Estrogen to fight brain aneurysms

In the heads of millions of Americans, they sit silently and can burst without warning. Brain aneurysms rupture in about 30,000 people every year, killing or disabling many.

Women are at a higher risk for aneurysms than men. Now, researchers are taking a closer look at how a major change in a woman's life could be to blame.

"The left side of my body got numb," Sande Skinner thought she was having a stroke. "It didn't feel right.”

Sande had a big bulging artery in her brain.

"The little sucker is right behind my right optic nerve," says Skinner.

If ruptured, brain aneurysms can lead to stroke or death. Risk factors include smoking, high blood pressure and possibly lower estrogen levels caused by menopause. Two of the largest brain aneurysm trials in the world found most happen in menopausal women.

"Average age of rupture of all patients with aneurysms is age 52, which just so happens to be the average age of menopause," says Michael Chen, MD, Neurointerventionalist at Rush University Medical.

Doctor Michael Chen says severe drops in estrogen may contribute to the weakening of artery walls. He conducted a study of 60 women with aneurysms and found, compared to the general population, they were less likely to have taken birth control or to be on hormone replacement therapy.

He believes estrogen treatments could help prevent women from developing aneurysms.

"Protect them from the effects of these severe changes and hormones on their blood vessels," says Dr. Chen.

Now, Dr. Chen is enrolling a new trial to put his theory to the test. He'll use low-dose hormone replacement therapy in pre-menopausal women in hopes of stopping aneurysms from forming.

After three surgeries and several stents, Sande's aneurysm is no longer a threat.

"I'm still walking and talking,” says Skinner.

The Dr. Chen hopes his research will help wipe out the threat for every woman.

Doctor Chen's study will start off with about 40 to 50 women with treated and untreated aneurysms. He hopes it will eventually expand into a multi-center trial around the country.

Estrogen to fight brain aneurysms
REPORT #1946

ANEURYSMS: An aneurysm is a bulge in the wall of an artery and if it grows to a large size it can burst and cause bleeding or even death even though there may not be any symptoms beforehand. Aneurysms can form in various parts of the body but the most common area is the aorta, the main artery traveling from the heart. (Source: www.nih.gov)

SIGNS: It has been estimated that about half of all aneurysms burst and typically there are no signs up until the aneurysm ruptures. While sudden death would be the most obvious and severe sign of a ruptured aneurysm, other times the signs are mistaken as something else and treatment is not sought. Some signs of a ruptured brain aneurysm are:
- A sudden, extremely painful headache is the most common sign of a ruptured brain aneurysm.
- Vision changes, eye lid drooping, lethargy, speech impairment and seizures may also be the result of a burst brain aneurysm and some of these signs may also signify a stroke caused by the rupture. (Source: www.womenshealthresearch.org)

Unfortunately, aortic aneurysms tend to have more fatal consequences when they rupture than brain aneurysms. More than 90% of ruptured aortic aneurysms are fatal so the best chance of survival is detection of the bulge before it bursts. There usually are no symptoms unless the aneurysm grows large enough that puts pressure on other organs, but there are some signs of a ruptured aortic aneurysm and it is extremely important to call 911 immediately if you experience these:
- Sudden and intense upper back or chest pain, such as a ripping or tearing sensation.
- Weakness, trouble standing, passing out, or feelings of dizziness.
- Confusion and anxiety (Source: www.hearthealthywomen.org)

RISK FOR WOMEN: Women are actually less likely to have an aortic aneurysm than men with the aneurysms 5 to 10 times more common in men. However, as women age their risk for an aortic aneurysm increases greatly, especially if they are smokers (Source: www.hearthealthywomen.org). On the other hand, women are twice as likely to develop cerebral aneurysms as men and their risk increases over the 35 years old. It is not known exactly why women are more prone to develop cerebral aneurysms but since the aneurysms are more often found in women close to or experiencing menopause, it is though that declining estrogen levels might make women more vulnerable. This has led some doctors to believe hormone replacement therapy will help to lower the risk but the benefits of this are still unclear. The best thing women can do is be aware of their risk and quit smoking. (Source: www.womenshealthresearch.org)

For More Information, Contact:

Deb Song, Associate Director of Media Relations
Rush University Medical Center
(312) 942-0588
deb_song@rush.edu


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