According to past reports, one of the most dreadful cerebral hemorrhages (subarachnoid hemorrhage), cerebral aneurysm, is known to occur more often as people grow older, especially into the 50’s. However, these days this incident age has lowered, and is now commonly observed in people in their 40’s.
I carried out research on 208 patients who received surgery for subarachnoid hemorrhage caused by cerebral aneurysm rupture, the rupture of the saccular and berry shaped vessel, and the highest incident age group was in 40’s, which comprises 70 (33.%) of patients.
Additionally, the incidence in the 50’s, 60’s, and 70’s was 51 (24.5%), 40 (19.2%) and 20 (9.6%), respectively, and even the incidence rate in 30’s was 27 (13%). Therefore, persons are not free from danger of subarachnoid hemorrhage even those in the younger 40’s age group, and therefore everyone should be aware of preceding symptoms.
Cerebral aneurysm is a bulging vessel (artery) which occurs when the blood stream hits the vessel wall which is congenitally or has become weak or thin, and then the artery bulges. Most cerebral aneurysms have been known to result from an inborn abnormality or inherited cause, but nowadays some studies have reported that causes may be related to hypertension, smoking, obesity, atherosclerosis, and family history. Especially, cigarette smoking can degenerate the vessel wall and cause cerebral aneurysm and the rupture of aneurysm.
These kinds of cerebral aneurysms may rupture when the pressure increases while in the bathroom and in bed (during bowel movement and sexual intercourse), during strenuous exercise, in a stressful situation, and sometimes even without any reason. Also in the past, the incidence of aneurysm rupture was high in the 40’s.
However, these days there are an increasing number of people in the 30’s and 40’s with hypertension and atherosclerosis, and many middle-aged people living in Korea are under excessive stress and labor, and it may be associated with the disease.
The frequency of people with aneurysm causing subarachnoid hemorrhage frequently are 1 – 5 of 100, and it has been reported that incidence of subarachnoid hemorrhage resulting from aneurysm rupture is 10 – 20 of 100,000 people per year. When the aneurysm ruptures, 3 of 10 people die or experience mental or physical problems caused by sudden death or need for others’ help to live for their entire lifetime, and from which it is impossible to recover.
Also, if aneurysm ruptures more than twice, 7 of 10 people may be affected with after effects or death. However, due to the development of medical diagnostic techniques, we can detect even a very small cerebral aneurysm before they rupture by MRI (Magnetic Resonance Imaging), especially MRA which visualizes the vessels.
Additionally, it is strongly recommended that people having a family history of CVA (stroke), hypertension and severe headache, or people with preceding symptoms like paralysis or decreased sensation in the hands and feet, and those with nausea and dizziness should visit the hospital and undergo regular tests to prevent subarachnoid hemorrhage by finding out the cause of the symptoms early, and receive suitable treatment.
Especially, quitting smoking and proper treatment of hypertension is the most important thing. Furthermore, occasionally there are some patients who experienced severe headache which they never had before visiting the hospital. In these cases, bleeding had occurred and passed already, so it is desirable to visit the doctor to check before ruptures.
If the cerebral aneurysm is found before rupture, it is possible to treat and cure more easily by placing about 1cm-sized small clip around the aneurysm, or filling platinium coils inside the cerebral aneurysm using angiography without opening the skull. Therefore, cerebral hemorrhage is recognized as a preventable disease.
Dr. Yong Sam Shin is Neurovascular Surgeon and Associate Professor in NeuroSurgery department in Ajou School of Medicine. His specialty is Cerebral Vascular Disease, Stroke intervention treatment. He was formally a director of Neurosurgery department at 121 hospital U.S. 8th Army in Seoul. He also studied in St. Luke’s Roosevelt Hospital in New York.
Ajou University Hospital is a general and teaching hospital with 1,083 beds. It operates 32 clinics, several disease-specific specialized clinics and centers such as breast cancer, stomach cancer, liver cancer, lung cancer, cartilage regeneration, stroke & neurovascular surgery clinics ect. and takes care of 4,000 out-patients and about 1,000 in-patients a day.
Dr. Shin can be reached at 82-31-219-4312