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Dr. Dre’s Brain Aneurysm | MedPage Today

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A photo of Dr. Dre.

Rapper and entrepreneur Dr. Dre, 55, was hospitalized earlier this month after suffering symptoms related to a brain aneurysm. He was taken by ambulance to Cedar Sinai hospital in Los Angeles where he was admitted to the intensive care unit. The next day, he was reported to be “lucid” and shared an update on Instagram: “Thanks to my family, friends and fans for their interest and well wishes. I’m doing great and getting excellent care from my medical team. I will be out of the hospital and back home soon. Shout out to all the great medical professionals at Cedars. One Love!!”

Dr. Dre, born Andre Romelle Young, first came to national prominence in the late 1980s when he joined with fellow rappers Ice Cube (O’Shea Jackson) and Eazy-E (Eric Lynn Wright) to form the iconic group N.W.A. The group’s first full album “Straight Outta Compton” became a major success, despite an almost complete absence of radio airplay or major concert tours. He went on to become a solo artist, co-owner of Death Row Records, and producer for other rappers including Snoop Dogg, Warren G, LL Cool J, Jay-Z, and Eminem.

In 2008, Dr. Dre released his first brand of headphones, Beats by Dr. Dre. In 2014, Apple purchased the Beats brand for $3 billion.

In 2013 Dr. Dre and Jimmy Iovine donated $70 million to the University of Southern California to create the USC Jimmy Iovine and Andre Young Academy for Arts, Technology and the Business of Innovation. Its goal is “to shape the future by nurturing the talents, passions, leadership and risk-taking of uniquely qualified students who are motivated to explore and create new art forms, technologies, and business models.”

In 2017, Dr. Dre committed $10 million to help build a performing arts center for the new Compton High School.

What is a brain aneurysm?

A cerebral aneurysm (or brain aneurysm) is a weak or thin area on an artery in the brain that balloons or bulges out and fills with blood. Aneurysms typically form at branch points in arteries because these sections are the weakest. A bulging aneurysm can put pressure on the nerves or brain tissue. It may also burst or rupture, spilling blood into the surrounding tissue. Cerebral aneurysms can occur anywhere in the brain, but most form in the major arteries along the base of the skull.

Brain aneurysms can occur in anyone and at any age. They are most common in adults between the ages of 30 and 60 and are more common in women than in men. People with certain inherited disorders are also at higher risk.

All cerebral aneurysms have the potential to rupture and cause bleeding within the brain or surrounding area. Approximately 30,000 Americans per year suffer a brain aneurysm rupture. Much less is known about how many people have cerebral aneurysms, since they don’t always cause symptoms. There are no proven statistics but a consensus of scientific papers indicate that between 3 and 5 percent of Americans may have an aneurysm in their lifetime.

What are the symptoms?

Most aneurysms are small — about 1/8 inch to nearly one inch — and an estimated 50%-80% of all aneurysms do not rupture. Most do not show symptoms until they either become very large or rupture.

A larger aneurysm that is steadily growing may press on tissues and nerves causing:

  • Pain above and behind the eye
  • Numbness
  • Weakness
  • Paralysis on one side of the face
  • Dilated pupil in the eye
  • Vision changes or double vision

Ruptured aneurysm

When an aneurysm ruptures, one always experiences a sudden and extremely severe headache (e.g., the worst headache of one’s life) and may also develop:

  • Double vision
  • Nausea
  • Vomiting
  • Stiff neck
  • Sensitivity to light
  • Seizures
  • Loss of consciousness (brief or prolonged)
  • Cardiac arrest

Leaking aneurysm

Sometimes an aneurysm may leak a small amount of blood into the brain (called a sentinel bleed). Sentinel or warning headaches may precede rupture by days or weeks. However, only a minority of individuals have a sentinel headache prior to rupture.

What is the Treatment?

Not all cerebral aneurysms require treatment. Some very small unruptured aneurysms that are not associated with any factors suggesting a higher risk of rupture may be safely left alone and monitored with MRA or CT angiogram to detect growth. It is important, however, to aggressively treat co-existing medical problems and risk factors.

Treatment considerations for unruptured aneurysms include the type, size and location of the aneurysm, the risk of rupture, and the patient’s age and health and family medical history. Individuals can also reduce their risk through blood pressure control, smoking cessation, and avoidance of cocaine and other stimulant drugs.

Surgery

There are a few surgical options available for treating cerebral aneurysms. These procedures carry some risk such as possible damage to other blood vessels, the potential for aneurysm recurrence and rebleeding, and risk of stroke.

One approach is microvascular clipping, which involves cutting off the flow of blood to the aneurysm and requires open brain surgery. A doctor will locate the blood vessels that feed the aneurysm and place a tiny, metal, clothespin-like clip on the aneurysm’s neck to stop its blood supply. Clipping has been shown to be highly effective, depending on the location, size, and shape of the aneurysm. In general, aneurysms that are completely clipped do not recur.

Endovascular treatment

Platinum coil embolization is a less invasive procedure than microvascular surgical clipping. A doctor will insert a catheter into an artery, usually the femoral artery, and thread it through the body to the brain aneurysm. Using a wire, the doctor will pass detachable platinum coils through the catheter and release them into the aneurysm. The coils block the aneurysm and reduce the flow of blood into the aneurysm. The procedure may need to be performed more than once during the person’s lifetime because aneurysms treated with coiling can sometimes recur.

Alternatively, flow diversion devices may be employed, such placing a small stent, like those used for heart blockages, in the artery to reduce blood flow into the aneurysm. A doctor will insert a catheter into an artery, usually the femoral artery, and thread it through the body to the artery on which the aneurysm is located. This procedure is used to treat very large aneurysms and those that cannot be treated with surgery or platinum coil embolization.

Research

Genetics: Scientists have long known about the link between cerebral and aortic aneurysm. However, they still do not fully understand the relationship between the two types of aneurysm. Recent genome-wide association studies (GWAS) provide molecular evidence for shared biological function and pathophysiology of these aneurysms. A specific site on chromosome 9 has been identified as increasing the risk for both cerebral and aortic aneurysms. This GWAS data, along with linkage data to other susceptible locations for genes or DNA sequences, indicate that individuals and families harboring one type of aneurysm may be at especially increased risk of the other.

Diagnostic tools: Cerebral aneurysms located at the posterior communicating artery and in the arteries in the back part of the brain (the vertebral and basilar arteries) are common and have higher risk of rupture than aneurysms at other locations. With federal funding, scientists are working to identify the features associated with rupture and use these factors to build a scoring scale to guide and support clinical decisions.

The risk of having an aneurysm burst is difficult to determine and there can be serious complications from surgical treatments. Researchers are developing a new model that uses imaging to detect brain aneurysms at high risk for rupture. Not only would this new tool be less invasive but would also allow for people to be treated before an aneurysm bursts.

Hormones and medications: Studies indicate aspirin lessens inflammation in cerebral aneurysms and reduces the risk of rupture. However, aspirin also inhibits platelets, which are important in stopping bleeding once a rupture occurs. Researchers are using mouse models to examine how inflammation influences the formation and rupture of cerebral aneurysms, and the molecular mechanisms that contribute to the protective effect of aspirin.

Cerebral aneurysms and subarachnoid hemorrhage are more common in postmenopausal women than in men. Estrogen replacement therapy reduces the risk for subarachnoid hemorrhage in post-menopausal women. Researchers are investigating exactly how estrogen protects women against developing aneurysms. They hypothesize protection primarily occurs through inflammatory cells.

(Sources: the National Institute of Neurological Disorders and Stroke and the Brain Aneurysm Foundation)

Michele R. Berman, MD, and Mark S. Boguski, MD, PhD, are a wife and husband team of physicians who have trained and taught at some of the top medical schools in the country, including Harvard, Johns Hopkins, and Washington University in St. Louis. Their mission is both a journalistic and educational one: to report on common diseases affecting uncommon people and summarize the evidence-based medicine behind the headlines.

Last Updated January 12, 2021



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