• 10 months ago
SAY ni DOK | Ano ang aneurysm, ano ang sanhi, sintomas at paano ito ginagamot
Transcript
00:00 Jovith Valdivino, a singer and actress from Isabel, Granada,
00:04 is the only one who was suddenly brought back to life due to aneurysm.
00:09 Aneurysm is also called a silent killer because it has no symptoms or any warning signs.
00:15 In fact, according to statistics,
00:17 it is estimated that half a million people die every year due to aneurysm.
00:23 Half of them are people aged 50 and below.
00:27 That's why this morning, we will find out the symptoms and how to avoid it here in "Saney Doc".
00:35 Good morning, KRS-P.A.
00:40 We are joined by the Interventional Radiologist and the current head of the Radiology Division of the Philippine Heart Center, Dr. Marvin Tamanya.
00:49 Good morning, Doc. Welcome to Rise and Shine Philippines.
00:51 Good morning, Doc.
00:53 What is brain aneurysm? Is it dangerous and deadly?
00:58 How common is it, especially for normal people who think they are okay?
01:04 Brain aneurysm is one of the causes of hemorrhagic stroke.
01:11 Brain aneurysm usually starts when the wall of the blood vessels becomes weak.
01:19 Once the wall becomes weak, it can bulge or collapse until it ruptures.
01:26 If it ruptures, it will cause bleeding within the brain of the patient and can kill the patient.
01:33 As we saw earlier, celebrities like Jovie Paldivino and Isabel Granada, who are almost our age,
01:43 are young and they are the ones who are affected by it.
01:49 This is a common case among the people.
01:52 Is there a way to avoid it? Are there any signs of aneurysm that are not just a common headache?
01:59 Well, the initial signs of brain aneurysm are that there are no symptoms.
02:06 It is caused by symptoms. It starts with a headache, which is most of the time ignored by the patient
02:14 until they experience a severe headache, which could be a sign of rupture already.
02:21 Based on the patients who survived brain aneurysm rupture,
02:27 they describe this headache as the worst headache of their life.
02:31 So, it is a very painful headache.
02:34 Is it preventable? Is it diagnosable?
02:37 Maybe it can be diagnosed through CT scan or MRI.
02:42 So, for patients who are suspected of having brain aneurysm, they could undergo CT scan or MRI of the brain.
02:50 So, if the headache you are experiencing is different, you should get it checked immediately.
02:56 But, doc, can it be that there is no headache but there is aneurysm?
03:00 Yes. In fact, based on statistics, 1 to 5 percent of the general population has brain aneurysm.
03:08 And as I mentioned, most of these patients do not have symptoms.
03:12 Okay, it's very clear that brain aneurysm is not contagious.
03:15 Yes.
03:16 And it's genetic, as you said earlier, doc. Correct?
03:19 It can be genetic or it can be environmental. Is it correct, doc?
03:23 Based on the statistics, aneurysm could be sporadic or familial.
03:27 If we say sporadic, it just happens. We don't know what causes it.
03:32 But if we say familial, it can be from the genes of the patient.
03:39 So, we don't know who really has aneurysm because most of the time, they don't have symptoms.
03:47 Okay. For example, an individual who is experiencing a very painful headache, undergoes CT scan and has aneurysm,
03:55 what is the treatment for this, doc?
03:57 Brain aneurysm can be managed in two ways.
04:01 Number one, it is operated on during surgery.
04:03 So, we incise the scalp of the head and then we open the skull.
04:12 The brain is exposed, the aneurysm is found, and a metallic clip is inserted.
04:18 In this procedure, a metallic clip is inserted. So, this is called clipping.
04:25 In some cases, it cannot be operated on.
04:28 Or sometimes, or most of the time, the patient really doesn't want to open their head.
04:34 So, there is an option, which is what we call endovascular management.
04:39 In endovascular management, there is no incision, no surgery.
04:43 We just insert a large root in the groin or sometimes in the wrist.
04:49 And then through that, we insert the guide wire.
04:53 It's like a stamp.
04:54 It's not a stamp. It's a guide wire and catheter until we reach the aneurysm.
05:00 Wow.
05:01 Then, when we reach the aneurysm, we insert the coil.
05:08 So, our goal is to remove the blood flow from the aneurysm and preserve the vessel.
05:14 So, if the blood flow is removed, we can prevent the rupture.
05:17 But preserving the blood vessel is a must because if we occlude the blood vessel, it will cause a stroke.
05:25 So, there are cases where the operation cannot be done, where the coil cannot be inserted.
05:30 So, in those cases, we have a new technology that we call flow diversion stenting.
05:36 In this case, we put a metallic stent.
05:40 It's called a flow diverter stent.
05:42 We put it in the parent artery to divert the flow from the aneurysm into the normal vessel.
05:50 Well, thank God, there is a technology to help us.
05:53 But I have a question.
05:54 Because sometimes, when I was in Manila these past few days, I saw people who underwent surgery.
06:00 Their heads were hollow.
06:02 Does this really happen?
06:04 After surgery, there's a hole, the area becomes hollow.
06:09 Is this connected to the surgery?
06:12 Yes, because when we do surgery, as I mentioned, we open the skull,
06:16 we remove the small portion so that the brain can open and the aneurysm can be found.
06:21 In endovascular management, there is no such thing.
06:24 So, we just insert it into a large vessel, in the cingit or ceris, and then we can access the aneurysm through that.
06:30 Okay. So, if that's the case, the skull can be returned or not?
06:33 It can be returned.
06:34 So, your head can still be normal after the surgery?
06:37 Yes. We put a suture, like a wire.
06:42 Okay. Worst case scenario, how can a person survive a rupture in the aneurysm?
06:54 Well, this is one scenario.
06:56 Based on statistics, in the first episode of bleeding, in the first rupture, 70% of patients survived.
07:05 Only 30% died.
07:08 However, on the second incidence of rupture, it's the opposite.
07:13 70% of patients died and only 30% survived.
07:19 Unfortunately, most of these 30% are disabled. They are vegetables.
07:26 So, it's important to be able to see them before.
07:32 30% suffered from first bleed, they can re-bleed.
07:37 The highest incidence of re-bleeding is during the first 10 days after the first bleed.
07:42 Doc, you mentioned earlier that prior to the pandemic, there are more cases of aneurysm.
07:51 Why did that happen? Is it stress-related or environmental?
07:58 I don't know. Why did that happen?
08:00 Well, there are reports that stress is being caused by brain aneurysm.
08:09 But of course, the lifestyle of the patient is also a big factor.
08:17 You mentioned the lifestyle.
08:19 Doc, what can we do to avoid getting aneurysm?
08:26 Well, stroke in general, the risk factors of stroke is number one, of course, hypertension, smoking, diabetes, and hyperlipidemia.
08:37 The blood fat is high.
08:39 Triglycerides, cholesterol.
08:42 For our viewers, is the procedure of treatment of aneurysm expensive?
08:52 Well, the procedures of aneurysm are expensive.
08:57 Of the three I mentioned, some are expensive.
09:01 But of course, the cost depends on where the hospital will do it.
09:05 Of course, if it's a private hospital, it's a bit higher.
09:08 If it's a government institution, it's a bit cheaper.
09:12 In our institutions, can I mention the hospital?
09:17 I'm connected to the Philippine Heart Center, it's a government institution.
09:21 One of the advantages is that the Philippine Heart Center is a government hospital.
09:26 We are the only one with seven cat labs in the Philippines.
09:30 Although the mandate of our institution is to treat patients with cardiac diseases,
09:35 our facilities are capable of treating aneurysm and other endovascular procedures.
09:40 That's good news, especially for our countrymen who are living in poverty.
09:45 At least we have support from the government.
09:48 Well, do you have any advice for our viewers?
09:52 For patients, aneurysm in particular can be treated.
10:00 You just need to know where or which institution you should go to.
10:06 We must know that the technology and expertise is already in the Philippines.
10:14 So, aneurysm can be treated.
10:16 If you have experienced repeated headaches,
10:19 it's probably time to get a CT scan or MRI to find out if you have aneurysm.
10:25 Thank you for all the information.
10:28 We were joined this morning by Dr. Marvin Tamanya from Libre Intelimed.
10:33 Again, thank you very much, Doc.
10:35 Thank you, Doc.

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