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Ask Dr. Gott 10/22
Docs offer no answers on aneurysm
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    DEAR DR. GOTT: I was recently in the hospital because of lightheadedness. I am a 73-year-old woman with a history with a brain aneurysm. In 1966, I was diagnosed with an aneurysm in the right side of the circle of Willis. (I guess you know what that means.) Because of this, the hospital doctors ordered a CT scan of my head. No one told me anything, but I got copies of my test reports and have determined I have encephalomalacia in the area of the right temporal lobe.
    Because I can never talk to my doctor (only his assistants), I was hoping you could tell me what this means.
    DEAR READER: The circle of Willis is an area at the base of the brain where several arteries join together. While all brain aneurysms are potentially dangerous, one situated in the Circle of Willis is especially so because the interior carotid arteries branch off from this area and supply about 80 percent of the brain's blood.
    Encephalomalacia is an abnormal softening of part of the brain, usually because of a restricted blood supply (ischemia) or death of the tissue (infarction, often due to loss of the blood supply).
    The right temporal lobe is responsible for the memory of shapes and sounds. Damage to this area can cause loss of that type of memory and occasionally can cause personality changes such as loss of libido, humorlessness, extreme religiosity and others.
    From your brief letter, I cannot determine whether you had the aneurysm surgically repaired or whether it has remained untouched. In either case, the aneurysm may be directly related to your brain softening because the right temporal lobe is in close proximity to the right side of the Circle of Willis.
    You need to have a follow-up examination, so I urge you to see a neurologist for further testing. He or she can explain in better detail what symptoms may be caused by the abnormality and if there are any possible treatment options. The specialist can also give an accurate outlook about how this may affect you in the future and whether it will require any special considerations as you age.
    I would like to add that I am disappointed at the hospital doctors and your personal physician for not providing you the diagnosis, prognosis and other vital information. If your doctor can't be bothered to speak with you about your situation, it is time to find a new physician who will be more caring and attentive. Because of your age, you may find that a gerontologist (practitioner who deals with senior citizens only) is an appropriate choice. These specialists are specially trained to recognize and care for maladies of the elderly. They also serve as general practitioners for normal routine check-ups and more.
    To give you related information, I am sending you copies of my Health Reports "Alzheimer's Disease" and "Parkinson's Disease."
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