Keith Allston knew the odds were stacked against him. His grandfather had died from a brain aneurysm, his mother endured a grueling recovery after surviving two ruptured aneurysms and his brother suffered a stroke caused by an aneurysm. For years, doctors urged Mr. Allston to get screened with an MRI/MRA scan, but like many people, he put it off.
Brian Snelling, M.D.
It was his daughter’s relentless persistence that finally convinced him to schedule an appointment — a decision that likely saved his life. By the time he arrived at Marcus Neuroscience Institute, part of Baptist Health, at Boca Raton Regional Hospital, doctors discovered a complex aneurysm located deep within his brain.
“I had no symptoms. I felt good all the time,” says the 69-year-old Highland Beach resident. “I never even had a headache.”
About Brain Aneurysms
An aneurysm can develop anywhere in the brain’s network of blood vessels. It occurs when a section of an artery wall weakens, causing the blood flowing through the area to put additional pressure on the artery wall. The vessel can then balloon or bulge, and if it bursts, the event becomes a life-threatening emergency.
Approximately one in 50 people have a brain aneurysm and roughly 500,000 people worldwide die every year when their aneurysm ruptures, according to the Brain Aneurysm Foundation.
Risk factors for brain aneurysms include smoking, high blood pressure and high cholesterol and increasing age (most occur between 30 and 60 years of age). Females and people of Hispanic and Black ancestry also have an increased risk. To decrease your chances of a brain aneurysm, experts advise that you exercise, maintain a healthy weight, control any health problems such as diabetes and high blood pressure and eat a balanced diet.
“The problem with brain aneurysms is that they often cause no symptoms until they rupture,” says neurosurgeon Brian Snelling, M.D., director of cerebrovascular and endovascular neurosurgery and director of the stroke program at Marcus Neuroscience Institute. “Then, patients experience the worst headache of their lives. Many don’t survive the bleeding, or, if they do, they can have serious disability.”
Treating an Unruptured Brain Aneurysm
Not all brain aneurysms are serious, however. Many are small enough that doctors recommend regular monitoring instead of intervention. But when a large or growing brain aneurysm like Mr. Allston’s is found, physicians must decide how to treat the problem.
“The decision to treat an unruptured brain aneurysm is individualized. There is no cookie-cutter answer,” Dr. Snelling notes. “Generally, the larger an aneurysm is, the more likely it is to rupture. But size alone doesn’t tell the whole story.”
To gather the complete picture, Mr. Allston underwent a catheter angiogram last July so that physicians could better learn about the shape, size and morphology of his aneurysm. During the minimally invasive procedure, Dr. Snelling threaded a small catheter into a blood vessel in Mr. Allston’s wrist and to the neck. There, a contrast material was injected so that detailed images of the arteries of the brain could be captured.
The study revealed that in a short period of time, Mr. Allston’s aneurysm had enlarged from 4.3 mm to 6.5 mm — roughly the size of a small blueberry.
“Dr. Snelling went over the options with me, which included clipping the aneurysm during a craniotomy through my skull or doing an endovascular approach where they fill the aneurysm with a platinum coil,” Mr. Allston said.
In August, he underwent the minimally invasive endovascular procedure, which like catheter angiography, involves reaching the aneurysm using a thin catheter through a small incision. Advantages over open surgery include less blood loss and a quicker recovery.
In addition to employing the coil into the aneurysm, Dr. Snelling also used a tiny metal stent, similar to those used in cardiac surgery, to provide support to the artery. “We place a stent to protect the artery,” he explains. “It serves as a scaffolding.” The stent and the coil remain in place permanently.
Living Life to its Fullest
After an overnight hospital stay, Mr. Allston returned home and a week later he was back to his active lifestyle, enjoying four-mile walks, playing with his dog and dining out with his wife of 51 years, Barbara.
“I am truly blessed,” says the retired real estate developer, who must remain on blood thinners for about six months. “And there are very few people in my condominium complex who haven’t heard my story. I tell everyone. I now know that if you have a family history of aneurysms, you should get checked. The odds of surviving a ruptured aneurysm are not good at all."
Mr. Allston’s outlook is good, Dr. Snelling says. “Patients like Keith are fortunate because at Marcus Neuroscience Institute we have our clinic, the neurovascular suite and the ICU all in one location with all of the necessary specialists and the greatest technology.”
It’s a message not lost on Mr. Allston, who emotionally praises those at the Institute who have cared for him. “Everyone here is so professional. They treat you with total respect and make you feel comfortable immediately. Dr. Snelling and this organization are incredible.”
Mr. Allston’s experience has led his son to schedule his first appointment for an aneurysm screening. His daughter, a nurse who has undergone screening every five years as recommended, discovered two small brain aneurysms during her most recent test in November. They are being monitored.
Click here for more information about the services and physicians available at Marcus Neuroscience Institute, part of Baptist Health, at Boca Raton Hospital.
