Brain aneurysms are more likely to rupture if they are growing even if they are small, a new study in Radiology reports. Aneurysms of 7 mm or more are the size where the benefits of treatment generally outweigh the risks of rupture, based on earlier studies. This had been interpreted that size alone is determinative of rupture risk. But ones that grow in size over time are at even greater risk for rupture, regardless of size. This means that all aneurysms of any size need to be followed. If they are growing, then treatment needs to be considered. Monitoring can be done by annual CT examination which is readily available and not cost prohibitive.
Whole body cooling reduces brain damage from oxygen deprivation during birth and can lessen death and disability rates for these infants. A study of the use of hypothermia therapy (reduced body temperature) for babies with a gestational age of 36 weeks or more and who had severe asphyxia during birth was performed. Infants were randomly assigned to normothermia or hypothermia, and neurodevelopmental outcomes were assessed at 18 to 22 months of age. Without hypothermia, infants with severe encephalopathy have a 60% chance of death and those that survive are handicapped. Reductions in brain temperature provide neuroprotection when assessed in animal experiments. The use of whole body cooling initiated within 6 hours of a birth and continued for 72 hours was studied. The results showed a decrease in death from 62% to 44% with hypothermia. The incidence of disabling cerebral palsy decreased from 30% to 19%.