneers of Micro- Vascular Neurosurgery in Rajasthan. During this time he also assisted Dr S.K Basandani another eminent Spinal Surgeon at Jaipur. Before joining Ivy Hospital as consultant Neuro Spinal Surgeon, he headed Department of Neurosurgery at Adesh Medical College Bathinda for some time. He has special interest in Spinal Surgery and Skull-Based Micro Neurosurgery. Apart from many national and international publications on Spine Surgeries, he also has research publications on Head Injury to his credit.TRANSCRIPT
DR VINEET SAGGAR M.B.B.S, MS, MCH(NEUROSURGEY) CONSULTANT DEPARTMENT OF NEUROLOGICAL AND SPINAL SURGERY IVY SUPERSPECIALITY HOSPITAL SEC-71, MOHALI. PUNJAB
INTRACRANIAL ANEURYSMS
I.V DRRUG ABUSE – A CAUSE OF MULTIPLE ANEURYSMS IN BRAIN?- Neurovascular surgery( surgery of blood vessels in brain)
is technically most demanding of neurosurgical procedures - A rare neurovascular surgery was performed at ivy
hospital few days back- A 35 years old male I/V drug abuser was admitted in our
hospital with headache followed by loss of consciousness. .Patient had experienced similar episode few days back which was ignored by local general practitioner and he was discharged on analgesics
Before coming to us he was seen by neurosurgeons in tricity and was refused treatment due to risk involved in the surgery
We did angiography of brain vessels and found not one but three ANEURYSMS( Balloon like dilatation in wall of brain vessels) in his brain vessels , one of which has burst causing massive hemorrhaged in his brain
Plain Ct Head showing Diffuse Sub Arachnoid Haemmorage
CT Angio Brain showing Multiple aneurysms LT MCA, RT Pcom and ANT choroidal Artey aneurysms
POST OP SCAN
POST OP SCAN WITH CLIPS IN SITU
Two of the Aneurysms on the right side were clipped in the same surgery By Dr Vineet Saggar and patient was Discharged after two weeks with advice of surgery on opposite side after six weeks.
Patient Just before Discharge
WHAT ARE ANEURYSMS
A cerebral or brain aneurysm is a cerebrovascular disorder in which weakness in the wall of a cerebral artery or vein causes a localized dilation or ballooning of the blood vessel.
The general incidence of aneurysms in the population at large is of the order of 1%-2%
Multiple aneurysms occur in 0.2% of the population
SIGNS AND SYMPTOMS
Most common symptom is sudden severe headache that can last from several hours to days
nausea and vomiting drowsiness and/or coma
The ruptured aneurism (hemorrhage) may also damage the brain directly, usually from bleeding into the brain itself. This is called a “hemorrhagic stroke.” This can lead to:
weakness or paralysis of an arm or leg
trouble speaking or understanding language
vision problems seizures
CAUSES
Aneurysms may result from congenital defects(MOST COMMON CAUSE),
Preexisting conditions such as high blood pressure and atherosclerosis (the buildup of fatty deposits in the arteries), or head trauma.
Cerebral aneurysms occur more commonly in adults than in children but they may occur at any age.
They are more common in women than in men, by a ratio of 3 to 2.
TREATMENT
Currently there are two treatment options for securing intracranial aneurysms:
Surgical clipping or Endovascular coiling
ANEURYSM CLIPS
SURGERY V/S COILING
Although endovascular coiling is associated with a shorter recovery period as compared to surgical clipping, it is also associated with a significantly higher recurrence rate after treatment
Also coiling may not be the best options in patients with giant aneurysms , wide neck aneurysms or patients with massive bleed or large clots in brain as was in our case .
A YOUNG 25 YEAR MALE WITH ANEURYSM RUPTURE -A candidate for Surgery
POST OP SCAN WITH ANEURYSM CLIP IN SITU
POST OP PIC OF PATIENT DURING RECOVERY
AFTER CRANIOPLASTY
Dr. Vineet Saggar (MCh)
Neuro Surgeon / Spinal SurgeonChandigarh, Mohali - Ivy Hospital Sector 71+91-9855990990http://www.neurosurgeoninchandigarh.com http://neurosergeonhead.blogspot.in http://www.facebook.com/neuro.surgeon.7186
http://www.linkedin.com/pub/dr-vineet/56/2a9/863
https://twitter.com/drvineetsaggar http://www.slideshare.net/neurosergeo
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