The singer and psychologist Josiane Belizário de Oliveira, better known as Josy Oliveira, died this Saturday (4), aged 43. She, who participated in “Big Brother Brasil 9”, suffered a stroke (cerebrovascular accident) during surgery to treat an aneurysm, diagnosed last year.
What is an aneurysm?
The disease is characterized by an abnormal dilation of a blood vessel caused by the weakening of the walls of the vein or artery. The problem is usually caused by trauma or vascular disease, but it may have an important genetic component.
Dilation is like a “bladder” that forms in the vessel wall and, as the internal pressure increases, it can rupture and cause a hemorrhagic stroke.
The most common is that, before bursting, the aneurysm is asymptomatic and is only discovered in routine exams or by chance. When it breaks, the most common sign is a severe headache, but it can also present mental confusion.
Can you treat?
Yes. All cases can be resolved surgically, it is difficult to have a case where it is not possible to operate. However, depending on the location of the aneurysm, it may be easier or more difficult to access.
The non-surgical treatment option would be a procedure called cerebral embolization, in which a catheter placed through access in the groin or arm reaches the dilated point of the vessel and fills the area with microscopic metal wires or springs, preventing the vessel from suffering with the blood pressure in that region.
Depending on the size and location, another choice might just be to monitor the frame. If this is the option, it is possible to lead a relatively normal life with the problem, but it is important to remember that the aneurysm can rupture during situations that require effort from the body, such as physical activity, sexual intercourse or even when pooping — one of the Preventive measures for those who live with the problem is to use laxatives to facilitate the elimination of feces without the need to exert much force.
What if the aneurysm ruptures?
In the case of a ruptured aneurysm, you need to measure the amount of blood that has leaked into the brain. The index ranges from 1 to 4, the highest value being indicative of greater severity. Ideally, the treatment should be done within 24 hours after the rupture, as brain inflammation is less and the chances of a successful surgery are greater.
After this period, the brain suffers from vasospasm, a defense reaction of the common organ after hemorrhage in which there is a kind of narrowing of the cerebral arteries. This reaction usually starts between the second and third day after the breakup and can continue until the tenth day after the breakup.
This condition is one of the leading causes of death after a ruptured aneurysm. In addition, surgery during this period is more complex, as it can lead to complications caused by vasospasm. The ideal, then, is to keep intracranial and blood pressure under control during this period until it is safe to operate again.
*With information from articles published on 9/26/2019 and 12/12/2019.