DEAR DR. DONOHUE: I would like to know about brain aneurysms. Two years ago, I was diagnosed with one. I was offered the choice of treatment or doing nothing. I chose to do nothing. I had follow-up MRIs. Now I have a smaller one, and the first one hasn’t grown. I am to have another MRI in the fall. I am concerned about all the radiation from these MRIs. I am 76 years old. — A.A.

ANSWER: The MRI radiation issue isn’t an issue. Magnetic resonance imaging doesn’t involve any radiation. It involves magnets and magnetic fields.

A brain aneurysm is like an aneurysm on any other body artery: It’s a bulge, and it represents a weak spot. Actually, it’s more like a blister. All aneurysms have an inherent risk of bursting and causing brisk bleeding. That’s a danger anywhere in the body. In the brain, it often is calamitous.

Your aneurysm was discovered by chance. Am I right? You had a silent aneurysm, and a brain scan was taken for some other purpose. That’s how many brain aneurysms are discovered. Few produce symptoms before they actually burst. Not all aneurysms break. Many, many remain silent for all of life.

Your age, the size of the aneurysm and its position in the brain are the factors that have to be considered in weighing whether to leave it alone or treat it. It can be treated by a neurosurgeon, who clips its base, or by a doctor, who inches a catheter — a slender, pliable tube — from a surface artery to the involved brain artery. When the aneurysm is reached, tiny latex or metallic coils are released into it to obliterate it.

A diameter of less than 7 mm is considered small, and such aneurysms often are left alone. Ones that are 10 mm or larger are more likely to break, and those often are treated. Those between 7 mm and 10 mm are iffy. Age is another important consideration. At ages older than 70, correction is less strongly urged, unless the aneurysm is quite large. Location is another important factor. Brain aneurysms in some places are less likely to break than those in other regions of the brain.

All of this is understandably overwhelming to a patient. Why not get a second opinion so you can better weigh your options?

DEAR DR. DONOHUE: Will you talk about Peyronie’s disease, its causes and treatments? — T.D.

ANSWER: Peyronie’s disease is a lump of scar tissue that forms in the penis and causes it to bend. The bend can make an erection and sexual relations painful or impossible. In some men, the condition regresses on its own. In a larger number, it stabilizes, and the pain greatly lessens. In a third group, the bend and pain worsen.

What causes it is disputed. It might be that trifling, unnoticed trauma occurring during sexual relations through the years sets the stage for the development of the scar lump.

Many medicines have been tried. Potaba is one. Pentoxifylline is another. Neither has been a great success. Injecting the scar lump with Verapamil is a frequent treatment, and the injection of collagenase, an enzyme that dissolves scars, also has been tried. Surgical corrections for Peyronie’s that has lasted longer than a year are worthy of consideration.

DEAR DR. DONOHUE: What happened to DMSO? It used to be available, but it has disappeared. Why? — W.K.

ANSWER: DMSO — dimethyl sulfoxide — was very popular as a treatment for arthritic joints. It is rubbed on the skin over the aching joint. The Food and Drug Administration never approved it for that use, and that may be why it lost its appeal.

There is a dedicated doctor and a dedicated group of DMSO fans who feel the same as you. They’re trying to get the FDA to re-evaluate its stance on this substance.

DMSO is approved for the treatment of interstitial cystitis, a painful bladder condition. The material is instilled into the bladder.

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. Readers may also order health newsletters from www.rbmamall.com.

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