Stroke is a disease often associated with the elderly, but this is not necessarily true. As much as 5% of the population carry a ticking time bomb in their brain, known as a berry aneurysm. An aneurysm is a weakening of the arterial wall, causing a localised ballooning of the vessel. A berry aneurysm is a common type of aneurysm where the ballooning resembles a berry. What is most troubling is that a large proportion of these aneurysms can present very early (usually congenital, meaning you are born with it), with one research suggesting that 1.3% of the population in the age group of 20 to 39 has a berry aneurysm. If this berry aneurysm was to burst, no matter how young and fit you are, you will bleed into the area around your brain (subarachnoid haemorrhage), suddenly develop a severe, crippling headache (“thunderclap headache”), become confused, show signs of stroke such as speech or movement problems, or simply drop dead.
Fortunately, only 10% of people carrying a berry aneurysm suffer a ruptured aneurysm and subsequent brain bleed. The other 90% will carry on living their lives, without ever knowing that they had a time bomb in their brain.
Certain factors make the risk of the aneurysm bursting go up, such as high blood pressure, which can be caused by a stressful lifestyle or smoking. But in some cases, as explained above, even a healthy teenager could suddenly drop to the ground with a massive brain haemorrhage.
Berry aneurysms are only one of many ways death could strike unnoticed, no matter how young you may be. You could live a long and healthy life and die peacefully in your sleep when you are 90 years old, or you may have a stroke and drop dead in a few minutes’ time. For all you know, a bus might run you over tomorrow, with no warning whatsoever. Ergo, youth is not an excuse to waste the day you are given. You do not have to achieve something great, or be productive, but at least spend your day knowing that you are doing everything in your power to make yourself happy, without harming your health, your future or other people.
When and what was the first surgery performed by mankind? Many would believe it to be a simple procedure such as suturing a wound. But would you believe that the earliest surgical procedure was brain surgery in 6500BC? Surprisingly, this is true.
Archaeologists have found a large amount of skulls with a large, round hole in them. Some of the oldest skulls with holes were found in France, where 40 skulls from the Neolithic era were excavated. Archaeologists believed these holes to be from a battle leading to a dent in the skull. However, these holes were actually the results of a surgery (signs of bone recovery can be seen around the edges of the hole, suggesting the patients were alive for some time even after the operation). These skulls all belonged to trepanation patients.
Trepanation is the surgical opening of the skull by drilling a hole in it. This is an ancient surgery that can be found throughout history. Hippocrates and Galen from ancient Greece both recorded detailed instructions on trepanation, ancient Incans performed the surgery and it was also common during the Middle Ages and the Renaissance in Europe. These surgeries were most likely indicated for skull fractures where fragments were embedded in the brain. During the Middle Ages when it was better known that the brain was the seat of the soul, trepanation was used for psychiatric treatments too. For example, in 15th century Netherlands, trepanation was used to excise a so-called stone of madness that was supposedly the cause of insanity. Like this, it was believed that trepanation could release the demons and insanity trapped in the skull.
Although this operation sounds hilariously misled, it is still used in modern medicine. Of course, it is not known to treat insanity, but rather to treat brain bleeds. Extradural and subdural haemorrhages occur when a rupture of an artery in the brain causes a collection of blood in the skull, compressing the brain. This is a dangerous situation which can lead to a stroke or even death. One treatment of this condition is trepanation, or a burr hole, where a small hole is drilled in the skull to relieve the pressure, lowering intracranial pressure and stabilising the patient. Trepanation is an excellent example of how we can learn from the past and how medical knowledge from ancient times is sometimes still valid.