What is Brain Aneurysm, AVM, and Trigeminal Neuralgia? Rare disorders that Salman Khan is suffering from | Doctor decodes

Salman Khan is one of those Bollywood superstars who prefers to stay away from the media spotlight and keeps his personal life private. However, he recently made an appearance on the new season of The Great Indian Kapil Show, where he opened up about his serious health struggles.

In the episode that was released on Netflix, the 59-year-old actor disclosed that he has a brain aneurysm, an arteriovenous malformation (AVM) and trigeminal neuralgia.

"I'm out here breaking my bones every day - ribs are fractured, I'm working despite having trigeminal neuralgia, there's an aneurysm in the brain, yet I'm still working. There is also an AV malformation, and still, I'm carrying on," he said.

A brain aneurysm, arteriovenous malformation (AVM) and trigeminal neuralgia are serious neurological disorders that can be difficult for a layman to understand. To help understand these conditions, WION took insights from Dr. Sunil V Furtado, who provided an in-depth explanation of each disorder and its potential effects.

What are Brain Aneurysm, AVM, and Trigeminal Neuralgia?

The brain, the body's central control system, is both resilient and susceptible to a range of conditions that can drastically alter the course of a person’s life. Among these are brain aneurysms, arteriovenous malformations (AVMs), and trigeminal neuralgia, each different in nature but sharing the potential to cause severe consequences if left untreated or not diagnosed on time.

Brain Aneurysm: A brain aneurysm is a weak spot in a blood vessel in the brain, bulging out like a tiny balloon. This "outpouching" can bleed devastatingly in the brain or can put pressure on surrounding nerves or brain tissue. Most aneurysms occur in the Circle of Willis, a network of arteries at the base of the brain.

Arteriovenous Malformation (AVM): An AVM is a tangle of abnormal blood vessels in the brain where arteries connect directly to veins, bypassing the crucial capillaries. This direct connection leads to high-pressure blood flowing into veins not designed to handle it, increasing the risk of bleeding.

Trigeminal Neuralgia: This is a chronic pain condition affecting the trigeminal nerve, which carries sensation from your face to your brain. It's characterised by sudden, severe, electric shock-like pain, usually on one side of the face.

How Dangerous Are They?

• Brain Aneurysm: A ruptured aneurysm is life-threatening. One-third of people die immediately. Survivors often have severe brain damage. Unruptured ones can also cause problems.

•Arteriovenous Malformation (AVM): AVMs can rupture and cause brain bleeding (stroke). This can lead to severe damage, disability, or death. Abnormal blood flow can also harm brain tissue and cause fits or cognitive changes.

•Trigeminal Neuralgia: Not deadly, but causes extreme pain. This pain is debilitating. It greatly affects the quality of life and mental health.

Symptoms

•Brain Aneurysm: Often no symptoms until it bursts. If unruptured, symptoms can be headaches, nausea, blurry vision, or memory issues. A burst aneurysm causes a sudden, severe headache ("thunderclap"). Other signs include weak limbs, confusion, speech trouble, loss of balance, or unconsciousness. A small leak might cause milder symptoms first.

•Arteriovenous Malformation (AVM): Many have no symptoms until they bleed. When symptoms appear, they can include headaches, seizures, muscle weakness, numbness, vision problems, or speech difficulty. Symptoms depend on the AVM's location.

•Trigeminal Neuralgia: Sudden, sharp, electric shock-like facial pain. Triggers include touch, chewing, brushing teeth, shaving or talking. Pain is usually on one side. It comes in short bursts.

Causes

•Brain Aneurysm: The Exact causes are unknown. High blood pressure, smoking, heavy drinking, and drug use are risk factors. Some genetic conditions also increase risk.

•Arteriovenous Malformation (AVM): Usually present from birth. Caused by errors in fetal blood vessel development. Symptoms may appear later in life.

•Trigeminal Neuralgia: Most often, a blood vessel presses on the trigeminal nerve. Tumours or conditions like multiple sclerosis can also be causes.

Treatment Options and Treatability

All three conditions are treatable.

•Brain Aneurysm: The main goal is to stop or prevent bleeding. Options include open surgery (clipping), endovascular coiling, or flow diverters. Highly treatable if found before rupture. A ruptured aneurysm has high risks. Lifelong monitoring may be needed.

•Arteriovenous Malformation (AVM): The Aim is to remove the AVM and prevent rupture. Options include surgical removal, embolisation (blocking blood flow), or stereotactic radiosurgery. Treatable, depending on the AVM's features.

•Trigeminal Neuralgia: Focuses on pain relief. Medications (e.g., certain anticonvulsants) are common. Surgical options include microvascular decompression (MVD) to relieve nerve pressure. Other procedures damage nerve fibres to block pain. Stereotactic radiosurgery also helps. Highly treatable, with many options for pain control.

Early diagnosis and treatment are crucial in managing neurological conditions or any life-altering conditions. Prioritising your brain through a healthy lifestyle, managing blood pressure, and avoiding smoking and alcohol can significantly contribute to a healthier brain. Being proactive and well informed are the first steps towards protecting your vital organs.

(Dr Sunil V Furtado, Senior Consultant and Head, Department of Neurosurgery, Ramaiah Institute of Neurosciences, Ramaiah Memorial Hospital, Bengaluru.)