1 00:00:00,680 --> 00:00:03,760 Speaker 1: Welcome to Wellness Unmasked. This is doctor Nicole Sapphire and 2 00:00:04,120 --> 00:00:07,840 Speaker 1: we have to tackle something that hit the news media 3 00:00:07,880 --> 00:00:11,000 Speaker 1: headlines this week. It is medical, but I guess when 4 00:00:11,000 --> 00:00:13,200 Speaker 1: you're talking about the Kardashians. 5 00:00:12,440 --> 00:00:15,600 Speaker 2: Though, it feels like a little less medical. That's right. 6 00:00:15,760 --> 00:00:19,720 Speaker 1: Kim Kardashian has announced that when she was undergoing brain 7 00:00:19,800 --> 00:00:23,920 Speaker 1: emri imaging that they found, in her words, a little 8 00:00:24,160 --> 00:00:27,840 Speaker 1: brain aneurism, and she said that they told her it 9 00:00:27,880 --> 00:00:31,360 Speaker 1: was probably due to stress, and she blames the divorce 10 00:00:31,400 --> 00:00:37,080 Speaker 1: stress from her tumultuous divorce from Kanye West. Kim Kardashian 11 00:00:37,600 --> 00:00:41,440 Speaker 1: blaming her brain aneurysm on divorce stress is probably the 12 00:00:41,479 --> 00:00:44,920 Speaker 1: most Kardashian thing I've seen this year, maybe even the 13 00:00:45,000 --> 00:00:47,760 Speaker 1: last several years. To truth be told, I've never actually 14 00:00:47,760 --> 00:00:51,159 Speaker 1: seen an episode of the show. Obviously, it's wildly popular, 15 00:00:51,520 --> 00:00:54,840 Speaker 1: and all of these sisters and their mamager Chris Jenner, 16 00:00:55,160 --> 00:00:59,440 Speaker 1: are wildly successful, so they're clearly doing something right. But 17 00:00:59,840 --> 00:01:03,120 Speaker 1: it seems to be they're always surrounded by drama and 18 00:01:03,400 --> 00:01:07,240 Speaker 1: this brain aneurism diagnosis. While it is dramatic and can 19 00:01:07,319 --> 00:01:10,080 Speaker 1: be lethal, the way that it came about kind of 20 00:01:10,080 --> 00:01:13,840 Speaker 1: made me chuckle in the sense that divorce brain aneurysm. Well, 21 00:01:13,880 --> 00:01:16,840 Speaker 1: that's a first for me. So I decided why not 22 00:01:17,000 --> 00:01:19,440 Speaker 1: ask an expert. I happen to be married to one, 23 00:01:19,560 --> 00:01:23,720 Speaker 1: doctor Paul Sapphire. He's an endovascular Board certified neurosurgeon who 24 00:01:23,760 --> 00:01:28,080 Speaker 1: specializes in yep, brain aneurisms, strokes. Here we go, let's 25 00:01:28,120 --> 00:01:30,560 Speaker 1: dive right in and here he is everyone, my husband, 26 00:01:30,600 --> 00:01:35,399 Speaker 1: doctor Paul Sapphire, As I mentioned, endovascular neurosurgeon who he 27 00:01:35,720 --> 00:01:41,880 Speaker 1: specializes in brain tumors, vascular malformation, strokes, but also brain aneurysms. So, Paul, 28 00:01:41,920 --> 00:01:43,480 Speaker 1: thank you so much for joining wellness. 29 00:01:43,480 --> 00:01:45,679 Speaker 2: I'm measked thank you for having me again. 30 00:01:46,200 --> 00:01:49,480 Speaker 1: So here's the question. I told you about this headline 31 00:01:49,520 --> 00:01:52,280 Speaker 1: because I know you're not up with the Kardashian drama, 32 00:01:52,400 --> 00:01:53,800 Speaker 1: But so what do you make of the fact that 33 00:01:53,880 --> 00:01:57,160 Speaker 1: Kim Kardashian now has this incidental brain aneurism? Tell us 34 00:01:57,160 --> 00:01:57,880 Speaker 1: a little bit about it. 35 00:01:58,800 --> 00:02:03,040 Speaker 3: Well, in a way, finding incidental brain aneurysms can sometimes 36 00:02:03,040 --> 00:02:07,880 Speaker 3: be almost like opening up Pandora's box, right, because clearly, 37 00:02:08,600 --> 00:02:11,000 Speaker 3: from what I understand, she's had no symptoms. This is 38 00:02:11,160 --> 00:02:15,239 Speaker 3: purely a screening type. Imaging scenario in which she under 39 00:02:15,400 --> 00:02:18,200 Speaker 3: a wellness check and they found this brain aneurysm. And 40 00:02:18,200 --> 00:02:20,600 Speaker 3: sometimes it's hard to know exactly what's the right thing. 41 00:02:20,800 --> 00:02:23,560 Speaker 3: You know, air quotes the right thing to do for aeurisms. Obviously, 42 00:02:23,600 --> 00:02:26,919 Speaker 3: whatever gets us to having patients of a long healthy 43 00:02:26,960 --> 00:02:29,560 Speaker 3: life is the right answer. But when we refer to 44 00:02:29,680 --> 00:02:34,600 Speaker 3: incidental aneurisms, you know, incidental means what incidental, I'm sorry, 45 00:02:34,720 --> 00:02:38,799 Speaker 3: means that it is incidentally discovered. It has not caused 46 00:02:38,800 --> 00:02:40,800 Speaker 3: a problem, it's not causing any symptoms. 47 00:02:40,840 --> 00:02:42,480 Speaker 2: But you found it one way or another. 48 00:02:42,560 --> 00:02:45,280 Speaker 3: Either you come from a long line of family members 49 00:02:45,280 --> 00:02:47,640 Speaker 3: that have a history of brain aneurysms or bleeding in 50 00:02:47,680 --> 00:02:50,680 Speaker 3: the brain or things like that, or you have certain 51 00:02:50,760 --> 00:02:53,560 Speaker 3: risk factors that maybe they screened you for, you know, 52 00:02:53,760 --> 00:02:57,119 Speaker 3: for brain aneurisms. But incidental in the sense that it's 53 00:02:57,160 --> 00:02:59,320 Speaker 3: not causing a problem, the question always becomes. 54 00:02:59,040 --> 00:03:00,840 Speaker 2: Well can it potentially cause a problem. 55 00:03:01,320 --> 00:03:03,560 Speaker 3: And anyone who's been a patient of mind that's set 56 00:03:03,600 --> 00:03:05,760 Speaker 3: in my office and has talked to me about their 57 00:03:05,800 --> 00:03:09,560 Speaker 3: incidental angeism has heard me use this analogy, which is 58 00:03:10,000 --> 00:03:14,799 Speaker 3: anything can happen to anyone. Any airplane, god forbid, could crash, right, 59 00:03:15,280 --> 00:03:17,880 Speaker 3: But there are things that may or may not make 60 00:03:17,919 --> 00:03:19,440 Speaker 3: an airplane crash more likely. 61 00:03:19,560 --> 00:03:19,720 Speaker 2: Right. 62 00:03:20,080 --> 00:03:23,000 Speaker 3: So you know, thankfully, if you're leaving from a you know, 63 00:03:23,200 --> 00:03:25,200 Speaker 3: lax or Newark airport in the middle of the day 64 00:03:25,240 --> 00:03:27,320 Speaker 3: and it's a beautiful weather and you're on a brand 65 00:03:27,320 --> 00:03:30,840 Speaker 3: new airplane, the risk you know, of the airplane crash 66 00:03:30,880 --> 00:03:34,240 Speaker 3: is incredibly low, not zero, but incredibly low. 67 00:03:34,560 --> 00:03:34,720 Speaker 1: Right. 68 00:03:35,240 --> 00:03:39,000 Speaker 3: So, there are certain characteristics of a brain aneurism that 69 00:03:39,080 --> 00:03:42,800 Speaker 3: may make it incredibly low risk of that andery bleeding 70 00:03:42,840 --> 00:03:46,880 Speaker 3: in someone's lifetime or higher. And if someone has an 71 00:03:46,960 --> 00:03:50,080 Speaker 3: aneurism that has certain characteristics, or they themselves have certain 72 00:03:50,160 --> 00:03:52,600 Speaker 3: health characteristics that may make it like more or less 73 00:03:52,680 --> 00:03:56,440 Speaker 3: likely in their lifetime or that aneurism to bleed, then 74 00:03:56,440 --> 00:04:00,000 Speaker 3: maybe we do correct that aneurism ahead of time before 75 00:04:00,200 --> 00:04:02,120 Speaker 3: or it becomes a problem for that person. 76 00:04:03,080 --> 00:04:05,640 Speaker 1: So I just want to give some background and aneurism. 77 00:04:05,680 --> 00:04:07,800 Speaker 1: If you think of the blood vessels in the brain, right, 78 00:04:07,840 --> 00:04:10,440 Speaker 1: they're kind of like, I mean to basically put like 79 00:04:10,440 --> 00:04:12,760 Speaker 1: a canal system. You have blood flowing through them, and 80 00:04:12,760 --> 00:04:15,920 Speaker 1: they're kind of like in these tubes. And aneurism is 81 00:04:16,080 --> 00:04:18,800 Speaker 1: like a focal area where that wall of the tube 82 00:04:18,800 --> 00:04:21,200 Speaker 1: has weakened and it's kind of ballooning out right. 83 00:04:21,240 --> 00:04:21,760 Speaker 2: That's right. 84 00:04:21,800 --> 00:04:27,119 Speaker 3: So an aneurism is a weakening the wall of blood vessel. 85 00:04:27,120 --> 00:04:29,719 Speaker 3: It can occur anywhere in the body. It can happen 86 00:04:29,760 --> 00:04:32,040 Speaker 3: in any blood vessel in the body. So when people say, oh, 87 00:04:32,120 --> 00:04:35,839 Speaker 3: my my grandmother had an aneurysm, well, I may know 88 00:04:35,880 --> 00:04:38,000 Speaker 3: if that means, but we don't really know exactly where 89 00:04:38,040 --> 00:04:41,280 Speaker 3: that anural is located. When we talk about a brain aneurism, 90 00:04:41,279 --> 00:04:43,719 Speaker 3: we're talking about obviously the blood vessels that are within 91 00:04:43,760 --> 00:04:46,880 Speaker 3: the brain. Now, the interesting thing is that when we 92 00:04:46,960 --> 00:04:49,920 Speaker 3: talk about brain aneurysms, we have to, you know, segregate 93 00:04:50,120 --> 00:04:54,359 Speaker 3: which blood vessels within the brain, because ironically, certain blood 94 00:04:54,400 --> 00:04:57,360 Speaker 3: vessels may have a higher or lower likelihood of those 95 00:04:57,720 --> 00:05:01,200 Speaker 3: having an aneurism of those aneurisms bleed, meaning that you 96 00:05:01,279 --> 00:05:04,719 Speaker 3: can have a brain aneurysm, a blood vessel that is 97 00:05:04,720 --> 00:05:08,440 Speaker 3: within the segment of the brain that has an aneurysm, 98 00:05:08,440 --> 00:05:11,040 Speaker 3: but the likelihood of that aneurism rupturing may be solow 99 00:05:11,120 --> 00:05:13,440 Speaker 3: we choose never treat it, and if it were on 100 00:05:13,560 --> 00:05:16,880 Speaker 3: a slightly different blood vessel within the brain, that same aneurism, 101 00:05:16,920 --> 00:05:18,920 Speaker 3: we may say, oh gosh, maybe we should treat it 102 00:05:18,960 --> 00:05:21,560 Speaker 3: before it cause the problem. But yes, it is a 103 00:05:21,600 --> 00:05:26,440 Speaker 3: weakening the wall of a blood vessel. Clearly the size 104 00:05:26,440 --> 00:05:29,480 Speaker 3: of that aneurism. The bigger, the larger that aneurism, the 105 00:05:29,480 --> 00:05:32,440 Speaker 3: more likely it is for that aneurism to rupture. Probably 106 00:05:32,440 --> 00:05:35,960 Speaker 3: what's the most important risk factor of that aneurism rupturing 107 00:05:36,040 --> 00:05:38,599 Speaker 3: is actually the rate of growth. So typically people aren't 108 00:05:38,839 --> 00:05:41,560 Speaker 3: born with brain androisms. They form over time. It can 109 00:05:41,600 --> 00:05:44,160 Speaker 3: happen in just about anybody. There are certain risk factors 110 00:05:44,200 --> 00:05:46,320 Speaker 3: which we can talk about in a moment that may 111 00:05:46,600 --> 00:05:49,000 Speaker 3: increase or decrease the likelihood of you having a brain 112 00:05:49,040 --> 00:05:51,920 Speaker 3: aneurysm or an angerism rupture. But probably the most important 113 00:05:51,920 --> 00:05:54,119 Speaker 3: thing is the rate of growth. So when we find 114 00:05:54,160 --> 00:05:57,359 Speaker 3: someone like ms Kardashian who gets a scan, you know 115 00:05:57,400 --> 00:06:01,000 Speaker 3: whenever you just recently had it done and snapshot in time, 116 00:06:01,240 --> 00:06:03,360 Speaker 3: we don't know what that aneism looked like six months ago, 117 00:06:03,400 --> 00:06:04,920 Speaker 3: six years ago, so we don't really know the rate 118 00:06:04,960 --> 00:06:08,360 Speaker 3: of growth of that aneurism. Now, she probably has been recommended. 119 00:06:08,360 --> 00:06:11,160 Speaker 3: If they're not recommending treatment for the aneurism, my supposition 120 00:06:11,279 --> 00:06:14,200 Speaker 3: is that they're recommending that she follow it with regular 121 00:06:14,200 --> 00:06:16,560 Speaker 3: imaging and so you're going to try from the fact. 122 00:06:16,360 --> 00:06:18,720 Speaker 1: That she said that it was very small, right. 123 00:06:19,080 --> 00:06:21,240 Speaker 3: Based upon that fact, I have no idea. I mean, 124 00:06:21,279 --> 00:06:23,840 Speaker 3: I'm assuming she's seeking treatment out in Los Angeles. I'm 125 00:06:23,839 --> 00:06:26,560 Speaker 3: assuming that's where she lives. And you know, I know 126 00:06:26,680 --> 00:06:29,000 Speaker 3: a lot of colleagues out there who are excellent and 127 00:06:29,040 --> 00:06:31,760 Speaker 3: I'm sure they're giving her very solid medical advice in 128 00:06:31,839 --> 00:06:36,440 Speaker 3: terms of how to manage or monitor that aneurism. But yeah, 129 00:06:36,480 --> 00:06:40,680 Speaker 3: if the angurism is small, incidental, and the risk calculated, 130 00:06:40,680 --> 00:06:43,080 Speaker 3: and we have different kinds of algorithms that we can 131 00:06:43,120 --> 00:06:45,520 Speaker 3: look at that give us a potential in terms of 132 00:06:45,520 --> 00:06:48,680 Speaker 3: someone's lifetime what that risk of rupturing is. If that 133 00:06:48,800 --> 00:06:51,520 Speaker 3: risk is low over their lifetime, well, then treating that 134 00:06:51,560 --> 00:06:55,000 Speaker 3: aneurism with some type of surgical maneuver ahead of time 135 00:06:55,040 --> 00:06:56,160 Speaker 3: may not be warranted. 136 00:06:56,880 --> 00:07:00,520 Speaker 1: Okay. So ultimately, when it comes to Brandy anisism, obviously 137 00:07:00,560 --> 00:07:02,839 Speaker 1: the thing that we're most concerned about is it rupturing, 138 00:07:03,040 --> 00:07:05,680 Speaker 1: because that is when there's bleeding in the brain. And 139 00:07:06,960 --> 00:07:10,400 Speaker 1: historically this had a very high fatality rate, right like 140 00:07:10,440 --> 00:07:12,720 Speaker 1: over fifty percent of people who had a ruptured brain 141 00:07:12,760 --> 00:07:13,920 Speaker 1: andewism would die. 142 00:07:14,200 --> 00:07:18,679 Speaker 3: So well, back in the day, you know, before people 143 00:07:18,680 --> 00:07:22,520 Speaker 3: were getting certainly screening MRIs so regularly or routinely. You know, 144 00:07:22,600 --> 00:07:24,640 Speaker 3: back vida, the only way that we really found patients 145 00:07:24,680 --> 00:07:27,200 Speaker 3: that had brain and were after they had ruptured. And 146 00:07:27,560 --> 00:07:31,760 Speaker 3: you know, the mortality rate for brain animal ruptures and 147 00:07:31,760 --> 00:07:34,280 Speaker 3: casts of bleeding in the brain, the risk of mortality 148 00:07:34,320 --> 00:07:37,680 Speaker 3: is actually really high. I think overall it's probably as 149 00:07:37,720 --> 00:07:41,040 Speaker 3: high as seventy percent in some instances seventy to eighty percent. 150 00:07:41,440 --> 00:07:44,360 Speaker 3: And really importantly too, is all those people that survive. 151 00:07:44,480 --> 00:07:47,520 Speaker 3: Of the twenty to thirty percent overall that survive, the 152 00:07:47,520 --> 00:07:51,360 Speaker 3: majority of those patients do not return to functional independence. 153 00:07:51,760 --> 00:07:55,800 Speaker 3: And functional independence doesn't necessarily mean going back to driving 154 00:07:55,920 --> 00:07:58,760 Speaker 3: and working. It we're talking about the daily activities that 155 00:07:58,800 --> 00:08:02,360 Speaker 3: we all take for granted until taken away. Bathing yourself, 156 00:08:03,240 --> 00:08:06,280 Speaker 3: clothing yourself, grooming, feeding yourself. 157 00:08:06,000 --> 00:08:06,680 Speaker 2: That sort of thing. 158 00:08:07,480 --> 00:08:09,520 Speaker 3: So you're talking about a really serious condition, and that's 159 00:08:09,560 --> 00:08:12,040 Speaker 3: why we have a low threshold as neurosurgeons. We have 160 00:08:12,080 --> 00:08:14,840 Speaker 3: a very low threshold for treating what might seem as 161 00:08:14,880 --> 00:08:17,960 Speaker 3: relatively small aneurism, especially in someone who's younger and has 162 00:08:18,040 --> 00:08:20,280 Speaker 3: many lives ahead of them, many years ahead of them 163 00:08:20,280 --> 00:08:23,440 Speaker 3: in their lifetime. Well aggregating that risk over time, that 164 00:08:23,560 --> 00:08:25,360 Speaker 3: risk of ayers and rupturing may be quite high, so 165 00:08:25,360 --> 00:08:27,560 Speaker 3: you may choose to treat that person. But yes, overall, 166 00:08:27,600 --> 00:08:30,680 Speaker 3: the risk of death and major disability from a rupture 167 00:08:30,680 --> 00:08:33,480 Speaker 3: brain and very very high. In fact, upwards of a 168 00:08:33,520 --> 00:08:35,280 Speaker 3: third of people that have a ruptured brain and yours 169 00:08:35,440 --> 00:08:37,480 Speaker 3: don't even survive to make it to the hospital. 170 00:08:37,720 --> 00:08:40,280 Speaker 1: You're listening to Wellness and Mass. We'll be right back 171 00:08:40,320 --> 00:08:45,199 Speaker 1: with more. So I know that I know this from 172 00:08:45,240 --> 00:08:47,679 Speaker 1: personal experience, because you get called in the middle of 173 00:08:47,720 --> 00:08:51,000 Speaker 1: the night or during dinner or wherever we may be, 174 00:08:51,160 --> 00:08:53,960 Speaker 1: or treating someone who's already had a ruptured brain anerism, 175 00:08:54,000 --> 00:08:56,720 Speaker 1: and you go in. You know, sometimes you do end 176 00:08:56,720 --> 00:08:59,760 Speaker 1: of vascularly where you're going in through the groin or 177 00:08:59,760 --> 00:09:02,199 Speaker 1: the and blood vessels to access the brain, but you're 178 00:09:02,200 --> 00:09:05,320 Speaker 1: also going in sometimes removing the skull, cleaning out if 179 00:09:05,360 --> 00:09:09,200 Speaker 1: it's already ruptured, all the blood. But you're saying, I 180 00:09:09,240 --> 00:09:11,760 Speaker 1: know this, but just for everyone listening. One of the 181 00:09:11,840 --> 00:09:15,520 Speaker 1: key things when you've identified an aneurysm, if you've determined 182 00:09:15,640 --> 00:09:17,760 Speaker 1: that it's at risk of rupture, and this is based 183 00:09:17,800 --> 00:09:20,360 Speaker 1: on many things, like you said, the size, the rate, 184 00:09:20,400 --> 00:09:24,079 Speaker 1: of growth, if you decide to treat it to try 185 00:09:24,120 --> 00:09:26,360 Speaker 1: and prevent it from rupturing, what does that look like. 186 00:09:27,280 --> 00:09:32,280 Speaker 3: So treatment has evolved in everything in medicine, but certainly 187 00:09:32,320 --> 00:09:35,520 Speaker 3: in neurosurgery has evolved tremendously, and so in twenty twenty five, 188 00:09:35,600 --> 00:09:37,920 Speaker 3: soon to be twenty twenty six, we have a lot 189 00:09:37,960 --> 00:09:40,040 Speaker 3: of treatment options for brain and reskins. But they fall 190 00:09:40,080 --> 00:09:44,080 Speaker 3: into two main category. Either conventional brain surgery, which although 191 00:09:44,120 --> 00:09:49,040 Speaker 3: that's the most most invasive and the most time consuming 192 00:09:49,120 --> 00:09:52,600 Speaker 3: and complex, is the most relatively straightforward to understand. 193 00:09:52,760 --> 00:09:55,560 Speaker 1: You know, conventional that's the clipping. You're talking about clipping. 194 00:09:55,960 --> 00:09:57,960 Speaker 3: So essentially what we do is we make an incision 195 00:09:58,040 --> 00:10:01,280 Speaker 3: wherever this in the head. We open up that part 196 00:10:01,320 --> 00:10:04,199 Speaker 3: of the skull which gently dissect the different layers of 197 00:10:04,240 --> 00:10:07,160 Speaker 3: the brain, identify the blood vessels and the aneurism itself, 198 00:10:07,360 --> 00:10:10,000 Speaker 3: and place a clip and a clip the analogy that 199 00:10:10,040 --> 00:10:10,760 Speaker 3: I use think of the. 200 00:10:10,800 --> 00:10:13,760 Speaker 2: Small clothes pin, so a little. 201 00:10:13,200 --> 00:10:15,440 Speaker 3: Matt but it's made out of metal, made out of titanium, 202 00:10:15,640 --> 00:10:19,600 Speaker 3: a little spring loaded pin that actually cinches down and 203 00:10:19,640 --> 00:10:22,439 Speaker 3: it seals off. You place that that cinch at the 204 00:10:22,520 --> 00:10:25,079 Speaker 3: base of the aneurism that called the neck of the aneurism, 205 00:10:25,400 --> 00:10:28,360 Speaker 3: and that blocks blood flow into the anurism, so blood 206 00:10:28,400 --> 00:10:31,280 Speaker 3: cannot flow into the aneurysm. If blood can't flow into 207 00:10:31,280 --> 00:10:34,160 Speaker 3: the aneurysm but still is flowing within the normal blood vessels, 208 00:10:34,280 --> 00:10:38,320 Speaker 3: the aneurysm cannot rupture. Again, that's a very basic conceptual 209 00:10:38,400 --> 00:10:41,880 Speaker 3: understanding of that and of vascular treatment on the other 210 00:10:42,000 --> 00:10:44,319 Speaker 3: end of the spectrum, And there's many different. 211 00:10:44,200 --> 00:10:47,480 Speaker 1: Like this is something specialized that you did advance straining for. 212 00:10:47,640 --> 00:10:52,319 Speaker 1: Actually at UCLA, not all neurosurgeons one can clip aneurysms, 213 00:10:52,360 --> 00:10:55,680 Speaker 1: but even fewer can do endovascular treatment. 214 00:10:55,440 --> 00:10:56,360 Speaker 2: Right, that's true. 215 00:10:56,440 --> 00:11:00,120 Speaker 3: So there are very few neurosurgeons, relatively speaking, across the 216 00:11:00,160 --> 00:11:02,880 Speaker 3: country who are dual trained, you know, doing both open 217 00:11:02,960 --> 00:11:06,720 Speaker 3: vascular and the aravascular surgery as well as doing endovascular surgery. 218 00:11:07,559 --> 00:11:10,840 Speaker 3: And the analogy that I use is very similar to say, 219 00:11:10,880 --> 00:11:14,680 Speaker 3: heart surgery. You have open heart surgeons that will crack 220 00:11:14,760 --> 00:11:16,720 Speaker 3: open the chest and do open heart surgery and fix 221 00:11:16,720 --> 00:11:18,839 Speaker 3: the heart that way, and then you also have interventional 222 00:11:18,880 --> 00:11:21,000 Speaker 3: cardiologists will go through the blood vessels usually in the 223 00:11:21,120 --> 00:11:23,400 Speaker 3: arm or the leg with their tubes and cafeters and 224 00:11:23,400 --> 00:11:26,160 Speaker 3: fix the heart from the inside out, and we do 225 00:11:26,320 --> 00:11:29,000 Speaker 3: something similar albeit very different for the brain and blood 226 00:11:29,040 --> 00:11:32,200 Speaker 3: vessels within the brain. And I'm capable of performing both 227 00:11:32,240 --> 00:11:36,160 Speaker 3: those types of procedures, and so for endovascular therapy or 228 00:11:36,240 --> 00:11:40,840 Speaker 3: endovascular surgery for brain aneurysms, there's a couple different ways 229 00:11:41,040 --> 00:11:43,760 Speaker 3: that we can treat them, a very couple different technologies 230 00:11:43,760 --> 00:11:45,120 Speaker 3: that we can employ right now. 231 00:11:45,480 --> 00:11:47,200 Speaker 2: But the basic principle. 232 00:11:46,840 --> 00:11:49,360 Speaker 3: Is, again, we go through the ardor usually oftentimes I'll 233 00:11:49,360 --> 00:11:51,240 Speaker 3: go through the ardor here in the wrist, the very 234 00:11:51,280 --> 00:11:53,240 Speaker 3: thin but long tube guide that all the way up 235 00:11:53,240 --> 00:11:55,000 Speaker 3: to the blood vessels of the neck. Using X ray, 236 00:11:55,320 --> 00:11:57,880 Speaker 3: inject a little bit of dye contrast see the blood vessels, 237 00:11:58,040 --> 00:11:59,760 Speaker 3: and then go further up into the blood vessels of 238 00:11:59,760 --> 00:12:03,360 Speaker 3: the brain. And then similar to the clipping in the 239 00:12:03,400 --> 00:12:07,040 Speaker 3: sense we're trying to exclude the brain aneurysm from the 240 00:12:07,080 --> 00:12:09,680 Speaker 3: normal circulation. So we're trying to block off the blood 241 00:12:09,679 --> 00:12:13,120 Speaker 3: flow into the aneurism, but preserve blood flow within the 242 00:12:13,120 --> 00:12:16,760 Speaker 3: main blood vessels. And again there's different devices that we use. 243 00:12:16,840 --> 00:12:18,920 Speaker 3: Some people have heard of coiling, some people have heard 244 00:12:18,920 --> 00:12:21,040 Speaker 3: of stints. We have other types of devices that we 245 00:12:21,040 --> 00:12:24,200 Speaker 3: can place within the aneurism, It doesn't really matter so 246 00:12:24,360 --> 00:12:26,480 Speaker 3: much as to how you accomplish it, as. 247 00:12:26,400 --> 00:12:28,600 Speaker 2: Long as you do accomplish it, accomplish it safely. 248 00:12:29,400 --> 00:12:33,079 Speaker 1: So well, you know, Kim Kardashian, she said that it 249 00:12:33,120 --> 00:12:36,480 Speaker 1: was the divorce stress that may have led to her aneurism. 250 00:12:36,800 --> 00:12:40,000 Speaker 1: I kind of rolled my eyes and chuckled at that 251 00:12:40,080 --> 00:12:43,160 Speaker 1: a little bit. Yes, I understand that chronic high blood pressure, 252 00:12:43,240 --> 00:12:47,000 Speaker 1: which in theory may come from you know, high cortisol 253 00:12:47,120 --> 00:12:50,440 Speaker 1: levels from chronic stress in your life, may result in 254 00:12:50,480 --> 00:12:52,840 Speaker 1: a brain aneurysm. But the truth of the matter is 255 00:12:53,400 --> 00:12:56,080 Speaker 1: her divorce probably did not cause her aneurysm. The fact 256 00:12:56,080 --> 00:12:58,120 Speaker 1: of the matter is she's a woman and she has 257 00:12:58,120 --> 00:13:01,240 Speaker 1: an autoimmune disease. Aren't those two in dependent risk factors 258 00:13:01,280 --> 00:13:02,479 Speaker 1: for brain aneurysms. 259 00:13:02,840 --> 00:13:05,120 Speaker 3: Well, I mean, I can tell you if the divorce 260 00:13:05,200 --> 00:13:08,000 Speaker 3: rate in the United States is approximately fifty percent, you know, 261 00:13:08,280 --> 00:13:11,920 Speaker 3: of married couples, we don't see nearly that many aneurysms. 262 00:13:12,000 --> 00:13:14,360 Speaker 3: So I don't know that divorce in and of itself 263 00:13:14,360 --> 00:13:17,560 Speaker 3: caused aneurism. I would eventually say divorce and of itself 264 00:13:17,600 --> 00:13:20,560 Speaker 3: did not cause aneurism. I think that, you know, one 265 00:13:20,600 --> 00:13:24,600 Speaker 3: of my colleagues back in back in la He taught 266 00:13:24,600 --> 00:13:26,600 Speaker 3: me this nice way of kind of breaking it down 267 00:13:26,640 --> 00:13:30,240 Speaker 3: for patients. There's modifiable and non modifiable risk fectives, things 268 00:13:30,280 --> 00:13:32,880 Speaker 3: that we can control modify, and things that we can't 269 00:13:32,880 --> 00:13:36,200 Speaker 3: control non modifiable. And you're right, actually being a woman 270 00:13:36,280 --> 00:13:38,360 Speaker 3: has a higher risk of having brain aneurism in men. 271 00:13:39,120 --> 00:13:41,080 Speaker 3: Being a woman has a higher risk of many medical 272 00:13:41,080 --> 00:13:46,120 Speaker 3: complications specifically related to unfortunately short end of the stick. 273 00:13:46,200 --> 00:13:48,400 Speaker 3: I apologize, but it is what it is. But being 274 00:13:48,400 --> 00:13:51,440 Speaker 3: a woman family history, right, so I know nothing about 275 00:13:51,480 --> 00:13:53,559 Speaker 3: her family history, but there either are some patients I 276 00:13:53,640 --> 00:13:56,600 Speaker 3: treat six of their family members because you know that 277 00:13:56,880 --> 00:14:00,000 Speaker 3: for certain family histories, certain genetic traits, there's a higher 278 00:14:00,080 --> 00:14:03,480 Speaker 3: risk of having a brain aneurism. Things like diabetes, high 279 00:14:03,520 --> 00:14:06,680 Speaker 3: blood pressure, cholesterol, you know, the sort of obvious things 280 00:14:06,720 --> 00:14:08,199 Speaker 3: in the sense things that are bad for the heart 281 00:14:08,240 --> 00:14:12,200 Speaker 3: are also bad for the brain. Certain substance abuse, cigarette smoking, 282 00:14:12,440 --> 00:14:19,400 Speaker 3: huge risk factor, huge modifiable risk factor for for aneurism, growth, 283 00:14:19,400 --> 00:14:24,160 Speaker 3: and aneurysm rupture. You know, certain illicit drug use like methamphetamine, cocaine, 284 00:14:24,120 --> 00:14:24,760 Speaker 3: stimulus like that. 285 00:14:24,840 --> 00:14:27,640 Speaker 2: Those are the those are some of the modifiable risk factor. 286 00:14:27,840 --> 00:14:32,520 Speaker 3: The unmodifiable age, gender, genetic predisposition that sort. 287 00:14:32,320 --> 00:14:35,960 Speaker 1: Of Obviously, from what I understand, I believe Kim Kardashian 288 00:14:36,080 --> 00:14:38,960 Speaker 1: was undergoing one of those kind of executive welleness scans 289 00:14:38,960 --> 00:14:41,480 Speaker 1: where they just scanned their entire body, which for the 290 00:14:42,040 --> 00:14:46,239 Speaker 1: general population has very expensive and we don't all necessarily 291 00:14:46,280 --> 00:14:49,360 Speaker 1: have Kardashian gender money. So for people out there who 292 00:14:49,400 --> 00:14:52,320 Speaker 1: are listening to this and essentially saying to themselves like, well, 293 00:14:52,320 --> 00:14:54,560 Speaker 1: how do I know maybe I have a brain aneurism, 294 00:14:55,120 --> 00:14:57,840 Speaker 1: what do you recommend for people who should be getting screened? 295 00:14:58,400 --> 00:15:01,600 Speaker 1: And where should we you know, the general population, what 296 00:15:01,640 --> 00:15:03,640 Speaker 1: should we do in terms of brain analysms. 297 00:15:03,920 --> 00:15:06,160 Speaker 2: That's I mean, that's a great fundamental question. 298 00:15:06,320 --> 00:15:10,680 Speaker 3: Yeah, I mean I do, oftentimes ingest somewhat say, yeah, 299 00:15:10,720 --> 00:15:13,480 Speaker 3: if anyone can get an MRI to look for brain aneurism, 300 00:15:13,600 --> 00:15:16,920 Speaker 3: why not, because sure, I mean, if you can find it, 301 00:15:17,320 --> 00:15:20,480 Speaker 3: and let's say, God forbid, let's say, you know, Kim 302 00:15:20,560 --> 00:15:23,960 Speaker 3: Kardashian's aneurism was a larger aneurism and she found it 303 00:15:24,000 --> 00:15:26,000 Speaker 3: and they treated it and she didn't have any complications 304 00:15:26,000 --> 00:15:29,040 Speaker 3: from the treatment, Well, yeah, she dodged a huge bullet there, right, 305 00:15:29,240 --> 00:15:31,360 Speaker 3: as do a lot of my other patients in such 306 00:15:31,400 --> 00:15:35,960 Speaker 3: a scenario. But in general, we identify certain people that 307 00:15:36,000 --> 00:15:38,920 Speaker 3: are higher risk for brain androalm. So family history is 308 00:15:38,920 --> 00:15:42,640 Speaker 3: a huge one. So and unfortunately a lot of families, 309 00:15:42,920 --> 00:15:46,320 Speaker 3: we don't know everyone's family history. I don't know every 310 00:15:46,400 --> 00:15:49,240 Speaker 3: member of my family's intimate family history. 311 00:15:49,520 --> 00:15:52,480 Speaker 1: But also but also with people with ruptured brain aneurism, 312 00:15:52,600 --> 00:15:55,000 Speaker 1: some people they just say they died of old age, 313 00:15:55,040 --> 00:15:56,720 Speaker 1: or they die a sudden death. They didn't have to 314 00:15:57,280 --> 00:15:59,360 Speaker 1: They don't know that it was actually a brain aneurism 315 00:15:59,400 --> 00:16:00,240 Speaker 1: in the coast front. 316 00:16:00,600 --> 00:16:02,840 Speaker 2: Or a stroke. People are, oh, Grandma died from a stroke? 317 00:16:02,880 --> 00:16:03,480 Speaker 2: What kind of stroke? 318 00:16:03,520 --> 00:16:06,200 Speaker 3: I have no IDEA stroke is a very big general term, 319 00:16:06,280 --> 00:16:08,680 Speaker 3: generalized term. It can mean a lot of different things 320 00:16:08,680 --> 00:16:10,280 Speaker 3: to a lot of different people myself. 321 00:16:10,200 --> 00:16:13,080 Speaker 1: And if a brain anaism ruptures, that could be called 322 00:16:13,240 --> 00:16:16,880 Speaker 1: that could cause what's called a hemorrhagic stroke. Right, people may. 323 00:16:16,840 --> 00:16:19,200 Speaker 2: Just as a hemorrhagic stroke. 324 00:16:19,480 --> 00:16:22,160 Speaker 3: And certainly, as you can imagine, based upon which generation, 325 00:16:22,240 --> 00:16:25,600 Speaker 3: in which decade that person suffered that event, who knows, right, 326 00:16:25,640 --> 00:16:28,360 Speaker 3: who knows what that was? So what I tell people 327 00:16:28,400 --> 00:16:30,560 Speaker 3: is you know family members that are families that have 328 00:16:30,640 --> 00:16:34,360 Speaker 3: two family members considering for either known brain aneurysms, a 329 00:16:34,360 --> 00:16:37,400 Speaker 3: condition called pecistic kidney disease, which is, you know, a 330 00:16:37,760 --> 00:16:40,000 Speaker 3: kidney disorder that carries a high rate of correlation with 331 00:16:40,040 --> 00:16:44,160 Speaker 3: brain aneurysms, or importantly, people that have had two family 332 00:16:44,240 --> 00:16:46,040 Speaker 3: members that have a history of bleeding in the brain, 333 00:16:46,640 --> 00:16:49,800 Speaker 3: brain aneurysms, or sudden death or died in their sleep. 334 00:16:50,400 --> 00:16:52,360 Speaker 3: Because there's only a couple of things that are caused 335 00:16:52,400 --> 00:16:55,520 Speaker 3: sudden death, and those couple of things are a massive 336 00:16:55,520 --> 00:16:58,560 Speaker 3: heart attack, it's not called a pulmonary embolism or a 337 00:16:58,640 --> 00:16:59,320 Speaker 3: rupture braining. 338 00:17:00,040 --> 00:17:02,000 Speaker 2: So let's say when I see. 339 00:17:01,760 --> 00:17:05,200 Speaker 3: A patient who's got a known aneurism, whether it's treatable 340 00:17:05,320 --> 00:17:09,040 Speaker 3: or not, doesn't require treatment, but they also have a 341 00:17:09,080 --> 00:17:11,879 Speaker 3: family history of oh, my aunt died in her sleep, 342 00:17:12,400 --> 00:17:16,760 Speaker 3: or my father went to work collapse suddenly died at 343 00:17:16,760 --> 00:17:18,639 Speaker 3: the age of fifty seven, and that was. 344 00:17:18,640 --> 00:17:20,480 Speaker 2: It, and we never did an autopsy. We just assumed 345 00:17:20,480 --> 00:17:21,200 Speaker 2: you had a heart attack. 346 00:17:21,960 --> 00:17:24,920 Speaker 3: What I encourage those patients' families to say is, well, 347 00:17:24,920 --> 00:17:27,600 Speaker 3: we know that patient X here in my office has 348 00:17:27,640 --> 00:17:31,879 Speaker 3: an aneurism, there is a family member that has sudden death. 349 00:17:32,760 --> 00:17:34,399 Speaker 2: Assume that was an aneurism. 350 00:17:34,720 --> 00:17:38,879 Speaker 3: Because now other people meet medical criteria for screening covered 351 00:17:38,880 --> 00:17:42,560 Speaker 3: by insurance the American Heart American Stroke Association's recommendations, or 352 00:17:42,560 --> 00:17:45,200 Speaker 3: that those patients should then be screened. And if they're 353 00:17:45,240 --> 00:17:48,199 Speaker 3: screened and it's like a mammogram, if they're screened and 354 00:17:48,240 --> 00:17:50,040 Speaker 3: it's normal, it doesn't mean they're not going to have 355 00:17:50,080 --> 00:17:53,200 Speaker 3: an aneurism today or in the future. Just me today 356 00:17:53,240 --> 00:17:54,680 Speaker 3: they don't have it. So they need to have a 357 00:17:54,760 --> 00:17:58,879 Speaker 3: routine screening on a regular interval. But if they end 358 00:17:58,960 --> 00:18:00,760 Speaker 3: up finding that they have an a at least they 359 00:18:00,800 --> 00:18:03,640 Speaker 3: have the option potentially doing something before it causes a major. 360 00:18:03,400 --> 00:18:05,840 Speaker 1: Problem, and doing something meaning you just watch it with 361 00:18:05,920 --> 00:18:09,399 Speaker 1: imaging see if it's growing it does. Just because you 362 00:18:09,400 --> 00:18:11,960 Speaker 1: have an aneurism doesn't mean you need surgery, you need 363 00:18:11,960 --> 00:18:12,600 Speaker 1: an intervention. 364 00:18:13,119 --> 00:18:14,880 Speaker 3: And I can't tell you the number of times I've 365 00:18:14,880 --> 00:18:17,000 Speaker 3: heard of some of my patient's family members say, yeah, 366 00:18:17,040 --> 00:18:18,800 Speaker 3: I spoke to my brother and he knows we come 367 00:18:18,840 --> 00:18:20,880 Speaker 3: from a high risk family, but he doesn't want. 368 00:18:20,800 --> 00:18:23,240 Speaker 2: To get screened. Why not? Knowledge is power? 369 00:18:23,600 --> 00:18:26,440 Speaker 3: Get screened, at least for your sake, for your kid's sake, 370 00:18:26,480 --> 00:18:29,080 Speaker 3: for your other family member's sake, get screened. Find out 371 00:18:29,160 --> 00:18:31,200 Speaker 3: that doesn't mean you have to commit to doing brain surgery. 372 00:18:31,240 --> 00:18:33,720 Speaker 3: Doesn't mean that you may need brain surgery, but at 373 00:18:33,800 --> 00:18:36,840 Speaker 3: least have that knowledge, have that power. Put yourself in, 374 00:18:37,280 --> 00:18:40,119 Speaker 3: you know, in the driver's seat for your own well being. 375 00:18:40,600 --> 00:18:43,360 Speaker 3: Some way you can make a conscientious decision that's appropriate 376 00:18:43,400 --> 00:18:45,959 Speaker 3: for you. Not knowing may not be the best answer, 377 00:18:46,080 --> 00:18:49,159 Speaker 3: you know, I think knowledge is key. Find out and 378 00:18:49,480 --> 00:18:51,440 Speaker 3: make the decision that's appropriate for you and your family. 379 00:18:51,520 --> 00:18:54,280 Speaker 1: I mean, I agree, obviously knowledge is power. More coming 380 00:18:54,320 --> 00:19:00,560 Speaker 1: up on Wellness Unmasked with doctor Nicole Sapphire, We're going 381 00:19:00,600 --> 00:19:02,439 Speaker 1: to put my radiologists cap on real quick as we 382 00:19:02,480 --> 00:19:04,760 Speaker 1: wrap this up. But people who were out there who 383 00:19:04,760 --> 00:19:07,320 Speaker 1: may have gotten a brain MRI for something else like 384 00:19:07,359 --> 00:19:09,520 Speaker 1: a headache, or a CT scan of their brain for 385 00:19:09,600 --> 00:19:11,919 Speaker 1: a car accident, just so you know, these will not 386 00:19:12,119 --> 00:19:15,800 Speaker 1: necessarily pick up brain aneurysms, especially if they're small. So 387 00:19:15,960 --> 00:19:18,960 Speaker 1: just because you've had a recent MRI or a CT 388 00:19:19,040 --> 00:19:21,600 Speaker 1: scan of your head and they didn't mention an aneurism, 389 00:19:21,600 --> 00:19:23,240 Speaker 1: that doesn't mean you don't have it. There's actually very 390 00:19:23,280 --> 00:19:27,480 Speaker 1: specialized sequences and images that neurosurgeons will order to look 391 00:19:27,480 --> 00:19:30,200 Speaker 1: at the vessels of the brain. That's why it's really 392 00:19:30,200 --> 00:19:33,200 Speaker 1: important if you consider yourself at higher risk for these 393 00:19:33,200 --> 00:19:36,640 Speaker 1: brain aneurysms, you talk to someone who specializes in them 394 00:19:36,680 --> 00:19:38,960 Speaker 1: so they can get you to the right thing. And 395 00:19:39,359 --> 00:19:43,440 Speaker 1: you know, again, I don't necessarily love these executive full 396 00:19:43,520 --> 00:19:47,399 Speaker 1: body wellness MRI scans because you know, we call them 397 00:19:47,480 --> 00:19:51,120 Speaker 1: incidental loomas. You do find a lot of incidental things. Now, 398 00:19:51,400 --> 00:19:54,880 Speaker 1: some things like a brain aneurysm, that's worth noting because 399 00:19:55,359 --> 00:19:58,000 Speaker 1: the risk with that is could be so detrimental that 400 00:19:58,080 --> 00:20:01,120 Speaker 1: you absolutely want to know if it's there. But oftentimes 401 00:20:01,160 --> 00:20:04,920 Speaker 1: these whole body MRIs just lead to more tests, sometimes 402 00:20:04,960 --> 00:20:10,400 Speaker 1: more invasive procedures, and it doesn't necessarily help the outcome. 403 00:20:10,520 --> 00:20:12,600 Speaker 1: I mean, that's just my that's just my opinion on 404 00:20:12,640 --> 00:20:15,919 Speaker 1: these whole breath or these whole that's the challenge. 405 00:20:15,960 --> 00:20:18,000 Speaker 2: You do kind of open up Pandora's box sometimes. 406 00:20:18,359 --> 00:20:22,200 Speaker 3: But in this particular case, in Kim Kardashian's case, Hey, 407 00:20:22,320 --> 00:20:24,119 Speaker 3: she now knows that she has a small aneurism. 408 00:20:24,160 --> 00:20:25,240 Speaker 2: She may not need to do anything. 409 00:20:25,240 --> 00:20:28,080 Speaker 3: But what I would tell her if I just met her, 410 00:20:28,320 --> 00:20:31,520 Speaker 3: you know, out and about which I find very unlikely 411 00:20:31,640 --> 00:20:33,920 Speaker 3: to happen. But if I happen to bump into her 412 00:20:34,200 --> 00:20:36,280 Speaker 3: at the supermarket, I would say, oh, yeah, you know, 413 00:20:36,480 --> 00:20:39,760 Speaker 3: you should really delve into your family history. Ask your mom, ask, 414 00:20:39,840 --> 00:20:42,320 Speaker 3: you know, find out if did somebody die suddenly and 415 00:20:42,359 --> 00:20:44,399 Speaker 3: they're sleep. Did they have a massive heart attack but no, 416 00:20:44,600 --> 00:20:46,080 Speaker 3: but no autopsy was performed. 417 00:20:46,160 --> 00:20:46,960 Speaker 2: Did someone have bleeding? 418 00:20:47,040 --> 00:20:49,480 Speaker 3: Because now, all of a sudden, her sisters should probably 419 00:20:49,480 --> 00:20:52,280 Speaker 3: be screened, you know, depending upon which parents side of 420 00:20:52,320 --> 00:20:53,040 Speaker 3: the family was on. 421 00:20:53,280 --> 00:20:55,560 Speaker 2: You know, other family members should be screened as well. 422 00:20:55,720 --> 00:20:57,639 Speaker 1: Based on the fact that just she has one. I mean, 423 00:20:57,680 --> 00:21:00,320 Speaker 1: do you think her siblings and her children at a 424 00:21:00,400 --> 00:21:02,960 Speaker 1: certain age should all be screened for brain aneurysms. 425 00:21:05,000 --> 00:21:08,440 Speaker 3: That's hard to say, you so, the official recommendation from 426 00:21:08,440 --> 00:21:11,479 Speaker 3: the American Heart and American Stroke Association is too family members. 427 00:21:12,240 --> 00:21:14,480 Speaker 3: But I always tell people someone's going to be number two, right, 428 00:21:14,800 --> 00:21:17,000 Speaker 3: So you know, it's hard to know. That's why I'm saying, 429 00:21:17,040 --> 00:21:19,280 Speaker 3: if there's a concern, if she's like, oh, yeah, I 430 00:21:19,280 --> 00:21:21,879 Speaker 3: spoke to my mom and maybe we'll see it on 431 00:21:21,880 --> 00:21:23,760 Speaker 3: the Kardashians one night. If she's like, oh, mom, did 432 00:21:23,800 --> 00:21:25,760 Speaker 3: you know what happened to grandma? Oh, Grandma just died 433 00:21:25,920 --> 00:21:27,679 Speaker 3: peaceful in heer, asleep at the age of seventy. But 434 00:21:27,760 --> 00:21:30,000 Speaker 3: you know, we don't know why. Maybe assume that was 435 00:21:30,000 --> 00:21:32,840 Speaker 3: a ruptured aneurysm, and now other people on that lineage 436 00:21:33,160 --> 00:21:33,960 Speaker 3: should be screened. 437 00:21:34,200 --> 00:21:37,080 Speaker 1: All right, Well, that's good advice, doctor Paul Sapphire. Also, 438 00:21:37,440 --> 00:21:40,000 Speaker 1: my husband, thanks so much for joining Wellness on MASS. 439 00:21:40,080 --> 00:21:43,040 Speaker 1: I'm so happy you came. This is an important conversation. 440 00:21:43,680 --> 00:21:46,680 Speaker 1: I'm sure a lot of people appreciated the advice. Thanks 441 00:21:46,680 --> 00:21:47,440 Speaker 1: so much for joining. 442 00:21:47,920 --> 00:21:48,679 Speaker 2: Thanks for having me. 443 00:21:49,280 --> 00:21:51,840 Speaker 1: I know talking about brain aneurysms can be scary, but 444 00:21:52,040 --> 00:21:54,560 Speaker 1: the good news is most people walking around do not 445 00:21:54,760 --> 00:21:57,679 Speaker 1: have brain aneurysms. In fact, only three to five percent 446 00:21:57,760 --> 00:22:01,600 Speaker 1: of the population has a brain annuals And of all 447 00:22:01,640 --> 00:22:05,040 Speaker 1: of those brain aneurisms out there, only about one to 448 00:22:05,080 --> 00:22:08,480 Speaker 1: two percent of those rupture every single year. So please 449 00:22:08,520 --> 00:22:11,240 Speaker 1: don't walk away from this podcast being scared. But it's 450 00:22:11,240 --> 00:22:14,480 Speaker 1: always good to have knowledge about risk. Like if you're 451 00:22:14,480 --> 00:22:17,040 Speaker 1: at high risk for breast cancer, you probably need more 452 00:22:17,080 --> 00:22:19,840 Speaker 1: than mammograms looking for breast cancer. If you have a 453 00:22:19,880 --> 00:22:24,359 Speaker 1: family history of brain aneurisms or questionable histories of sudden death, 454 00:22:24,359 --> 00:22:27,520 Speaker 1: as you heard my husband say, you should consider being 455 00:22:27,560 --> 00:22:30,600 Speaker 1: screened for brain aneurisms. Chances are you don't have them. 456 00:22:30,640 --> 00:22:34,040 Speaker 1: Statistically speaking, you don't have one. But if you do 457 00:22:34,160 --> 00:22:37,359 Speaker 1: have one, albeit if it's tiny, you'll just monitor it. 458 00:22:37,720 --> 00:22:40,240 Speaker 1: If it's bigger, you want to make sure someone like 459 00:22:40,320 --> 00:22:44,879 Speaker 1: an endovascular neurosurgeon like my husband intervenes before it ruptures, 460 00:22:45,040 --> 00:22:49,040 Speaker 1: because rupturing is worst case scenario. And for the Kardashian 461 00:22:49,119 --> 00:22:51,240 Speaker 1: Jenner clan, I mean you heard it here on Wellness 462 00:22:51,240 --> 00:22:54,760 Speaker 1: and MASS, it's possible that all the siblings and maybe 463 00:22:54,760 --> 00:22:58,679 Speaker 1: even Kim Kardashian's kids should be screened for brain aneurisms 464 00:22:58,720 --> 00:23:00,640 Speaker 1: in the future. You have to kind of to dig 465 00:23:00,720 --> 00:23:03,600 Speaker 1: deep into that family history and see. At the end 466 00:23:03,600 --> 00:23:06,560 Speaker 1: of the day, knowledge is power, and you are the 467 00:23:06,680 --> 00:23:10,600 Speaker 1: quarterback of your healthcare team. You know your body, you 468 00:23:10,720 --> 00:23:13,240 Speaker 1: know your family better than anyone else, and you're going 469 00:23:13,280 --> 00:23:15,480 Speaker 1: to do what's right for you. Thanks so much for 470 00:23:15,560 --> 00:23:18,840 Speaker 1: listening to Wellness on MASS. I'm doctor Nicole Saffire. Make 471 00:23:18,880 --> 00:23:23,760 Speaker 1: sure you get your podcasts on Apple Podcasts, iHeartRadio, or 472 00:23:23,760 --> 00:23:25,920 Speaker 1: wherever you listen to your podcasts, and we will see 473 00:23:25,920 --> 00:23:26,480 Speaker 1: you next time.