What is a brain aneurysm, how are they treated and what is the outlook for patients?
What is a brain aneurysm?
An aneurysm is a bulge in a blood vessel caused by a weakness in the blood vessel wall.
As blood passes through the weakened blood vessel, the blood pressure causes a small area to bulge outwards like a balloon.
The Brain Aneurysm Foundation in the US compares it to a weak spot on a bike tyre’s inner tube.
More on Health
Related Topics:
Because the walls of the artery are thin, the aneurysm is at risk of bursting.
What happens when a brain aneurysm bursts?
Advertisement
The first symptom is normally an agonising headache.
It’s been described as a “thunderclap headache”, the NHS says, similar to a sudden hit on the head.
Other possible symptoms include vomiting, pain on looking at light, loss of consciousness and a stiff neck.
When an aneurysm ruptures, blood spills into the space between the skull and the brain.
This is called a haemorrhage or haemorrhagic stroke and is considered a medical emergency.
What are the symptoms of an unruptured brain aneurysm?
Unruptured brain aneurysms normally do not have any symptoms.
However they occasionally cause symptoms if they’re particularly large or press against tissues or nerves inside the brain.
According to the NHS, symptoms can include visual disturbances, pain above or around your eye, numbness or weakness on one side of your face and difficulties with speech, memory and concentration.
How are brain aneurysms treated?
Not all aneurysms are at risk of rupturing. Where an unruptured aneurysm is considered low-risk, it will usually be monitored rather than treated because the risk of operating often outweighs the benefit.
An aneurysm that is at risk of or has already burst may be treated with coiling or surgical clipping.
Coiling involves filling the aneurysm with a series of platinum coils that are threaded up from the patient’s groin.
The coils prevent more blood flowing into the aneurysm and pressing against the weakened walls.
Surgical clipping involves removing a section of the skull and placing a metal clip over the “neck” of the aneurysm to stop blood from flowing into it.
The same treatments are used for aneurysms that have already burst.
Who is at risk of having a brain aneurysm?
Brain aneurysms can develop in anyone at any age, but are more common in people over 40.
They are also more common in women.
People who smoke and those with high blood pressure are at greater risk of brain aneurysms.
Excessive alcohol consumption and drug use, particularly cocaine, are also associated with brain aneurysms.
What’s the outlook after a ruptured brain aneurysm?
Ruptured brain aneurysms are fatal in about 50% of cases, according to the Brain Aneurysm Foundation.
About 15% of people with a ruptured aneurysm die before reaching the hospital. Most of the deaths are due to rapid and massive brain injury from the initial bleeding.
Of those who survive, about two thirds suffer permanent neurological problems.
A pizza delivery woman stabbed a pregnant customer over a $2 tip, authorities in the US say.
Brianna Alvelo, 22, is charged with attempted murder after allegedly stabbing the woman multiple times at a motel in Kissimmee, Florida.
The victim, her boyfriend and her five-year-old daughter were staying at the Riviera Motel to celebrate a birthday and ordered Marco’s pizza on Sunday, according to a court document reported by Sky News’ US sister outlet NBC News.
Alvelo delivered the pizza which cost around $33 (£26) and was asked to provide change for a $50 bill but did not have the change, the affidavit said.
The woman then searched for smaller bills and in the end gave Alvelo a $2 tip.
She told police that some time later she heard a loud knocking on the door. A man and a woman wearing masks and all black forced themselves into the room when she opened the door, she said.
The man brandished a silver revolver and demanded that the woman’s boyfriend go into the bathroom and the other person, believed to be Alvelo, pulled out a pocketknife, the document said.
As the woman turned to shield her child she felt a strike on her lower back, she said.
She then “threw her daughter onto the bed and attempted to pick up her phone”, the affidavit said, but Alvelo grabbed it and smashed it.
Alvelo then “began striking her multiple times with the knife”, according to the affidavit. The man who had the gun then yelled it was time to go, stopping the assault, it said.
The judge overseeing the case of a woman who says she was raped by Jay-Z and Sean “Diddy” Combs when she was 13 has criticised the “inappropriate” behaviour of Jay-Z’s lawyer.
In a written order, Judge Analisa Torres hit out at Alex Spiro for what she described as his combative motions and “inflammatory language” against the plaintiff’s lawyer, Tony Buzbee.
The Manhattan judge has said she can proceed anonymously at this stage but may be required to reveal her identity at a later date.
Combs remains in a Brooklyn jail awaiting trial on federal sex trafficking and racketeering charges. He has pleaded not guilty.
He is facing a wave of sexual assault lawsuits, many of which were filed by Texas lawyer Mr Buzbee, who says his firm represents more than 150 people, both men and women, alleging sexual abuse and exploitation by Combs.
The lawsuits allege many individuals were abused at parties in New York, California and Florida after being given drugged drinks.
Combs’ lawyers have dismissed Mr Buzbee’s lawsuits as “shameless publicity stunts, designed to extract payments from celebrities who fear having lies spread about them, just as lies have been spread about Mr Combs”.
Jay-Z, whose real name is Sean Carter, previously said in a statement that Mr Buzbee was trying to blackmail him to settle the plaintiff’s allegations.
Mr Buzbee said in an email that his firm does not comment on court rulings.
In her lawsuit, the woman claims Jay-Z and Sean Combs raped her when she was 13 after the MTV Video Music Awards in 2000.
Both men strenuously deny the allegations.
Mr Spiro has previously asked the judge to dismiss Jay-Z from the woman’s lawsuit.
Citing an interview the plaintiff did with Sky’s US partner NBC News, Mr Spiro wrote that the broadcast revealed “glaring inconsistencies and outright impossibilities” in the plaintiff’s story.
Judge Torres wrote in her order on Thursday that Mr Spiro had submitted a “litany of letters and motions attempting to impugn the character of Plaintiff’s lawyer, many of them expounding on the purported ‘urgency’ of this case”.
She added: “Carter’s lawyer’s relentless filing of combative motions containing inflammatory language and ad hominem attacks is inappropriate, a waste of judicial resources, and a tactic unlikely to benefit his client. The court will not fast-track the judicial process merely because counsel demands it.”
She said Mr Spiro – who had accused the plaintiff’s lawyer of having a “chronic inability to follow the rules” – had failed to follow the rules himself. She warned him against future “unacceptable” behaviour.
The woman, who was 23 at the time, said she felt sick and fell unconscious after being served two premade drinks by waitresses, later waking up in hospital with a ripped shirt, missing underwear and shoes, and no recollection of how she got there.
The suit said the woman was left with pain in her vagina for around a week, which she believed was from rough intercourse.
She also said an unknown woman with a New York number later called her, allegedly threatening her to keep quiet.
Combs’ attorney has called the allegations “pure fiction”.
As well as Combs, the woman is also suing Bad Boy Entertainment Holdings, which Combs founded; Atlantic Records, which she said facilitated the event; Mike Savas, a promoter for Atlantic at the time; Delta Airlines, which flew her to New York; KKJamz 105.3, the radio station she said held the contest; and the Roger Smith Hotel, where she stayed.
Ten “John and Jane Does” are also listed as defendants.
Donald Trump says that when he takes power next month he will direct the US Justice Department to “vigorously pursue” the death penalty.
The US president-elect, 78, said he would do so to protect Americans from what he called “violent rapists, murderers and monsters”.
Mr Trump was responding to President Joe Biden’s decision to commute the sentences of almost all federal inmates on death row – whom Mr Trump called “37 of the worst killers in our country”.
“When you hear the acts of each, you won’t believe that he did this. Makes no sense,” Mr Trump posted on his social media platform Truth Social.
“Relatives and friends are further devastated. They can’t believe this is happening!”
He continued: “As soon as I am inaugurated, I will direct the Justice Department to vigorously pursue the death penalty to protect American families and children from violent rapists, murderers, and monsters.
“We will be a Nation of Law and Order again!”
President Biden, 82, announced on Monday that he would reduce the sentences of 37 of the 40 federal death row prisoners to life in prison without the possibility of parole, saying he was “guided by my conscience and my experience as a public defender”.
The three others the president did not spare are Robert Bowers, who fatally shot 11 people at a Pittsburgh synagogue in 2018; Dylann Roof, who gunned down nine black churchgoers in Charleston, South Carolina, in 2015; and Dzhokhar Tsarnaev, who carried out a 2013 bombing at the Boston Marathon that killed three people and injured almost 300 others.
‘I condemn these murderers’
Despite sparing the lives of 37, Mr Biden added: “Make no mistake: I condemn these murderers, grieve for the victims of their despicable acts, and ache for all the families who have suffered unimaginable and irreparable loss.”
During Mr Trump’s first term in office between 2017 and 2021, the US Justice Department put 13 federal inmates to death.
He has since said he would like to expand capital punishment to include child rapists, migrants who kill US citizens and law enforcement officers, and those convicted of drug and human trafficking.
Mr Biden, who ran for president opposing the death penalty, put federal executions on hold when he took office in January 2021.
His latest decisions come after a coalition of criminal justice advocacy groups, former prosecutors and business leaders wrote letters to the White House asking for Mr Biden to commute the sentences ahead of Mr Trump’s inauguration on 20 January.
Pope Francis also appealed to Mr Biden, who is Catholic, to reduce the sentences to imprisonment.
Unlike executive orders, clemency decisions cannot be reversed by a president’s successor, although the death penalty can be sought more aggressively in future cases.