Dear Dr. Roach: During an MRI on my mom for a seizure, they found two brain aneurysms.
A year later, when she was in a nursing home, she had a few mini-strokes and died at age 87 of 鈥渃erebral vascular disease.鈥� One brother died of a sudden stroke while shopping in his 70s, and her other brother and sister died in their 80s with vascular problems, and they also had mini-strokes.
My question is whether I should have an MRI or be tested for a brain aneurysm. I am 65, five-feet, 4 1/2-inches tall and weigh 118 pounds. I never smoked or drank and have low blood pressure and good cholesterol readings.
Should I be concerned about the family predisposition to brain aneurysms? J.S.
Just like aortic aneurysm, a brain aneurysm is a weakening of the wall of an artery, which eventually can rupture, with devastating effects, usually resulting in a large stroke. Up to six per cent of people can have unruptured brain aneurysms, most of which will never cause problems.
A strong family history of two or more first-degree relatives (parent, sibling, child) with aneurysms does make a person more likely to have one, and makes the case for screening. However, with only one family member 鈥� in your case, your mother 鈥� your risk isn鈥檛 much higher than the general population鈥檚, and you also have done as well as you can to reduce your risk by maintaining good blood pressure, keeping your cholesterol low and by not smoking.
Dear Dr. Roach: I have been diagnosed with a form of vertigo, but neither a change in an eye medication known to aggravate this condition nor basic tai chi has done anything to help.
I am nearly 77 and in good shape except for this. W.S.
Congratulations on remaining so active.
I can鈥檛 be sure you have vertigo. You have fallen a few times but haven鈥檛 described the spinning sensation that is most common with vertigo. Rapid neck motion can bring on vertigo but it also can cause a totally unrelated type of fall 鈥� carotid sinus hypersensitivity. In this condition, stretching the neck triggers a reflex for the heart rate to slow, and you can fall or even lose consciousness.
If you have had symptoms of vertigo, I would consider vestibular rehabilitation, done by occupational or physical therapists.
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