Speaking of brain scans
http://wcco.com/health/brain.scan.ab....2.479876.html
* Oct 31, 2007 10:10 pm US/Central
Brain Scan Abnormalities Not Uncommon
ATLANTA (AP) One in 60 older people may be walking around with benign
brain tumors and don't know it. Even more may have bulging blood vessels
in the head that could burst. These results come from a surprising new
Dutch study that finds brain abnormalities are not all that uncommon.
It's not clear how alarming this is. Most of the abnormalities hadn't
caused any symptoms, though some were potentially life-threatening.
But the findings may have implications for patients in the future: As more
of these abnormalities are spotted with more sophisticated equipment
during routine medical tests, some doctors may urge patients to have
surgery or other treatment as a precaution. Or some patients may push
doctors to fix the potential problem.
"It's very scary to learn there's something wrong in your head," said Dr.
Aad van der Lugt, an associate professor in radiology at Erasmus MC
University Medical Center in Rotterdam and a co-author of the study
published in Thursday's New England Journal of Medicine
The study is based on MRI, or magnetic resonance imaging scans of 2,000
healthy adults with an average age of 63. They were participating in a
study to look at the causes and consequences of age-related brain changes.
The new paper's findings were incidental to the main research.
Participants who needed additional evaluation or treatment were referred
to specialists. None of the brain tumors spotted by the MRIs required
surgery, the researchers said.
Scans are increasingly being used, raising the chances that abnormalities
will be spotted. About 20 million MRIs are done worldwide each year on the
head, according to GE Healthcare, which makes scanners.
Even so, physicians do not recommend routine MRIs to look for brain
problems in the way that people now get mammograms or colonoscopies.
"There's no evidence that screening MRIs of the brain are valuable," said
Dr. Carolyn Meltzer, chairman of radiology at the Emory University School
of Medicine.
The Dutch scientists found that 145 people — or 7.2 percent — had some
dead brain tissue caused by a loss of blood flow. These are sometimes
called silent strokes and usually don't result in a loss of speech or
motion.
However, a patient who's had a silent stroke may be more likely to have
another, more serious stroke, said Dr. Greg Joseph, a Charlotte, N.C.,
neuroradiologist who is part of a doctors group that reads 100 brain scans
a day. Finding silent strokes allows doctors to prescribe medications or
other measures that could prevent future problems, he said.
Another 32 people in the study — or 1.6 percent — had brain tumors. All
but one were non-cancerous, but even benign tumors can kill if they grow
and shut down vital brain functions. Doctors sometimes treat these, or do
annual MRI scans to watch for signs of growth.
Another 35 people — or 1.8 percent — had bulging blood vessels, called
aneurysms. Blood vessels that burst can cause serious strokes. However,
all but five aneurysms found in the study were small and not considered
dangerous.
The Dutch participants were mostly white, middle class and healthy;
whether the same brain abnormalities would be found in other groups of
people isn't known, the researchers said.
In brain scans to investigate headaches or other problems, it's not
unusual to find a small percentage of unexpected abnormalities. But the
new study — one of the largest of its kind which used a state-of-the-art
MRI scanner — gives perhaps the best estimate of how often these occur in
the general public, said Judy Illes, a University of British Columbia
professor who has written extensively on the topic.
One person who is glad she had an MRI is Seattle physician Sarah
Hilgenberg. Five years ago, as a 24-year-old medical student, she joined a
study in which participants got an MRI brain scan in exchange for $40.
That afternoon, while peeling apples at her kitchen sink, she got a call
saying a problem had been spotted. More tests revealed a spider web of
blood vessels over an eye that doctors feared could burst. They placed a
kind of glue in the blood vessels and then removed the tangle in surgery.
The risky treatment could have killed her, but she is fine now and did not
want to live in fear of a fatal brain bleed.
"In the end, I feel very lucky that it happened," she said of the original
scan.
Speaking of brain scans - Brain Scan Abnormalities Not Uncommon 
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