The figures are actually worse in India. In a report published in Neurology India publication, ‘Need for India’s Brain Aneurysm Treatment Registry: How are we effectively treating intracranial aneurysms in India?’ Sudhir Ambekar, who is also a fellow at the University of Miami, said that about 40% of aneurysms in India are fatal. He stressed the dire need for a multi-pronged approach, where there is a national registry to effectively identify and treat cases of brain aneurysm.
This is common and fatal for many
According to Gaurav Goel, Director and Head – Neuro Interventional Surgery, Institute of Neurosciences, Medanta Hospital, “It is such a common disease that we usually say that 1 out of every 100 people will have it. An aneurysm is a condition of inflammation in the blood vessel. which forms a balloon or bubble, which eventually bursts and causes bleeding from the brain.”
“We see aneurysms day in and day out. These are among the most common conditions I see. When this aneurysm ruptures, 1/3 of people just collapse and die. when they are drinking tea, reading the newspaper or even sleeping. 1/3rd of the patients who are able to reach the hospital but are in coma, paralyzed or on ventilator. Only 1/3 of the people in such condition where they can talk about their treatment. But this is very common in our emergency department. This sudden death is a common feature of a brain aneurysm,” he adds.
Need to spread awareness in India
Only in India people do not pay attention to it. “If you look at the Indian health screening systems, it is primarily designed around blood tests and to a large extent heart diseases. But from the point of view of the brain, we just do a carotene Doppler which is a screening of the vessels of the neck that will not show whether a person has an aneurysm. So the way to detect those aneurysms is through an MRI or MRI angiography, which is a non-invasive thing, absolutely safe but a bit expensive. The pattern has changed so much that 20-30 years ago, our Western colleagues in Europe, America, saw many ruptured brain aneurysms, but today they rarely see cases of brain aneurysms. This is because most are prediagnosed on MRI. In our practice, we see 80% of ruptured aneurysms and only 20% that are diagnosed through screening. We have not been able to create that kind of awareness among our Indian population.”
Signs and symptoms
Most of the time these aneurysms are asymptomatic. Something like you and I can harbor an aneurysm and we may never know about it, until it starts growing and pushing off a particular side of the brain. A large aneurysm will give symptoms, such as pain behind the eye, double vision, or speech becomes affected, coordination is affected and you have a headache. Headache is a kind of warning that the body gives you. If someone is having frequent headaches, it could be a migraine, but if you start screening all patients with headaches, you will be surprised to see how many aneurysms can be diagnosed in the preemptive stage.
Some common symptoms of brain aneurysm are sudden severe headache, nausea, neck stiffness, blurred vision, sensitivity to light, pain behind the eyes, loss of consciousness, confusion. Undiagnosed brain aneurysms cause no symptoms
About 76,500 to 204,100 new cases are reported in India every year. Timely screening can prevent many casualties.