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So since trending Rep Mike Reese died of an aneurysm and I am vaguely a neuro nurse, and everyone who follows me is a nerd, let's ride!
(Vaguely bc I've only been one for two yrs. More exp neuro RNs can soooo smoke me.)
(Mostly cerebral) Aneurysms, a thread!
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(Vaguely bc I've only been one for two yrs. More exp neuro RNs can soooo smoke me.)
(Mostly cerebral) Aneurysms, a thread!
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At their most basic, aneurysms represent a weakness in an arterial cell wall -- usually due to some other damage, like atherosclerosis or high BP. (Shit, if I'd known I was gonna have to look up spelling atherosclerosis I would not have started this thread....)
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They can also be (in your brain) caused by AVM malformations, which is where your arterial and venous systems meet in an inappropriate tangle which can cause an area of higher pressure and cell wall thinness.
Here's a crazy illo of one of those:
https://www.bcm.edu/healthcare/specialties/neurosurgery/cerebrovascular-and-stroke-surgery/brain-arteriovenous-malformations-avms
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Here's a crazy illo of one of those:
https://www.bcm.edu/healthcare/specialties/neurosurgery/cerebrovascular-and-stroke-surgery/brain-arteriovenous-malformations-avms
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As you might imagine, pressure/damage causing an aneurysm anywhere in your body to burst is a bad scene. If it's an abdominal aortic aneurysm, that's called an AAA -- that when the main pipe from your heart to your organs/legs is gonna blow.
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(Okay, I can't just cheat and talk about brain stuff, we'll come back to brains.)
Your aorta is taking the most pressure, it's the artery right after your heart. Your heart is pumping hard (likely harder than it ought too, bc of untreated high BP, causing fluid issues...
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Your aorta is taking the most pressure, it's the artery right after your heart. Your heart is pumping hard (likely harder than it ought too, bc of untreated high BP, causing fluid issues...
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and possible pre-existing tissue damage -- athersclorisis (sp! so close! :P.)
So something bursting there means high pressure blood is going to leak out pretty instantaneously and everything south (organs, limbs) won't be getting any.
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So something bursting there means high pressure blood is going to leak out pretty instantaneously and everything south (organs, limbs) won't be getting any.
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(There's a a lot of room in your abd cavity for extra blood, alas.)
Here's an illo of normal vs abnormal (but not ruptured):
https://www.uchicagomedicine.org/conditions-services/heart-vascular/aortic-disease/abdominal-aortic-aneurysm
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Here's an illo of normal vs abnormal (but not ruptured):
https://www.uchicagomedicine.org/conditions-services/heart-vascular/aortic-disease/abdominal-aortic-aneurysm
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if it's unruptured, they can possibly fix it via surgical means. If you know you have one and you feel a sudden sharp pain, lose blood pressure (bc it's going into your abd cavity rather than staying in circulation) then it's burst, and it's a significant medical emergency
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Usually on the scale of 'you need hospitalization right away and/or you will die if you're not already in a hospital.
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(I'm not the best at AAA's because I don't see them often, but I couldn't not mention them because ppl should know they exist. And, again, I'm better than Nate Silver.
Let's go back to brains tho!)
Your brain's got a ton of circulation up there.
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Let's go back to brains tho!)
Your brain's got a ton of circulation up there.
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I know that sounds stupid to say, but a lot of people don't think about it. Like _every single living cell_ you have has to be touched by something (circulating blood!) that will give it the oxygen and nutrients it, as an individual cell, needs to survive.
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But the same long term damage of high BP and sclerosis (argh) can mess up the arterial wall integrity of the arteries going into your brain, too.
Here's pix!
12/ https://www.google.com/imgres?imgurl=https%3A%2F%2Fwww.gwinnettmedicalgroup.com%2Fmedia%2FImage%2FPicture1.png&imgrefurl=https%3A%2F%2Fwww.gwinnettmedicalgroup.com%2Fneurosurgery-and-spine-associates%2Fservices%2Fbrain%2Fbrain-aneurysm&tbnid=K28MP37A5zu_qM&vet=12ahUKEwiYusKYuv7tAhUMmp4KHfG9BuIQMygEegUIARCuAQ..i&docid=W1_Ena-wbq1f3M&w=482&h=340&q=types%20of%20cerebral%20aneurysm&ved=2ahUKEwiYusKYuv7tAhUMmp4KHfG9BuIQMygEegUIARCuAQ
Here's pix!
12/ https://www.google.com/imgres?imgurl=https%3A%2F%2Fwww.gwinnettmedicalgroup.com%2Fmedia%2FImage%2FPicture1.png&imgrefurl=https%3A%2F%2Fwww.gwinnettmedicalgroup.com%2Fneurosurgery-and-spine-associates%2Fservices%2Fbrain%2Fbrain-aneurysm&tbnid=K28MP37A5zu_qM&vet=12ahUKEwiYusKYuv7tAhUMmp4KHfG9BuIQMygEegUIARCuAQ..i&docid=W1_Ena-wbq1f3M&w=482&h=340&q=types%20of%20cerebral%20aneurysm&ved=2ahUKEwiYusKYuv7tAhUMmp4KHfG9BuIQMygEegUIARCuAQ
And you could just have a congenital defect or the AVM malformation I mentioned above.
Seeing as all this stuff is in your head, and we don't scan for it (it wouldn't make sense too, too invasive, not worth it statistically) -- most times ppl just get...DUN DUN DUNNNNNNNNN
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Seeing as all this stuff is in your head, and we don't scan for it (it wouldn't make sense too, too invasive, not worth it statistically) -- most times ppl just get...DUN DUN DUNNNNNNNNN
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The Worst Headache They've Ever Had.
Now, because it's not coming straight off of your aorta, blood spurting out like a firehose, you've got some time.
But it's still not great.
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Now, because it's not coming straight off of your aorta, blood spurting out like a firehose, you've got some time.
But it's still not great.
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Because unlike your generously stretchy abdominal cavity, your brain is encased by your skull.
You bleed too much in there and something's gotta give. Either new blood can't get in (no room, bad for cells, start to starve) or tissue gets compressed (poss brain damage).
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You bleed too much in there and something's gotta give. Either new blood can't get in (no room, bad for cells, start to starve) or tissue gets compressed (poss brain damage).
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So -- recap -- worst headache ever (like a one time event headache, not a chronic thing) -- possible nausea, vomiting, stroke-like symptoms (since it's a head bleed, yeah).
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How do we fix a leak in your brain? Glad you asked. (Some of these fixes we use for unruptured aneursyms too, if they feel its needed) -- clips and coils.
Here's a illo of a clip:
17/ https://www.google.com/imgres?imgurl=https%3A%2F%2Fapi.kramesstaywell.com%2FContent%2Febd5aa86-5c85-4a95-a92a-a524015ce556%2Fmedical-illustrations%2FImages%2Fpnerv20140309v0002&imgrefurl=https%3A%2F%2Fwww.urmc.rochester.edu%2Fencyclopedia%2Fcontent.aspx%3FContentTypeID%3D85%26ContentID%3DP08772&tbnid=344bMXZ5bPPfNM&vet=12ahUKEwiYusKYuv7tAhUMmp4KHfG9BuIQMygIegUIARC3AQ..i&docid=GSHJnslJFksOvM&w=600&h=334&q=types%20of%20cerebral%20aneurysm&ved=2ahUKEwiYusKYuv7tAhUMmp4KHfG9BuIQMygIegUIARC3AQ
Here's a illo of a clip:
17/ https://www.google.com/imgres?imgurl=https%3A%2F%2Fapi.kramesstaywell.com%2FContent%2Febd5aa86-5c85-4a95-a92a-a524015ce556%2Fmedical-illustrations%2FImages%2Fpnerv20140309v0002&imgrefurl=https%3A%2F%2Fwww.urmc.rochester.edu%2Fencyclopedia%2Fcontent.aspx%3FContentTypeID%3D85%26ContentID%3DP08772&tbnid=344bMXZ5bPPfNM&vet=12ahUKEwiYusKYuv7tAhUMmp4KHfG9BuIQMygIegUIARC3AQ..i&docid=GSHJnslJFksOvM&w=600&h=334&q=types%20of%20cerebral%20aneurysm&ved=2ahUKEwiYusKYuv7tAhUMmp4KHfG9BuIQMygIegUIARC3AQ
(sorry this is taking so long, finding pix takes time)
Clipping requires getting in there and getting at it, alas. Brain surgery.
Coiling is when they send up a titanium thread through your groin up and fill in the danger zone to clot it off:
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https://www.google.com/search?q=aneurysm+coiling&sxsrf=ALeKk01-7-qr_6QCNbX8O0qVKlAM2_jeGQ:1609632599952&source=lnms&tbm=isch&sa=X&ved=2ahUKEwj92dravP7tAhUYQ80KHV2wA3IQ_AUoAXoECBAQAw&biw=1093&bih=526#imgrc=LcPN9SiZ2XYQ2M
Clipping requires getting in there and getting at it, alas. Brain surgery.
Coiling is when they send up a titanium thread through your groin up and fill in the danger zone to clot it off:
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https://www.google.com/search?q=aneurysm+coiling&sxsrf=ALeKk01-7-qr_6QCNbX8O0qVKlAM2_jeGQ:1609632599952&source=lnms&tbm=isch&sa=X&ved=2ahUKEwj92dravP7tAhUYQ80KHV2wA3IQ_AUoAXoECBAQAw&biw=1093&bih=526#imgrc=LcPN9SiZ2XYQ2M
It seems less traumatic, but tbh, I don't actually know why they pick one over the other. It's above my pay grade and, again, I'm not Nate Silver, lol.
A family member I had recently, back 3 months ago when they were briefly allowed wanted to know why
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A family member I had recently, back 3 months ago when they were briefly allowed wanted to know why
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her husband wasn't automatically better after having had a surgery done, and the way I explained it was -- he had a leaky faucet. We fixed the pipes, but fixing the water damage takes time.
Depending on how much bleeding there is, etc
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Depending on how much bleeding there is, etc
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when things were caught (if they were caught, as that Rep illustrations, plenty of ppl straight up die from aneurysms), people segue into a subarachnoid hemorrhage pathway, and their recovery thereafter depends on the severity of the damage done....
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By the blood that leaked out.
Did you know your brain's not meant to process free blood? And that blood just hanging out in there irritates it and can cause vasopasms so bad they can cause secondary strokes?
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Did you know your brain's not meant to process free blood? And that blood just hanging out in there irritates it and can cause vasopasms so bad they can cause secondary strokes?
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so we give special meds to prevent that, as well as do ultrasound through people's temples (the thinnest part of the skull wall) to measure the pressures up there to make sure that's not happening.
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I think that's all I have to say about that, thanks for hanging out w/me, and y'all can all be very happy when I go back to writing fiction tomorrow instead of nattering on here, heh ;).
