DEAR DR. DONOHUE: 2003 has been a tragic year for me. I lost my wife. On the day of her death I talked with her at 9 p.m. She was fine. She died at 1 a.m., according to the coroner. After reading the autopsy report, I am not sure what she died from or why. The report says she died from a ruptured berry aneurysm. What does this mean? I feel guilty not knowing she was dying and not doing anything to help her. – L.B.

An aneurysm (ANN-your-is-um) is a bulge from the wall of an artery. It is a weak spot. Berry aneurysms are small bulges on a brain artery. They look like tiny berries, and that’s where the name comes from.

If a berry aneurysm bursts, the consequences are disastrous. Blood fills and destroys sections of brain, sometimes large sections. Ruptured berry aneurysms are hemorrhagic (bloody) strokes. In North America more than 50,000 hemorrhagic strokes, mostly due to a bleeding berry aneurysm, occur yearly.

I can’t take your grief away, but I can take your guilt away. Your wife died suddenly and peacefully while she was sleeping. There was nothing you could have done to detect trouble or to help her if she had been wide awake. Berry aneurysms often end in this kind of tragedy.

What causes aneurysms is a big unknown. Genes, as they do for most things, have a hand in their development.

I don’t want to paint the picture of berry aneurysms completely in black. Sometimes there is a warning. Alert people suddenly complain of an unbearable headache. If they are immediately taken to a hospital and emergency surgery is performed, some of those people can be saved. And a few people have warning headaches before the aneurysm breaks, probably due to small leaks of blood. Treatment for these people can save their lives.

The stroke pamphlet outlines the symptoms, treatment and prevention of the more common kind of stroke, one due to blood flow obstruction in a brain artery. Readers can order a copy by writing: Dr. Donohue ­- No. 902, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. along with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: My granddaughter is going to give birth in March. She had an ultrasound a month ago. Today she had another one because the doctor says “the placenta is down in her uterus.” I am concerned that all these ultrasounds will be harmful to the baby – like too many X-rays. And what does a placenta being down mean? – M.S.

: I believe your granddaughter has a placenta previa. The placenta is the structure that delivers nutrients from the mother to the fetus. It normally is located in the topmost parts of the uterus. A placenta previa is one that is in the lowermost portion of the uterus. Such locations for the placenta happen once in about every 200 pregnancies. Many of those placenta previas migrate upward in the uterus and pose no problem when delivery is about to take place. If the misplaced placenta continues to block the birth canal, a cesarean section is performed.

Ultrasound is a marvel of modern medicine. It takes pictures of internal organs, and in this case, of the placenta, without resorting to radiation. Sound waves are directed at the desired structure, and those waves bounce off it and are captured on special paper to produce a clear image. Your great-grandchild is not going to suffer any damage. The doctor can see if the placenta has moved so all will be prepared when delivery occurs.

DEAR DR. DONOHUE: I read what you had to say about chickenpox and shingles. I had shingles, and my parents are convinced that I never had chickenpox. So my first experience with the virus was shingles and not chickenpox. – J.M.

I am as sure as I am about anything that a first encounter with the chickenpox virus causes chickenpox, not shingles. You might have had such a mild case that it was not recognized as chickenpox.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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