DEAR DR. DONOHUE: What happens to the blood in your head when an aneurysm breaks? I have been searching for an answer for years. This happened to me in 2000. I had what was called a subarachnoid hemorrhage. I have another aneurysm that didn’t break. They wanted to operate, but my daughter (God bless her) wouldn’t let them. I was in the hospital for two months and then rehab. I am on no medicine. I just want to know where the blood went. The doctor said it dissipates. “If that’s true,” I asked him, “why did you get angry at my daughter for not allowing you to operate?” He didn’t answer. – F.K.

You had a stroke. Strokes come in two varieties. Eight-five percent are ischemic (is-KEY-mick) strokes, strokes due to obstruction of blood flow to the brain by a thrombus (a clot) in a brain artery, by an embolus (a piece of a clot that traveled to the brain from a distant blood vessel) or by a narrowing of a neck artery that supplies the brain with blood. You had the other kind of stroke, a hemorrhagic stroke, bleeding from a brain artery. In your case, the bleeding came from a burst aneurysm – a bulge of the artery wall, a weak spot. Mortality from such a stroke approaches 45 percent. The operation the doctor proposed was to remove any pooled blood pressing on your brain and to seal the aneurysm. If the aneurysm isn’t closed off, it can rebleed and cause even greater damage. The body absorbs blood that has pooled on your brain. “Subarachnoid” is the space between one of the brain’s coverings and the brain itself – the place where blood pools.

Let me stick my nose into your business, even though you didn’t ask. If you have a second aneurysm that is large, it should be evaluated by a neurologist or a neurosurgeon. Large aneurysms tend to burst, and you don’t want to press your luck a second time. Yours might be able to be treated without surgery. A slender, pliable tube is inched from a surface blood vessel to the site of the aneurysm. When it arrives at that spot, the doctor releases coils that obliterate it.

DEAR DR. DONOHUE: Enclosed is an article on dry macular degeneration, something I have. What I would like to know if the vitamins, beta-carotene, zinc and copper recommended in the article come in one pill? – S.B.

Dry macular degeneration is the more common kind of macular degeneration – the condition that comes with advancing age and robs so many of their sight. Recommendations have been given for vitamin C, vitamin E, beta-carotene (a vitamin A equivalent), zinc and copper to slow the progress of macular degeneration.

You can find many commercial preparations that contain the suggested amounts of these vitamins and minerals in one capsule or tablet. Two names are Ocuvite and PreserVision. Your druggist can tell you the names of others in your local drugstore.

Let your doctor know you’re putting yourself on this supplement. He or she can tell you if this combination might interfere with any other medicines you take or if you are adding too large a dose of vitamins to the other vitamins you’re already taking.

Smokers shouldn’t take beta-carotene. It can promote lung cancer for them.

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