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Thursday, 28 November 2013

Cerebral aneurysm Treatments in Conventional Medicine

Cerebral aneurysm is defined as a cerebrovascular disorder causes of the blood vessel to bulge or balloon out of the wall of a blood vessel as a result of the weaken of blood vessels and veins and occurred mostly at the bifurcations and branches of the large arteries located at the Circle of Willis.
Treatments
A.1. In conventional medicine perspective
Treatment for a symptomatic aneurysm is to repair the blood vessels to prevent blood to enter the aneurysm to cause further growth or blood leakage.
1. Surgical Clipping was introduced by Walter Dandy of the Johns Hopkins Hospital in 1937
Clopping is the operation of the brain by cutting open the skull to find the damaged blood vessel and putting a clip across the aneurysm.

2. Endovascular coiling was introduced by Guido Guglielmi at UCLA in 1991
The operation passes a catheter into the femoral artery in the groin, through the aorta, into the brain arteries to the aneurysm and fill the aneurysm with coils of platinum wire or with latex.
Depending to he severity of the patient's condition, the EEG changes, an intracranial hematoma, and correspondence of the region of the operation with the zone of the vascular spasm were the most informative preoperative signs of the prognosis of the outcome of early operations. Bleeding during the operation and the duration of the arrest of the blood flow in the main vessel were the most informative intraoperative signs(80). Other study of One hundred and sixty of the aneurysms had ruptured; for 150 "typical" supratentorial aneurysms, the operative case fatality rate was 10%, and a satisfactory outcome was obtained in 85%. There were no deaths and little morbidity in 108 operations on grade 0 or 1 patients. Among a number of factors influencing outcome, the most obvious were age, hypertension, cerebral arterial spasm, and the clinical condition of the patient at the time of operation. The timing of surgery had no effect on results(81).
In a study to compare the quality of life (QOL) of surgically versus endovascularly treated patients with ruptured cerebral aneurysms.Methods We treated 45 patients surgically (surgical clipping [SC] group) and 44 by endovascular therapy (coil embolization [CE] group), the differences in QOL in the patients treated by either coiling or clipping were small and nonsignificant(82). 
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Sources
(81) http://www.ncbi.nlm.nih.gov/pubmed/6738404
(82) http://www.ncbi.nlm.nih.gov/pubmed/22585565