Keith Allston felt completely fine. No headaches, no dizziness, nothing that would suggest anything was wrong inside his head. Yet the 69-year-old Highland Beach resident was harboring a brain aneurysm that had quietly grown from 4.3 millimeters to 6.5 millimeters, discovered only because he finally agreed to get screened.
A Family History Too Dangerous to Ignore
Allston knew brain aneurysms ran in his family, and for good reason. According to baptisthealth.net, his grandfather died from a brain aneurysm, his mother survived two ruptures during a grueling recovery, and his brother suffered a stroke caused by an aneurysm. Doctors had urged him for years to get screened, and it was ultimately his daughter's persistence that pushed him to finally schedule the appointment, per the same account. A separate account from physicianresources.baptisthealth.net describes it as his daughter's relentless persistence that finally convinced him, while the baptisthealth.net account instead states that it was Allston's experience that led his son to schedule his own first screening appointment. Despite feeling nothing out of the ordinary, Allston said, “I had no symptoms. I felt good all the time,” per baptisthealth.net.
A catheter angiogram last July revealed the aneurysm had enlarged from 4.3 mm to 6.5 mm, the outlet reports. Doctors at Marcus Neuroscience Institute, part of Baptist Health at Boca Raton Regional Hospital, found that the aneurysm was complex and located deep within his brain.
Treated Without Open Brain Surgery
Rather than performing open surgery through a craniotomy, Dr. Brian Snelling, director of cerebrovascular and endovascular neurosurgery and director of the stroke program at Marcus Neuroscience Institute, treated Allston through a minimally invasive endovascular procedure in August. He used a catheter to place a platinum coil inside the aneurysm, and also inserted a tiny metal stent, similar to those used in cardiac surgery, to provide support to the artery, according to the same report. The approach carries real advantages: it avoids the blood loss and longer recovery tied to open surgery, physicianresources.baptisthealth.net notes.
Allston stayed just one night in the hospital. A week later, he was back to his active lifestyle, per baptisthealth.net's report. As reported by WPEC, brain aneurysm repair broadly has shifted toward these kinds of minimally invasive endovascular procedures in recent years.
The Screening That Found More Than One Aneurysm
The family's story didn't end with Allston. His daughter, who had been undergoing screening every five years, was found to have two small brain aneurysms during her most recent test in November, according to physicianresources.baptisthealth.net. They are being monitored, the report notes.
Allston's case arrives during Brain Aneurysm Awareness Month, which the Brain Aneurysm Foundation marks every September. The foundation estimates that 1 in 50 people in the United States has an unruptured brain aneurysm, and that a brain aneurysm ruptures somewhere in the country every 18 minutes. Roughly 30,000 Americans suffer a rupture each year, according to a statement from the foundation carried by prnewswire.com, which also reported that the foundation awarded a record $650,000 this month to support 18 research projects covering genetics, artificial intelligence, diagnostics, imaging and new treatment strategies.
Risk Factors and Treatment Options
Beyond family history, risk factors for brain aneurysms include smoking, high blood pressure, high cholesterol and increasing age, per physicianresources.baptisthealth.net. Treatment decisions, whether observation, surgical clipping, endovascular coiling or flow diversion, largely depend on an aneurysm's size, location and neck geometry along with the patient's overall health, according to mayfieldclinic.com.
Minimally invasive endovascular treatment can address damaged brain vessels without open skull surgery, often resulting in better outcomes and shorter recovery times, according to umiamihealth.org. The introduction of stent-assisted coiling, similar to what Allston underwent, has allowed many patients to avoid surgical procedures altogether and recover much more quickly, the source notes. Coiling works by placing micro-coils into an aneurysm through a catheter to close off blood flow and prevent rupture or stop active bleeding.
Another option, flow diversion, may be used to treat a variety of unruptured brain aneurysms without a craniotomy, according to hopkinsmedicine.org. Many patients who once needed extensive surgery can now go home the next day, and some return to work within a week, the source states.
