Relationship of BAV and Cerebral Aneurysms

[Sbullock]

Hello all. I'm just shy of my 5 month anniversary of my surgery on my ascending aortic aneurysm and feeling just fine.
I have a question for all of you post op types that have or had a bicuspid valve.
Considering the small study (may 2010) that found a link between bavs and cerebral aneurysms I'm curious to know how many of you had an MRI to see if you had cerebral aneurysms and did your post op surgeon suggest the scan.My surgeon didn't feel the link was that strong but I'd hate to not request a scan and find out I was wrong.
I'm especially curious to know whether any fellow BAVers did in fact have a cerebral aneurysm.
I hoping none of you.

 

[ALCapshaw2]

If you are concerned, it would not be out of line to discuss this with your Surgeon and Cardio and PCP and then decide if you would like to have a brain scan to calm your fears and concern.

'AL Capshaw'

 

[Davidr]

I agree with Al,

This is your life, your health you are talking about!

I had aBAV replaced in 2000, and only now am seeing any info on aortic aneurisms, CTD and not cerebral anneurisms. Could you point me to that study you mentioned, I'd like to read up more on it...

Thanks

 

[Lynlw]

Hi Steve, I also would talk to your Cardiologist about your concern

I agree with Al,

This is your life, your health you are talking about!

I had aBAV replaced in 2000, and only now am seeing any info on aortic aneurisms, CTD and not cerebral anneurisms. Could you point me to that study you mentioned, I'd like to read up more on it...
Thanks

David, Have you found the Bicuspid Aortic Foundations site? They have alot of really good info About BAV http://www.bicuspidfoundation.com/Bicuspid_Aortic_Valve_Disease.html#Anchor19

I don't know if this is the same study but here is one article http://www.neurology.org/content/74/18/1430.abstract
"Screening for intracranial aneurysms in patients with bicuspid aortic valve" That was listed one their "Medical Reference" section

 

[Sbullock]

Sorry,I should have added the link to the study. The link that Lyn posted is the correct study.

 

[normofthenorth]

What they didn't mention in the study (or at least in the free Abstract) was how many of the 6 cerebral aneurysms could be treated in some meaningful way (either medically with drugs or surgically). I'm now an expert on Achilles Tendon Ruptures, and learning fast about BAVs and Aortas, etc., but I'm a real neophyte about cerebral aneurysms.

If (say) only 5% of detected CAs respond to treatment, then I'm even LESS interested in adding brain surgery to OHS than you'd expect me to be! Anybody got a clue, about how helpful early detection is with CAs? I'm also curious about the estimated detection ratio of the angiography they used.

BTW, I'm one of the BAVers who also grew up with migraines, which is also a risk factor for strokes (maybe most of which are caused by CAs). I'm not planning to obsess about this, but it does seem that some more background info would be helpful.

 

[Sbullock]

Hi Norm. Here's a good description of treatment for cerebral aneurysms.
http://www.mayfieldclinic.com/PE-Clipping.htm
My brother had this done last year at St. Mikes in Toronto and he is fine now despite the fact that his aneurysm had started to rupture.

Steve

 

[normofthenorth]

Thanks, neighbour!

Another current treatment (esp. for higher-surgical-risk patients) is at www.mayfieldclinic.com/PE-Coiling.htm .

Unfortunately, I think there are still some other unknowns (to me) that might rationally affect a decision to insist on scanning -- probably including the probability of false positives and false negatives in the scan, and definitely including the % of detected aneurisms that can be successfully treated, etc.

Any of us might have an undetected cerebral aneurysm or two at present. Might. And the probability of a detected one bursting looks like around 1% per year, unless I misunderstood something I read. (It happens!) If they (e.g.) detect one or more that can't be treated, that might be negative for QOL.

CBC Radio -- probably "White Coat, Black Art" with Dr. Brian Goldman, but maybe "Ideas" -- had a recent show about the perils and downsides of comprehensive scanning. (Both programs post podcasts, so it's probably online at cbc.ca .) It was interesting stuff, esp. as a corrective for our/my natural "I want to know everything" tendencies.

E.g., if you've got a slow-growing cancer that's got a 23% chance of causing problems before you die of old age (or get shot by a jealous husband), detecting it will most likely make your life worse, no? These CAs might fall into that same category unless the detection and treatment rates are both reasonably high.

 

[malibu82]

hi there

i don't know if this helps you or not. i had a BAV and it was replaced in May 2010 with a tissue valve. One month ago I had an MRI, MRA with and without contrast. I had one because I have been lightheaded for a few months. However, thankfully, my brain was just fine! No aneurysms.

i find myself not so much concerned about cerebral aneurysms, but worry about AAA's, or abdominal aortic aneurysms since i believe they are more commonly linked.

take care!

 

[Sbullock]

Hi malibu. That's great news. The More I hear about the negative cerebral aneurysm MRIs the better I feel. Thanks

 

[normofthenorth]

Maybe it would be quicker just to list the health problems that we BAVers are NOT at increased risk of getting!!

 

[Davidr]

Haha! I hear you...ever since I found this site, and started looking at the other issues that BAV can be associated with, I just get more concerned!

I prefer, however, to be informed...

I remember when I was very young (teen, or perhaps pre-teen), I was taken for a head MRI due to my migraine. As far as I know, there were no concerns at that stage - at least my parents did not mention anything to me at the time.

if CA is going to be a concern, would it develop later in life, or would the evidence be there from birth, and progress?

David

 

[skeptic49]

I had a brain MRI about ten years ago for another condition that I have (Meniere's Disease) before I knew I was BAV. My brain MRI was normal.

Jim

 

[Arlyss]

Video by Dr. Wouter Schievink, lead author of paper published in Neurology, May, 2010:

BAV and Brain Aneurysm Part One http://www.youtube.com/bavdtaad#p/u/3/99oT4dS3epQ

BAV and Brain Aneurysm Part Two http://www.youtube.com/bavdtaad#p/u/2/RKShzX7KGik

Best wishes,
Arlyss

 

[AZ Don]

The small study that screened 61 people with BAV for Brain Aneurysms seems to be referenced everywhere. Other relevant studies are harder to find so posting here for reference.

http://www.ajnr.org/content/33/6/1182.full

There was no association between ascending aortopathy, bicuspid aortic valves, and IAs.

Where IA = Intracranial Anuerysm. But the study was limited to those with Coractation of the aorta.

http://www.neurology.org/content/ear...000000001104v1
Out of over 1000 patients treated for IA,

317 had adequate echocardiography for assessment of BAV ... Conclusions: Our data demonstrate an association between IA and TAA, but not independently for BAV.

 

[HopefulHeart]

Hi all....this is an older thread, but I asked my cardiologist specifically about this and thought I'd share what he told me. Back in 2012, I asked my Cardiologist this question. He said that the gene that codes for the connective tissue for the heart (valve and aorta) is different than the gene that codes for the connective tissue in the brain. So if you have a "genetic hiccup" as he called it that caused bad connective tissue in the aorta leading to an aneurysm or BAV, that would not be the case for the brain. He said doctors (at least none that he knows) have not seen someone with a heart aneurysm develop an aneurysm somewhere else like in the brain. So he told me not to worry about it.