Is it a Lingering New Year Hangover or Should I Worry? – Head Injuries in Anime Part 5- Cerebral Aneurysm

Do you like my Light Novel style post title? Today we have another guest post from the fascinating Anime Science 101.

Anime Science 101 is an American science teacher with eight years of experience working in high school and middle school classrooms. His last teaching job was overseas in Mongolia, where he had easy access to the home islands of Japan, which went to twice for a total of 9 weeks spent travelling the country. While his main background is Biology, specifically all things related to medicine due to two years of medical school, he can teach all aspects of science, including anime science.

His love of anime began as a small child spending hours watching Voltron and Transforms, although he didn’t know it was anime at the time. This continued with Ronin Warriors among others, until college, when he saw the first anime that he knew was anime, Gundam Wing. From then on he was hooked on all things anime. He enjoys a wide variety of shows from the likes of Black Lagoon and Hellsing to Slayers, and Martian Successor Nadesico. More recently he has enjoyed Miss Kobayashi’s Dragon Maid, and My Hero Academia. When he isn’t endlessly grading student work or traveling, Anime Science 101 struggles to keep up with all of the new anime being produced each year. Currently he is trying to find the time to finish Amanchu and is always up for new recommendations.

This post is courtesy of reddit user Worm38, who asked about the following. 

Can people instantly pass out and have spasms right after a hit to the skull, like in this scene? 

f it’s something that can happen (even if perhaps not as instantaneously), is blood involved in that reaction of the body?

The answer to that question is yes, Worm38, you can instantly pass out from a blow to the head causing a concussion or a subarachnoid hemorrhage.

As to the having spasms, which is known by the more technical term seizure, is typically not a symptom of a concussion or subarachnoid hemorrhage.  This does not mean that it cannot happen, but that it is more commonly seen in another type of brain injury called a ruptured cerebral aneurysm, which also happens to involve blood as part of the condition.

Aneurysm

An aneurysm is a section of a blood vessel that is enlarged as a result of a weakness in the wall of the blood vessel.

Aneurysms can happen in arteries or veins and are classified by size, shape and location.  For today I will be focusing cerebral aneurysms, which are located in the brain.

What causes an Aneurysm?

What causes an aneurysm is quite clear and that is a weakness in the wall of the artery causing it to expand.  As to what causes the weakness in the wall of artery that leads to its expanding is less clear.  That being said, there are things that can increase your risk of developing an aneurysm.

1. Smoking- studies have shown that a majority of individuals who developed brain aneurysms have been smokers at some point in their life.
2. High blood pressure exerts extra pressure on the arteries which raises the risk of developing an aneurysm
3. Family History- if a close family member has had an aneurysm that raises the risks of the patient having one
4. Age- The risk of a brain aneurysm increases over the age of 40
5. Sex- women are more likely to develop brain aneurysms than men
6. Heavy Alcohol use

Does Tomoe’s father have an Aneurysm?

Full disclosure: I have not seen The Garden of Sinners: Paradox Spiral.  I have only seen the scene with Tomoe’s parents.  That being said, I still think I can answer the question does Tomoe’s father have an aneurysm.  First, we can see a number of Sake bottles on the table and Tome’s father is drinking one.

One article I found stated that as many as 10 million people in Japan potentially have an issue with alcohol dependency.  Now when you combine this with Japan’s total population of 128 million and some simple math, we can see that 0.9% of Japan has a potential alcohol problem.  So, by the numbers it’s not likely that Tomoe’s father doesn’t have an alcohol problem.  There are 5 bottles of alcohol and 5 beer cans, which speak for themselves and one doesn’t need to be an alcoholic to have the health problems associated with heavy drinking.  Thus, I think it’s safe to say that Tomoe’s father has the heavy alcohol use risk factor.

Next up is age, and while I could not find the age of Tomoe or his parents on the typemoon wiki, we can make some assumptions.  Based on his appearance and the information I could distill from the wiki Tomoe is probably somewhere between 15-18 years old.  The average age that women first give birth in Japan is 30 years old, which puts Tomoe’s mother between 45-48 years old.  Now the average age gap between couples in Japan is around 1.4 years, making Tomoe’s father between 46 to 49 years old.  This makes him old enough that his age can be considered a risk factor for a brain aneurysm.

Hypertension, or high blood pressure is often called the silent killer because it has no readily observable symptoms that a person suffering from it would notice on a daily basis, short of actually checking their blood pressure.  In Japan 43 million people or 34% of the population is believed to suffer from this condition.  That is a little higher than 1 in 3 people.  Given the alcohol and junk food that is littered on the table I think it is safe to assume that Tomoe’s father probably has high blood pressure, increasing his risk for a brain aneurysm.

We can see no evidence of smoking in the scene in question, but 29% of Japanese men smoke, so I don’t think that I can remove this risk factor from the list.  I think it is safe to assume that at some point Tomoe’s father smoked or at the very least had exposure to a significant amount of second-hand smoke.  However, we don’t know his family history and he is not a woman, so Tomoe’s father does have that working in his favor.  That being said, he does have 3 of the 6 risk factors so I am comfortable saying that he likely has a brain aneurysm.

Symptoms of a Brain Aneurysm 

A brain aneurysm sits quietly waiting for something to happen causing it to burst so there is not much in the way of symptoms prior to it leaking or rupturing.

Ruptured Aneurysm

As we already know the walls of the blood vessels where an aneurysm has occurred are weaker, hence the expansion of the blood vessel.  These weaker blood vessels can eventually break or rupture leaking blood into the surrounding brain tissue, essentially causing a hemorrhagic stroke.  Aneurysms can break on their own just from the pressure of the blood pumping against the weakened arterial walls, or they can break due to outside force.

n the case of Tomoe’s father’s brain aneurysm, it most likely ruptured due to Tomoe’s mother hitting him on the back of the head with a frying pan.  The aneurysm ruptured spilling a large amount of blood into the surrounding brain tissue rapidly, rather than slowly leaking out a small amount of blood.  As such we would see the following symptoms.

• sudden onset of a severe headache
• nausea and vomiting
• stiff neck
• sensitivity to light
• blurred or double vision
• loss of consciousness
• seizures

While we only see Tomoe’s father exhibit loss of consciousness and seizures, these are two of the more severe symptoms which imply the aneurysm has ruptured.

Treatment

There are treatments for unruptured and ruptured aneurysms but in the case of Tomoe’s father, the outcome does not look good even when excluding the subsequent stabbing.  10% of patients with a ruptured aneurysm die before receiving medical attention, and another 50% die by the end of the first month of treatment.  The treatment, had he received any, would have consisted of medication to slow the bleeding and then surgery to repair the damaged blood vessels.

Conclusion

Yes, Worm38, you can see a person pass out and have seizures after a blow to the back of the head, if the blow causes the person being struck to rupture a pre-existing aneurysm.

Well, that was instructive. And if you want to read more awesome anime themed educational posts, don’t forget to mosey on over to Anime Science 101. I’m sure you could also ask a question on Twitter. Why not give it a try and find out something you’ve always been wondering about.