Navigation Links
Specialized care by experienced teams cuts death and disability from bleeding brain aneurysms
Date:5/17/2012

ANN ARBOR, Mich. People with bleeding brain aneurysms have the best chance of survival and full recovery if they receive aggressive emergency treatment from a specialized team at a hospital that treats a large number of patients like them every year, according to new guidelines just published by the American Stroke Association.

Diagnosing and immediately treating this kind of "bleeding stroke", and using advanced techniques to prevent re-bleeding and aneurysm recurrence, reduces the chance of immediate death and disability by 30 percent for patients with aneurysm-related subarachnoid hemorrhages (aSAH), according to the newly published guidelines.

What's more, this kind of evidence-based treatment means better long-term survival and quality of life for survivors, say the guideline's authors, who include University of Michigan neurosurgeon B. Gregory Thompson, M.D. The guideline is published online in the journal Stroke.

In a subarachnoid hemorrhage, blood collects on the surface of the brain after leaking from an aneurysm, or a weak spot in a brain blood vessel. About 5 percent of all strokes are caused by aSAH, which can occur at any time in any of the millions of Americans who have brain aneurysms.

Many people who suffer an aSAH have no idea they have an aneurysm. Their first sign is a severe headache "the worst headache of their life" as many describe it -- that comes on suddenly and doesn't fade away for hours if at all. The condition is often misdiagnosed.

The guidelines emphasize the importance of getting such patients diagnosed quickly and transporting them immediately to a hospital that treats more than 35 aSAH patients in a year, which typically have a multi-specialty team available to quickly assess and treat each patient.

"The take-home message for physicians and patients is that admission to specialized high volume centers is associated with lower rates of death and disability," says Thompson, who heads U-M's cerebrovascular team and is the John E. McGillicuddy Collegiate Professor of Neurosurgery at the U-M Medical School.

Last year, more than 100 subarachnoid hemorrhage patients were treated by U-M's team, as well as more than 200 brain aneurysm patients who had their condition treated before a hemorrhage could occur.

Because each aneurysm is different, the team of physicians must decide quickly what technique they will use to prevent aneurysm re-bleeding. For some patients, the aneurysms are treated by microsurgery to "clip" the aneurysm and for others, the treatment choice is use of minimally invasive endovascular (through the blood vessel) techniques, which employ coils, stents and other implants inserted through a catheter and threaded into the brain through blood vessels in the neck.

At a few highly specialized centers, such as U-M, a "brain bypass" operation that transplants a section of blood vessel from the arm or leg into the brain can be done for patients with "unclippable" or ruptured fusiform aneurysms, an especially complex type to repair.

Patients with an aSAH need to be treated within hours of the start of their hemorrhage, though the urgency is not quite as time sensitive as the more common type of stroke caused by a clot that blocks blood flow into the brain. In about 50 percent of patients with subarachnoid hemorrhage the blood clot at the site of the arterial weakening between the brain and skull stops the arterial leak long enough for the patients to survive and be treated successfully. But if the bleeding begins again before the aneurysm can be secured, the risk of death is even higher, says Thompson.

"We want to treat these patients within the first 24 hours after their hemorrhage, to prevent re-bleeding and to give them the best chance for full recovery," he says. "Mortality increases to 80 percent after a second hemorrhage."

That's why it's important for patients to seek emergency care for their initial symptoms, whether by calling 911 or going to a local hospital. And, the guidelines note, initial diagnostic imaging with CT, CT angiography or MRI, or cerebrospinal fluid analysis, is needed to pinpoint the cause of symptoms. The guideline also calls for the immediate use of drugs to bring down blood pressure.

Thompson notes that the availability of medical helicopters staffed by trained teams, such as U-M's Survival Flight, helps speed patients to a highly experienced hospital.

Even after the initial operation, careful management of aSAH patients in Intensive Care Units and after discharge from the hospital is also crucial, say the guideline authors. U-M's Neurointensive Care Unit is an example of the kind of specialized inpatient care that can increase the odds of healthy survival, says Thompson. After the hospital stay is over, patients can benefit from the kind of testing and treatment offered through programs such as U-M's Stroke Rehabilitation Program.


'/>"/>

Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

Related medicine news :

1. Specialized Warm-Up May Reduce Girls Knee Injuries
2. Specialized Stroke Centers Deliver on the Weekends
3. Specialized Adult Stem Cells Re-Grow Fingertips
4. Specialized regulatory T cell stifles antibody production centers
5. Specialized blood plasma treatment does not improve rotator cuff healing, study finds
6. Clinical waste management needs specialized regulation
7. The Walden Group, a Specialized Strategic Healthcare Investment Banking Firm, Adds Key Advisory Services
8. Serving the World With Specialized Insurance for Missionaries
9. Racial disparities diminish in specialized cancer centers
10. Chateau Amber Retreat Provides Specialized Post-Cosmetic Surgery Care in Palm Springs Luxury
11. CareTech Solutions Presents Specialized Healthcare Call Center at HIMSS10
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... , ... June 24, 2016 , ... People across the ... Genome magazine’s Code Talker Award, an essay contest in which patients and their families ... to be presented at the 2016 National Society of Genetic Counselors (NSGC) Annual Education ...
(Date:6/24/2016)... ... June 24, 2016 , ... Puradigm® & ... (TGIG), has initiated cultivation and processing operations at its production facility, and opened ... , Puradigm is the manufacturer of a complete system of proactive air and ...
(Date:6/24/2016)... ... June 24, 2016 , ... Venture Construction Group (VCG) sponsors ... on June 20th at the Woodmont Country Club at 1201 Rockville Pike, Rockville, Maryland, ... to helping service members that have been wounded in battle and their families. Venture ...
(Date:6/24/2016)... ... June 24, 2016 , ... Finally, a bruise cream that ... dermaka cream can be incorporated into the post-surgical treatment plans of a variety of ... , dermaka cream is very effective for bruising and causes a rapid resolution of ...
(Date:6/24/2016)... New York (PRWEB) , ... June 24, 2016 , ... ... marijuana patients optimize the ingestion of their medication by matching users with high quality ... users to compare pieces with no commitment. , Inhale was founded by two brothers, ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 ... CAPR ), a biotechnology company focused on the ... announced that patient enrollment in its ongoing randomized ... has exceeded 50% of its 24-patient target. Capricor ... the third quarter of 2016, and to report ...
(Date:6/23/2016)... BOGOTA, Colombia , June 23, 2016  Astellas today announced the establishment of Astellas Farma Colombia (AFC), a ... second affiliate in Latin America . ... ... ... ...
(Date:6/23/2016)... , June 23, 2016  Experian ... integrating and transforming the patient payment and ... several innovative new products and services that ... its revenue cycle offerings. These award-winning solutions ... efficient workflows, remain compliant in an ever-changing ...
Breaking Medicine Technology: