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Thursday, November 29, 2018

Ambulances Get New Home at NCB Hospital


HEALTH- NYC Health + Hospitals/North Central Bronx celebrated the opening of two newly designated ambulance bays.


Directly adjacent to the emergency room, the additional bays were created to ensure dedicated parking spaces for ambulances dispatched to NYC Health + Hospitals/North Central Bronx. 

Hospital administrative and clinical leaders were joined by representatives from the New York City Fire Department Bureau of Emergency Medical Services, which controls the operation of all ambulances in the New York City 911 system, and elected officials in cutting the ribbon on the two new bays, which, combined with the existing two bays, doubles ambulance capacity.

When ambulances bring patients to the hospital, the duties of their emergency medical technicians (EMTs) take time. The EMTs come into the emergency department to provide a report on the patient to the clinical staff and to answer any related questions. They also often need to hose down stretchers and clean out the ambulance to prepare it for the next patient.

Typically, an ambulance may occupy a bay for 15 to 30 minutes. In the past, when the hospital’s two ambulance bays were occupied, EMTs would need to take their patients to another hospital where the ambulances could park. The added capacity will allow more patients to get emergency care at NYC Health + Hospitals/North Central Bronx.
“These spaces were designated specifically to provide FDNY and other ambulance providers increased access to our emergency room,” said Cristina Contreras, executive director of NYC Health + Hospitals/North Central Bronx. “The additional ambulance access will be reassuring to the north Bronx community. It’s just another way we are working to engage, encourage, and empower our patients to live their healthiest lives.”

“With these new ambulance spaces, the hospital is making a positive impact in the emergency medical care FDNY members provide,” said FDNY Fire Commissioner Daniel A. Nigro. “Every second matters when transporting a patient to the emergency room, and these spaces will provide greater and quicker access for our members as they care for their most critical patients.”

“In the first few weeks since our soft launch, we have already seen a dramatic decrease in the number of times ambulances are diverted from NYC Health + Hospitals/North Central Bronx because there was previously not enough room for them to park,” said Dr. Mark Melrose, chief of emergency services at the hospital. “As a result of this change, we will see more patients arriving by ambulance, and that is a win for everyone.”

“I’m extremely excited about the ambulance bay expansion at NYC Health + Hospitals/North Central Bronx,” said New York State Senator Jamaal Bailey. “This will provide even greater capacity and better access for the hospital to admit patients and provide even more incredible service to Bronx residents, specifically the Norwood/Bedford Park section. Congratulations to the leadership of Christina Contreras and Christopher Mastromano and the entire hospital staff for this and providing excellent care to the community.”

“I am excited to see these two new ambulance bays next to the emergency room at NYC Health + Hospitals/North Central Bronx,” said Assemblywoman Nathalia Fernandez. “Providing easier access to FDNY and ambulance providers to emergency rooms will be greatly beneficial to our community, and I’m proud that the investment has been made here in the Bronx.”

“We must ensure that our community always has access to immediate medical attention, so it is important that we designate more space for emergency service vehicles,” said New York Council Member Andrew Cohen. “I know that in critical times these new ambulance bays will have a major impact. I am thrilled that NYC Health + Hospitals/North Central Bronx Hospital is committed to offering high caliber services while expanding to meet the needs of our growing community.”


Wednesday, November 28, 2018

Lincoln Nurse Honored for Caring for Diabetes Patients


HEALTH- NYC Health + Hospitals honored six nurse professionals from across the public health care system, as part of its annual Nursing Excellence Awards celebration. The awardees are nurse trailblazers who demonstrate leadership in various capacities.


“While our nurses work in various specialties and provide care in a wide range of settings, they share a common characteristic: a deep commitment to the New Yorkers who seek our care,” said Mitchell Katz, MD, president and chief executive officer of NYC Health + Hospitals.

“Our nurses are at the heart of our mission to care for every New Yorker without exception. They are also at the frontlines of health, delivering the patient-centered, collaborative, community-based care that will help us succeed in the future. I cannot thank them enough for the work they do.”

One hundred fifty-nine nurses from across the health system were nominated by their colleagues in honor of their valued achievements and commitment to providing the best possible care and experience for our patients. The nurses honored today are among the 8,000 nurses at NYC Health + Hospitals—women and men who provide care around the clock each day for New York City through our hospitals, post-acute care centers, community health centers and neighborhood clinics, home care, and the correctional health system, throughout the five boroughs.

“Our Nursing Excellence honorees embody NYC Health + Hospitals’ guiding principles by always keeping patients first and pursuing excellence in clinical, educational, leadership, and service aspects of the profession,” said Mary Anne Marra, DNP, MSN, RN, NEA-BC, interim chief nursing officer for NYC Health + Hospitals. “These nurses exhibit various talents all put to use to demonstrate a commitment to providing the best possible care and experience for every patient, every time.”

When my patient makes good progress and improves, and realizes self-improvement, I am most proud,” said Tsae Jiang Su, RNC, who is recognized for being a bundle of energy, passion, and expertise. 

At NYC Health + Hospitals/Lincoln since 1993, Ms. Su provides care to around 20 patients each day, providing critically important diabetes management and lifestyle changes to every individual she sees. In the South Bronx, diabetes affects a disproportionate share of the community.

Ms. Su’s diabetes patients are always energized and as excited as she is to see them. Due to her dedication and creativity, patients learn to manage diabetes through interactive projects, guest speakers, neighborhood and celebrity chefs, the Lincoln Greenmarket’s weekly visits, and healthy cooking events. Her ready smile, easy laughter, and obvious love of her patients pull them close to her.

As a Nurse Supervisor, Ms. Su partners with endocrinologists and the hospitalist to adjust insulin and oral medication regimens for patients. She also works collaboratively with a multidisciplinary diabetes team to perform a thorough assessment of each patient and establish an education plan to assist in the management of their disease.

Ms. Su earned her Bachelor of Nursing from Taiwan Nursing College.

The 2018 Nursing Excellence Awards program is available in its entirety at https://www.nychealthandhospitals.org/nursing-excellence.


Jacobi Hailed for #Cancer Treatment



HEALTH- The Commission on Cancer, a quality program of the American College of Surgeons, has granted three-year accreditation With commendation to the cancer program at NYC Health + Hospitals/Jacobi.


To earn voluntary Commission on Cancer accreditation, a cancer program must meet or exceed its quality care standards, be evaluated every three years through a survey process, and maintain levels of excellence in the delivery of comprehensive patient-centered care. 

Three-year accreditation with silver-level commendation is awarded only to a facility that exceeds standard requirements at the time of its triennial survey. 

As a Commission on Cancer-accredited cancer center, NYC Health + Hospitals/Jacobi takes a multidisciplinary approach to treating cancer as a complex group of diseases that requires consultation among surgeons, medical and radiation oncologists, diagnostic radiologists, pathologists, and other cancer specialists. This multidisciplinary partnership results in improved patient care.

The accreditation with commendation is the result of over a year of training, coordination, and collaboration among many members of the care team at NYC Health + Hospitals/Jacobi. The hospital received special commendation for several standards, including:
Oncology Nursing Care – More than 25 percent of the nursing staff is certified in cancer care. 

Patient Enrollment in Clinical Trials – The cancer programs at NYC Health + Hospitals/Jacobi enroll 10 percent or more cancer patients in clinical trials. Because patient access to the kinds of cutting-edge treatment available through clinical trials can benefit both current and future cancer patients, a screening process has been developed to track effectiveness.

Public Reporting of Outcomes – The Community Advisory Board of NYC Health + Hospitals/Jacobi reports on participation in screening and prevention activities. 
“Our entire team worked very hard to achieve this important designation,” said Tarek Elrafei, MD, chair of NYC Health + Hospitals/Jacobi’s Oncology Department. 

The Commission on Cancer Accreditation Program provides the framework for facilities to improve quality of care through various programs that focus on the full spectrum of cancer treatment and encompass prevention, early diagnosis, cancer staging, optimal treatment, rehabilitation, life-long follow-up, and end-of-life care. When patients receive care at a Commission on Cancer facility, such as NYC Health + Hospitals/Jacobi, they also have access to information on clinical trials and new treatments, genetic counseling, and patient-centered services, including psycho-social support, a patient navigation process, and a survivorship care plan that seeks to improve cancer survivors’ quality of life. 

The new accreditation builds on earlier third-party validation of the exceptional cancer care available at the hospital, including from the American College of Surgeons’ National Accreditation Program for Breast Centers, which has recognized the hospital’s Breast Health Service as a “Center of Excellence,” and from the American College of Radiology, which has bestowed multi-year recognition of the service as a “Breast Imaging Center of Excellence.” 

The hospital’s Breast Health Service performs more than 12,000 mammograms each year and provides treatment and care for more than 1,600 patients annually.

If you or someone you know has been diagnosed with cancer and is looking for extraordinary care, please call 718-918-4318. 

Tuesday, November 27, 2018

Keep Chronic Inflammation in Check with Your Diet



HEALTH- Inflammation isn’t always a bad thing—it’s an effective tool that your body uses to get you to pay attention, whether to a blister or bursitis. But when inflammation becomes chronic, it goes beyond helpful.


In fact, numerous studies have found that it may play a serious role in a wide variety of diseases including heart disease and stroke. 

The good news is? “The same practices that keep your heart in good shape can help you to reduce your chances of developing chronic inflammation and reduce inflammation already present: get regular exercise, improve sleep, don’t smoke, adequate hydration and eat right,” says registered nurse Constance Washington with VNSNY CHOICE Health Plans. 

VNSNY CHOICE, a special plan from the not-for-profit Visiting Nurse Service of New York, was created especially for New York seniors who are eligible for Medicaid and/or Medicare and want to live independently in their own homes as they face the challenges of getting older, instead of moving into a nursing home.

“Many of the members I care for find eating healthy meals a challenge—especially those who live alone,” says Washington. “I spend time on the phone with each person and their personal care workers helping them better understand the importance of eating a balanced diet which is vital for good health and overall well-being. Personal Care Workers often help with grocery shopping and food preparation, which really helps members with adopting new and healthier habits.”

To reduce inflammation and improve health in general, here are four tips that Washington shares with her patients:

1) Up the Produce Factor
Shoot for two cups (or two pieces) of fruit and two to three cups of vegetables or more every day.  

Those that are high in pigments called carotenoids – such as carrots, sweet potatoes, tomatoes, bell peppers and dark green leafy vegetables (spinach, kale & collard greens) – are particularly beneficial.  

Deep red or purple grapes, berries and beets also are excellent choices, but all fruits and veggies will add to your anti-inflammation arsenal. According to a 2001 Harvard University study, just one extra serving a day can reduce your risk of heart disease by four percent.

2) Get Omega Smart

When it comes to fats, the right balance of omega-3 and omega-6 fatty acids can help to reduce inflammation. How can you find the right balance? Washington says to cut back on processed and fast foods which can be high in omega-6’s and focus on increasing omega-3’s found in fatty fish such as salmon, sardines, tuna and mackerel, or vegetarian sources such as walnuts, almonds, flax seeds and cruciferous vegetables such as cauliflower, cabbage, garden cress, bok choy, broccoli, brussels sprouts.  

3)  Eliminate Trans Fats

This type of fat is abundant in processed and fried foods. It increases foods shelf life and boosts flavor. However, it also clogs arteries, contributes to weight gain and causes inflammation. Avoid crackers, cookies or other packaged baked goods (or stay well within portion sizes) and limit fried foods or those made with hydrogenated oils. 

To find delicious heart-healthy recipes for Quick Lasagna, Fruit Muffins, Oven Barbequed Chicken and other favorites, visit http://www.cooks.com/rec/

4) Go with the Grain

Whole grains are packed with compounds that can help protect against disease, and they’re teaming with B and E vitamins, minerals like iron and magnesium, and fiber—all of which are great at holding off inflammation and promoting cardiovascular health.
For more information about VNSNY CHOICE Health Plans from the Visiting Nurse Service of New York, please call 1-866-469-7774 or visit www.VNSNYCHOICE.org.  
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Friday, November 23, 2018

Diabetes and Your Neighborhood


1 in 5 in the Bronx have Diabetes

BySandra ArĂ©valo, MPH, RDN, director, Nutrition Services and Outreach at Community Pediatrics, 

HEALTH- In the United States today, diabetes affects 9.4% of the population, over 30.3 billion people. Do you think that is a lot? Consider the Bronx, NY, where diabetes affects up to 15% of the population.

That means that almost 1 in 5 individuals in the Bronx have diabetes.

Diabetes is a chronic condition characterized by high sugar levels in the blood. There are different types of diabetes. The most common is type 2 diabetes. It is caused by resistance to insulin, which is the hormone that regulates your blood sugar levels. Diabetes is the leading cause of blindness, kidney disease, and amputations. It also puts you at higher risk for cardiovascular disease including heart attacks and strokes. The good news is that many consequences are preventable if diabetes is diagnosed and treated timely and effectively. 

Diabetes disproportionally impacts blacks and Latinos. In the Bronx about 80 of the population falls into these categories. Risk factors for diabetes include obesity, low income, lack of exercise, high levels of stress, lack of healthy foods in your diet such as an abundance of vegetables and fruits, and family history of diabetes.

Lack of money, as well as many other stressors such as legal issues, lack of child care, taking care of a sick family member, unemployment, divorce, etc. bring stress into the picture as well. High levels of stress generate resistance to insulin. This means that when you are stressed your insulin doesn’t work properly and your sugar levels can rise above the normal and cause diabetes. 

If you suffer from diabetes or if you think you are at risk for diabetes you should visit your health care provider and ask to have your Hemoglobin A1c, or A1c, checked. The A1c is a blood test that will indicate how your blood sugars have been in average for the past 3 months. If your A1c is lower than 5.7 you have nothing to worry about. If your A1c is 6.4 and above, you need to get further testing to confirm if you have diabetes. If you have an A1c in between 5.7 and 6.4 you might have pre-diabetes. Pre-diabetes is a condition in which your sugars are not high enough to be diagnosed with diabetes but if you don’t take care of yourself you could get diabetes. In the United States 34% of individuals have pre-diabetes - that is about 84.1 million adults. 

What you didn’t know about diabetes. 
But not all is dark in the picture. Being aware of your A1c and the factors that cause diabetes is a good start. If you want to better manage your diabetes or if you have pre-diabetes you can join free and fun classes that help you with both. These classes not only teach you about diabetes but most importantly they help you set goals towards a healthier you. They cover nutrition education, and share exercise and stress management tips that you can actually do. Montefiore Hospital offers classes in different locations. For more information call 718-991-0605 or 781-920-4011.

If you know that you don’t eat well and you want to eat better you are not alone. In the Bronx there are many resources that can help you achieve your dietary goals. Eating a half of a plate of fruits and vegetables with your lunch and/or dinner every day makes a huge difference in your weight and sugar levels. Non-starchy vegetables such as spinach, kale, carrots, cucumbers, string beans or okra provide lots of dietary fiber, vitamins and minerals that can help lower your sugar levels.

If vegetables aren’t in your budget, reach out to your health care provider and ask if they have Health Bucks available. Health Bucks are $2 coupons that you can use at the Farmers Markets. Different health centers in the community, including Montefiore clinics, have partnered with the Department of Health to be able to distribute Health Bucks among their patients.  City Harvest also has two markets in the Bronx and is offering free fresh fruits and vegetables to families in the community twice a month for a year. The Melrose Mobile Markets are held at 286 E 156th Street, at the Classic Center every 2nd Saturday & 4th Wednesday of each month from 9:30 am – 11:30 am. The St. Mary’s Mobile Markets are held in the parking lot adjacent to 595 Trinity Avenue every 2nd Saturday & 4th Tuesday of each month from 9:30 am – 11:30 am. 

To learn if you qualify call City Harvest at 646.412.0600. 

If what you need is exercise but you can’t afford a gym membership? Consider joining Shape Up New York. This is a program from the Department of Health that offers an array of fitness activities for adults and families. From Zumba, to swimming, yoga and cross training there are programs for everyone. These programs are free and most of them are in the evenings, so you can exercise after work or school. To learn about the programs in the Bronx visit https://www.nycgovparks.org/programs/recreation/shape-up-nyc.

Managing your stress is important too. Oftentimes we don’t know how to deal with it. If you can, try to walk to release your stress. Not only will you be relaxing, you will be active too. Every time you walk your glucose levels go down. Taking deep breaths during the day, learning how to meditate, doing some yoga or counting backwards from 10 are all simple techniques that can help release some stress. Other people feel more relaxed when they share their concerns or vent to friends or family members. If you have no one to listen to you, you are not alone. You can reach NYC Well 24 hours a day, 7 days a week by phone, text and online chat. They provide bilingual help in Spanish and other 200 languages. 

To contact NYC Well, call 1-888-NYC-WELL (1-888-692-9355) or text “WELL” to 651-73. Health insurance is not required. 

Diabetes can be prevented or controlled when it is with simple lifestyle changes. Visit your health care provider to learn what your A1c is, and if you are at risk create a plan to lower your blood sugar levels. Your doctor, dietitian, or certified diabetes educator can help you put a plan together that targets your needs and means. Use the resources that our community offers to be healthier and help change the statistics for a healthier you and a healthier Bronx.

Monday, November 12, 2018

Veterans Day: Honoring Those Who Served in Their Final Hours


By Rosemary Baughn, Senior Vice President, VNSNY Hospice and Palliative Care

HEALTH– When Joseph Vitti first meets a veteran to whom he will provide the comfort care of hospice, he usually begins by saying, “Thank you for your service.” But for those who served in Vietnam, he begins with words that have long eluded them: “Thank you and welcome home.” A fitting thought to keep in mind as Veteran’s Day approaches.


Vietnam is very much in the national conversation now, with the debut last year of Ken Burns and Lynn Novick’s documentary series marking the 50th anniversary of the war’s escalation. Among the powerful legacies that the series brings to life is the toll that the war’s brutality and divisiveness still exacts on those Americans who fought and returned.

My colleagues in the Visiting Nurse Service of New York’s Hospice and Palliative Care program who are caring for veterans at the end of their lives find that the silence common to many veterans on the subject of war is compounded in Vietnam veterans by the lack of support—and even enmity—they experienced when they came back home. 

End of life is the last chance to change the equation—to build bridges of communication to family members and loved ones, to other generations—and even to oneself. 

VNSNY’s special hospice program tailored to military veterans helps do just that. Our veterans hospice team of physicians, nurses, social workers, spiritual care counselors and home health aides is specially trained to provide care for not only the physical illness at hand, but also conditions such as PTSD, survivor’s guilt, depression, and substance abuse. We help connect veterans and their families with community resources and veteran-specific benefits, and hold bedside recognition ceremonies that honor their military service. VNSNY’s hospice initiative also benefits greatly from our participation in “We Honor Veterans,” a program created by the National Hospice and Palliative Care Organization in collaboration with the Department of Veteran Affairs, to address the unique physical, emotional and logistical needs of veterans and their families at end of life.

Sharing Stories

This specialized hospice care includes prompting and listening to stories. “End of life is a time—for anyone—to look back on one’s life and reflect on what mark they have left,” says Joseph, who is the U.S. Army Veteran Supervisor for VNSNY’s Veteran’s Program, and is also a veteran himself. “For veterans, we work to create an environment that lets them understand it’s okay to talk, to share stories. It’s not that they don’t want to—it’s that they don’t know who to tell the stories to, or how to tell them.”

So conversations typically begin slowly, with Joseph or a colleague asking straightforward questions: What was your branch of service? Where did you serve? For how long? “Then,” says Joseph, “we take one small step forward: ‘Tell me about your friends.’ That’s where the stories are.” 

Joseph further supports the veterans in sharing their experiences by explaining to them that their stories could help him help other veterans and families. “Veterans are very selfless. Helping others is something they certainly want to do.”

Joseph describes what happens once the stories begin to come. With a Vietnam veteran living on Staten Island, a former machine gunner referred to our service by the Veteran’s Administration, Joseph began with his standard greeting: “From one soldier to another, Welcome home.”

“He broke down in tears,” Joseph recalls. “An instant bond formed between us, and a visit that was supposed to be about connecting his family with benefits became about connecting in a whole different way. It opened the floodgates. He talked about things he’d never talked about before, and said that there wasn’t a day that went by that he didn’t think about them.”

Another veteran, a deeply religious Catholic who was in the final stages of cancer thought to be caused by his exposure to Agent Orange during the war, felt that his life, and now his war-related terminal illness, were a form of purgatory for what he did during the war—namely, survive when friends around him were killed. Joseph helped him reframe the narrative and achieve a measure of closure. “Did you ever think that this wasn’t your purgatory,” he said, “but that you survived because you had another mission—to be a husband to your wife and a father to your children?”

The veteran embraced the conversation, talking as he never had before. “These veterans don’t want to be forgotten, and don’t want their stories or their friends to be forgotten,” says Joseph. “They just don’t know how to begin. So we say, ‘Tell us. We want to know about your experience. We need to know.’”

For those who are unable to share their stories, families can learn their loved one’s history from military discharge papers, which the hospice team will help track down, along with any medals the veteran might have received. One soldier’s discharge paper detailed the circumstances behind his Silver Star, the military’s third-highest honor—a story the family had never heard. The only one in his eight-man team to survive an attack during the Tet Offensive, he kept firing even after he was shot and wounded—saving the lives of countless Americans ahead of him on the battlefield. When Joe shared the papers and the story with the family, including a young grandson, everyone was in tears, hugging the patriarch and hailing him as a hero. “They were a close family, but this brought them even closer,” Joseph notes. “That, the family’s support, is the ultimate medication and therapy.”

Joseph sees this time and again with veterans of all wars, but it is most pronounced with Vietnam veterans—who, after keeping their stories bottled up for decades, take the leap of faith in opening up to their families and find grace where they expected judgment, and honor where they expected contempt. 

“Imagine, your father afraid to tell his stories, maybe because he accidentally killed innocent civilians and he thinks he’s going to hell,” Joseph explains, citing a composite father built out of many fathers he’s worked with. “And then imagine that, instead, he hears from his children: ‘We love you, we’re proud of you. You’re not going to hell. You are a hero.’”

“What we need is a real national conversation that encourages people—especially a younger generation—to engage these veterans and hear their stories,” says Vitte. “Ask a friend, a neighbor, a loved one. Comfort care doesn’t begin with hospice. Many of these veterans have emotional and physical scars that go deep, and we owe it to them to listen.”

Thursday, November 8, 2018

Know the Warning Signs for Brain Aneurysms

By Janet M. McHenry DNP, FNP-BC, CCRN, CNRN
Doctor of Nursing Practice
Family Nurse Practitioner, Department of Neurosurgery

HEALTH– The journey begins: “I looked up from my desk and I felt like a bomb went off in my head. It was the worst headache of my life, it just exploded.”

“I wasn’t feeling well for about two weeks before this happened. The last thing I remember, I went into the grocery store and I woke up three weeks later in the rehabilitation hospital.”

“I was attending a family party and thought I had food poisoning. I felt like something popped behind my right eye and there was flashing in my eye like a light bulb went off, then I vomited.”

“My sister came home from work and said she had a bad day and a headache. She went upstairs to lie down before dinner. That was the last time we spoke, she died the next day.”

These stories are typical of survivors and their loved ones who have experienced a ruptured brain aneurysm resulting in a subarachnoid hemorrhage a type of hemorrhagic stroke.
Fortunately, aneurysmal subarachnoid hemorrhages account for only about 3% of all strokes. However, it is important for everyone to know the symptoms and risks, particularly in our community. First and foremost if you or a loved one get the “WORST HEADACHE OF YOUR LIFE,” please seek immediate and emergent medical attention.  

The sudden onset of the worst headache of your life is a “red flag” and may be a sign of a ruptured brain aneurysm. Other symptoms of brain aneurysm which may accompany the headache include: stiff neck, sharp pain behind or in the eye, blurry vision, light sensitivity, drooping eyelid, nausea & vomiting weakness of the arms or legs numbness and tingling of one side of the face or body, dizziness, confusion & seizures and/or loss of consciousness. There is normally a sudden onset of symptoms as described in the stories. There are a small percentage of brain aneurysms that leak a week or two before the rupture. People report that they have headaches and generally feel lousy, similar to the flu symptoms. When a brain aneurysm ruptures causing a subarachnoid hemorrhage it can cause brain damage, coma and even death.

What is a brain aneurysm?

A brain aneurysm is a balloon that arises from a cerebral artery. A brain aneurysm results from a weakness in the wall of the artery that supplies blood to the brain. Because blood continues to flow and finds the path of least resistance the vessel balloons out. 

Blood fills that sac and as pressure rises, that balloon can rupture and pours blood into the brain. 

Important Statistics

A Brain aneurysm ruptures in this country every 18 minutes impacting approximately 30,000 people a year. Women are affected more than men approximately 3:2 ratio, generally between 40 and 60 years of age. In contrast, approximately 6 million people in the US have unruptured brain aneurysms or 1 in 50. Cerebral aneurysms are twice as likely to rupture in African Americans and 1.6% times more likely to rupture in Latinas and Latinos.  Of those who develop a subarachnoid hemorrhage resulting from a ruptured brain aneurysm 25% will die within 24 hours many more than 50% will have permanent neurologic deficits; approximately 50% will be unable to return to work and others will recover fully. 
 Risk Factors

Certain genetic diseases carry higher risk for the development of brain aneurysm such as polycystic kidney disease, genetic connective tissue disorders that weaken blood vessel walls, history of rupture in a first degree relative: parent, child or siblings. Those with sickle cell disease and Arteriovenous malformations carry a higher risk for development of brain aneurysms. Other associated risk factors include: smoking, drug use particularly cocaine and amphetamines and uncontrolled hypertension. Patients who have a known brain aneurysm are 20% likely to have a second brain aneurysm, usually on the other side.

Unruptured Aneurysms

Since there are rarely signs of unruptured aneurysms they are often discovered “incidentally”.  Patients may complain of headaches or dizziness and they are seen on magnetic imaging. We strongly recommend that anyone who has an incidental finding of a brain aneurysm be seen by an aneurysm specialist such as a neurosurgeon or neuroradiologist. They can offer treatment if it is required, further imaging to better characterize the aneurysm or to follow you on a regular basis. In particular, it is very important for family members of first degree relatives who have ruptured to be screened with an MRI and MRA or CTA if over age 21. We know about the connection to ruptured brain aneurysms it’s always better to find it before the rupture occurs and treat it then.

Brain Aneurysm Treatment

The only treatment for brain aneurysms in the past was open brain surgery. The aneurysm was located and a clip or clips were placed to secure the neck and stop blood from flowing into the sac. While this surgery is performed least often but is sometimes required due to the location or configuration of the aneurysm. Endovascular treatment has developed over the past 25 years and is utilized more commonly to treat aneurysm. The patient is taken to interventional suite and a cerebral angiogram is performed similar to a cardiac catheterization.  

The angiogram or catheterization of the brain is performed. The aneurysm can be treated through a microcatheter by inserting platinum coils to fill the aneurysm. In addition a stent device re-directs blood flow away from the aneurysm may also be used so the aneurysm will shrink. 

Message to the Community 

There are disparities in health care in this country based upon race and economic status. I know from my own experience speaking to patients that this often prevents community members from seeking the help that they need. 

Please don’t ignore the symptoms if they occur, Montefiore is here to help. We are not interested in your insurance or immigration status. We are a nationally designated comprehensive stroke center. We are in the forefront of aneurysm treatment and research. At Montefiore we have a multidisciplinary team that collaborates for the patients highest quality and most efficient care. In order to attain Joint Commission of Hospital Accreditation national designation as a Comprehensive Stroke Center there must be a high number of aneurysms treated and both operative and endovascular treatment must be offered. The entire staff including MDs, nurses and all health care workers who touch the patient must be educated. We must continuously maintain excellent standards of care that are benchmarked against the national standards. The standards are high, but so are the stakes for our community members who deserve only world class healthcare.

http://www.strokeassociation.org

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