A brain aneurysm is a serious condition that can result in stroke, significant disability, or death. Brain aneurysms are often asymptomatic and found accidentally on brain imaging that is performed for other reasons. They are present in about 3% of the population and occur in people of all ages. Most, or about 50-80% of all aneurysms do not rupture. Once ruptured approximately 50% of people die and two-thirds of the survivors have permanent neurological deficits. Treatment once an aneurysm starts to leak or rupture is dangerous and difficult due to the fragility of the brain, the sensitivity and hyper-reactivity of aneurysms to surgical manipulation, and their tendency to spontaneously rupture at any time, especially during surgery.
After rupture free blood in the brain is highly caustic. It causes considerable damage to brain tissue, constricts blood vessels causing additional strokes, and is difficult to remove. With time it can be metabolized and absorbed, but this is a very slow process. Many patients have been led to believe there are few, if any, treatment options once the aneurysm ruptures. In fact, hyperbaric oxygen has been used to successfully treat ruptured brain aneurysms and the strokes that they cause, and prevent further strokes. HBOT is noninvasive, safe, and effective.
What is a Brain Aneurysm?
A brain aneurysm is a dilation or bulging in an artery that can balloon out and look like a berry on a stem. Aneurysms develop from a weakness in the wall of a blood vessel, usually at branch points. The two most common places in the body for an aneurysm are the brain and the aorta, which is the largest artery in the body. The most common place in the brain for an aneurysm to develop is in the front of the brain in the area between the brain and the thin layer of tissue, meninges, that surrounds and protects it. There is nothing that can be done to prevent a brain aneurysm from rupturing except surgery or invasive arterial treatments, Once the aneurysm becomes symptomatic, starts to leak, or rupture emergency treatment can be life-saving. Hyperbaric oxygen treatment of a ruptured brain aneurysm can be an effective treatment for symptom management and long-term healing, in addition to surgeries or invasive treatments or when these treatments cannot be performed.
Symptoms of Brain Aneurysm
Most patients experience no symptoms from a brain aneurysm until it enlarges and begins to press on other brain tissue, leaks, or ruptures. Since most of the aneurysms are in the front of the brain when they enlarge they cause problems with the eye such as pain above or behind one eye, changes in vision, numbness and loss of feeling in one side of the face, or a dilated pupil on one side. If the aneurysm begins leaking most people experience a sudden, severe headache. Doctors describe it as a “thunderclap” headache. Patients often say it is the worst headache of their life. When an aneurysm overtly ruptures extreme headache is still the hallmark symptom, but patients also can experience nausea, vomiting, sensitivity to light, seizure, drooping of the eyelids, loss of consciousness or confusion, and frequently death.
After-effects of Brain Aneurysms
Once a brain aneurysm has ruptured, there is bleeding inside the brain. This can last only a few seconds but causes brain damage and cell death in a matter of minutes. Depending on the exact location of the aneurysm and its positioning next to brain tissue the blood can pour into the fluid system in the brain (the ventricles) or penetrate into brain tissue like a water jet from a hose, forming an expanding blood clot in the brain tissue. Alternatively, it can spread along the white matter tracts like water in a stranded rope. When the blood pours out the ruptured aneurysm the pressure in the artery downstream from the rupture drops, decreasing blood flow and oxygen to the brain tissue. Since blood is filled with oxygen and iron it is intensely inflammatory to brain tissue once it is out of blood vessels. It causes spasm of other arteries it contacts, leading to secondary strokes. All of this damage to brain tissue increases pressure inside the skull.
After an aneurysm ruptures, there are only a few treatments available. Some of these include surgeries to close off the blood vessel just before and after the aneurysm (clipping) or insert metal objects in the artery at the aneurysm to clot off the aneurysm. Of course, these are invasive and very risky. Other treatments include medications to prevent the artery constriction that causes the secondary strokes, Once the aneurysm bleeding has been controlled, there are no post-aneurysm treatments available except standard stroke care. Until now. The benefit of HBOT for people with brain aneurysm is that it is safe and can lead to measurable results.
Hyperbaric Oxygen Treatment of Brain Aneurysm
Similar to nearly all emergency conditions in which there is lack of blood flow and oxygen HBOT is best delivered after aneurysm rupture while the patient is still in the hospital. This is exactly what was done in 1999 by Japanese physician, Dr. Kohshi, who showed that HBOT delivered a few days after aneurysm rupture at the time when secondary strokes occur could minimize secondary strokes, improve strokes that had already occurred, and improve outcomes. Unfortunately, for a variety of reasons we are often unable to deliver emergent HBOT in the hospital when the patients need it the most. We have to wait until the patient is discharged from the hospital. At this time patients may be experiencing residual brain damage due to the secondary strokes and the lowered blood flow and oxygen downstream from the ruptured or clipped aneurysm.
Hyperbaric oxygen treatment of brain aneurysm residua is similar to treatment of stroke and can help the body to heal the damaged areas in the brain on its own. HBOT increases the amount of oxygen in the bloodstream, boosts the immune system, inhibits the inflammation in the brain caused by the free blood, helps re-energize damaged brain cells, and stimulates new cell growth. Hyperbaric oxygen treatment of patients with ruptured brain aneurysm can show results after only one session, but usually more treatment is required, proportionate to the amount of time since the aneurysm has ruptured. Once in the chronic phase, six months or later, Dr Harch generally recommends 40 sessions over the course of about two months. This can be coupled with ongoing therapies to maximize recovery of brain function and improve symptoms.
The Benefit of HBOT for People with Brain Aneurysm
The most obvious benefits of hyperbaric oxygen treatment for ruptured brain aneurysms are the reduction in stroke deficits and improvement in quality of life. Depending on how soon HBOT is delivered and the amount of injury caused by the ruptured aneurysm HBOT can have a significant impact on the patient. Hyperbaric oxygen treatment of brain aneurysm is different for each patient, which is why dosing HBOT properly is so vital. Dr. Harch is the worldwide expert in dosing HBOT. The benefit of HBOT for people with brain aneurysm is that it can truly make a difference in the healing process and overall well-being of the patient after an aneurysm has ruptured.