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I.v drrug abuse – a cause of multiple aneurysms in brain

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Dr Vineet Saggar is an alumnus of D.A.V Chandigarh. After MBBS from (M.A.M.C) New Delhi in 2002, he did his P.G. in General Surgery from Safdarjung Hospital (2002-05). He went for his training in MCh Neuro Surgery at S.M.S Medical College Jaipur. After completing his MCh in July 2009, he trained under Prof. S.R. Dharker one of the pioneers of Micro- Vascular Neurosurgery in Rajasthan. During this time he also assisted Dr S.K Basandani another eminent Spinal Surgeon at Jaipur. Before joining Ivy Hospital as consultant Neuro Spinal Surgeon, he headed Department of Neurosurgery at Adesh Medical College Bathinda for some time. He has special interest in Spinal Surgery and Skull-Based Micro Neurosurgery. Apart from many national and international publications on Spine Surgeries, he also has research publications on Head Injury to his credit.

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I.v drrug abuse – a cause of multiple aneurysms in brain

  1. 1. INTRACRANIAL ANEURYSMSDR VINEET SAGGAR M.B.B.S, MS,MCH(NEUROSURGEY)CONSULTANT DEPARTMENT OF NEUROLOGICAL ASPINAL SURGERYIVY SUPERSPECIALITY HOSPITAL SEC-71, MOHALPUNJAB
  2. 2. I.V DRRUG ABUSE – A CAUSE OFMULTIPLE ANEURYSMS IN BRAIN?- Neurovascular surgery( surgery of blood vessels in brain)is technically most demanding of neurosurgical procedures- A rare neurovascular surgery was performed at ivy hospital few days back- A 35 years old male I/V drug abuser was admitted in our hospital with headache followed by loss of consciousness. .Patient had experienced similar episode few days back which was ignored by local general practitioner and he was discharged on analgesics
  3. 3.  Before coming to us he was seen by neurosurgeons in tricity and was refused treatment due to risk involved in the surgery We did angiography of brain vessels and found not one but three ANEURYSMS( Balloon like dilatation in wall of brain vessels) in his brain vessels , one of which has burst causing massive hemorrhaged in his brain
  4. 4. Plain Ct Head showing DiffuseSub Arachnoid Haemmorage
  5. 5. CT Angio Brain showing Multipleaneurysms LT MCA, RT Pcom and ANTchoroidal Artey aneurysms
  6. 6. POST OP SCAN
  7. 7. POST OP SCAN WITH CLIPS INSITU
  8. 8.  Two of the Aneurysms on the right side were clipped in the same surgery By Dr Vineet Saggar and patient was Discharged after two weeks with advice of surgery on opposite side after six weeks.
  9. 9. Patient Just beforeDischarge
  10. 10. WHAT ARE ANEURYSMS A cerebral or brain aneurysm is a cerebrovascular disorder in which weakness in the wall of a cerebral artery or vein causes a localized dilation or ballooning of the blood vessel. The general incidence of aneurysms in the population at large is of the order of 1%-2% Multiple aneurysms occur in 0.2% of the population
  11. 11. SIGNS AND SYMPTOMS Most common symptom is sudden severe headache that can last from several hours to days nausea and vomiting drowsiness and/or coma
  12. 12.  The ruptured aneurism (hemorrhage) may also damage the brain directly, usually from bleeding into the brain itself. This is called a “hemorrhagic stroke.” This can lead to: weakness or paralysis of an arm or leg trouble speaking or understanding language vision problems seizures
  13. 13. CAUSES Aneurysms may result from congenital defects(MOST COMMON CAUSE), Preexisting conditions such as high blood pressure and atherosclerosis (the buildup of fatty deposits in the arteries), or head trauma. Cerebral aneurysms occur more commonly in adults than in children but they may occur at any age. They are more common in women than in men, by a ratio of 3 to 2.
  14. 14. TREATMENTCurrently there are two treatment options for securing intracranial aneurysms: Surgical clipping or Endovascular coiling
  15. 15. ANEURYSM CLIPS
  16. 16. SURGERY V/S COILING Although endovascular coiling is associated with a shorter recovery period as compared to surgical clipping, it is also associated with a significantly higher recurrence rate after treatment Also coiling may not be the best options in patients with giant aneurysms , wide neck aneurysms or patients with massive bleed or large clots in brain as was in our case .
  17. 17. A YOUNG 25 YEAR MALE WITHANEURYSM RUPTURE -Acandidate for Surgery
  18. 18. POST OP SCAN WITH ANEURYSMCLIP IN SITU
  19. 19. POST OP PIC OF PATIENTDURING RECOVERY
  20. 20. AFTER CRANIOPLASTY
  21. 21.  Dr. Vineet Saggar (MCh) Neuro Surgeon / Spinal Surgeon Chandigarh, Mohali - Ivy Hospital Sector 71 +91-9855990990 http://www.neurosurgeoninchandigarh.com http://neurosergeonhead.blogspot.in http://www.facebook.com/neuro.surgeon.7186 http://www.linkedin.com/pub/dr- vineet/56/2a9/863 https://twitter.com/drvineetsaggar http://www.slideshare.net/neurosergeonhead

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