The
Brain
Dock
for
Prevention
of
Cerebral
Stroke
Kazuo
Hashi
Department
of
Neurosurgery
School
of
Medicine
Sapporo
Medical
University
Sapporo,
Japan
A
health
check
system
for
cerebral
and
cerebrovascular
diseases
is
now
widely
performed
in
Japan
by
the
name
of
"The
Brain
Dock".
The
items
of
checking
include
images
of
MRI
and
MRA
making
the
diagnosis
possible
for
asymptomatic
cerebral
infarctions
or
asymptomatic
unruptured
cerebral
aneurysms
(UCA).
In
1995
a
nation
wide
survey
revealed
that
the
brain
dock
is
available
in
approximately
500
institutes
in
Japan
and
detecting
asymptomatic
cerebral
infarctions
in
20.4%
and
UCA
in
2.7%
of
the
applicants.
By
using
more
sophisticated
methods
of
detection
it
is
possible
to
detect
UCA
in
more
than
5%
of
the
applicants
if
they
are
older
than
50
years
of
age.
While
it
may
still
need
some
time
to
evaluate
the
effect
of
intervention
to
the
patients
with
asymptomatic
cerebral
infarctions
for
prevention
of
future
stroke,
the
effect
of
surgical
clipping
of
UCA
for
prevention
of
subarachnoid
hemorrhage
would
be
straight
forward.
Therefore,
the
discussion
will
be
focused
on
the
matter
of
UCA.
The
Shinsapporo
Neurosurgical
Hospital,
one
of
our
affiliated
hospital
in
Sapporo,
can
detect
UCA
in
6.0%
out
of
1000
applicants
with
mean
age
of
54
years,
5.7%
in
males
and
7.7%
in
females.
It
increases
with
age
reaching
more
than
10%
in
sixties.
Of
particular
interest
was
that
the
most
apparent
predisposing
factor
for
UCA
was
not
the
presence
of
hypertension
but
the
presence
of
family
history
of
subarachnoid
hemorrhage
(SAH),
showing
discovery
rate
of
UCA
of
11.4%.
To
persuade
family
members
of
SAH
patients
to
take
MRA
is
now
a
regular
practice
in
many
neurosurgical
clinics
in
Japan.
By
doing
so
The
Shinsapporo
Neurosurgical
Hospital
detected
UCA
in
the
family
members
in
13.4%.
The
current
methods
of
detecting
UCA
in
the
brain
dock
will
be
presented,
as
well
as
the
guideline
recently
presented
from
The
Japanese
Brain
Dock
Society
in
which
the
author
is
the
founder
member.
|