A brain dock is a type of medical checkup that uses brain magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), and carotid ultrasonography to diagnose brain-related diseases or to detect the risk of diseases at an early stage. In other words, it is not a treatment, but a diagnosis, by observing the condition of the brain at the time of the examination. Although the human health check is well known, it does not usually cover brain examinations; a separate brain check is required to examine the brain as it is difficult to identify brain diseases based on data from physical examination alone.
Brain dock may diagnose cerebrovascular diseases (asymptomatic cerebral infarction, unruptured cerebral aneurysm etc.,), brain tumors, dementia, and other diseases. This increases the likelihood of an early detection, and appropriate action. One of the advantages of having a brain check is that you can review your life. If there are any risk factors found during the physical examination or checkup, it will be taken into consideration. However, this can be an opportunity to reduce the risk of future cerebrovascular diseases through lifestyle improvement.
Just because one has undergone a brain check and confirmed to be free of disease does not mean that one is safe for a long time thereafter. Periodic examinations are necessary at certain intervals, similar to health checkups and physical examinations.
A brain dock is a type of medical checkup that uses brain magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), and carotid ultrasonography to diagnose brain-related diseases or to detect the risk of diseases at an early stage. In other words, it is not a treatment, but a diagnosis, by observing the condition of the brain at the time of the examination. Although the human health check is well known, it does not usually cover brain examinations; a separate brain check is required to examine the brain as it is difficult to identify brain diseases based on data from physical examination alone.
Brain dock may diagnose cerebrovascular diseases (asymptomatic cerebral infarction, unruptured cerebral aneurysm etc.,), brain tumors, dementia, and other diseases. This increases the likelihood of an early detection, and appropriate action. One of the advantages of having a brain check is that you can review your life. If there are any risk factors found during the physical examination or checkup, it will be taken into consideration. However, this can be an opportunity to reduce the risk of future cerebrovascular diseases through lifestyle improvement.
Just because one has undergone a brain check and confirmed to be free of disease does not mean that one is safe for a long time thereafter. Periodic examinations are necessary at certain intervals, similar to health checkups and physical examinations.
These factors are called "risk factors". Although the word “risk" is attached to them, it does not imply that they are in immediate danger; rather they are factors that have a high possibility of causing illness in future.
The primary diseases found by a brain dock are cerebral infarction and microhemorrhage that do not cause symptoms, cerebral aneurysm that may cause subarachnoid hemorrhage, brain tumor, and narrowing of the carotid artery that sends blood to the brain. Recently, an increasing number of facilities have included a detailed examination of cognitive functions in the examination items of the brain dock. Even if an abnormality is found, there are few cases that require immediate surgical treatment; most of them can be treated with internal medicine or follow-up imaging without treatment. One should not feel anxious and discuss future plans with one’s doctor. The following is a brief explanation of each disease.
Asymptomatic cerebral infarction is a condition in which there are findings of cerebral infarction on imaging, but no symptoms corresponding to the lesion. This lesion can only be detected after a brain checkup. Despite a cerebral infarction, the patient has no symptoms. Most of these are small cerebral infarctions, called lacunar infarctions. These are not uncommon and occur in 10-20% of the elderly, however, it is considered a risk factor for future stroke and dementia. For treatment, antiplatelet agents, commonly known as blood thinners, are effective in preventing the onset of future cerebral infarctions.
Microhemorrhages are often small hemorrhages that do not cause symptoms. These are known to be related to aging and hypertension and are found in 5-20% of elderly people, 30-40% of cerebral infarction cases, and 60-70% of cerebral hemorrhage cases. There is a high possibility of cerebral hemorrhage or cerebral infarction in the future, and it is also suspected to be related to cognitive decline; therefore, it is important to manage blood pressure and other risk factors.
Cerebral aneurysms are found in approximately 3% of adults over the age of 30 years. In particular, people with high blood pressure, smoking, and a family history of subarachnoid hemorrhage are said to require attention. If it ruptures, subarachnoid hemorrhage will occur. However, the rupture rate is not high; it varies depending on the location and size of the lesion. Please consult the doctor regarding when, and how the treatment is needed. The rupture rate of unruptured cerebral aneurysms in Japanese patients has been shown in the Table.
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| Site | Annual rupture rate (95% confidence interval) | ||||
| Size | |||||
| 3-4 mm | 5-6 mm | 7-9 mm | 10-24 mm | 25 mm | |
| Middle cerebral artery aneurysm | 0.23 （0.09-0.54) |
0.31 （0.10-0.96) |
1.56 （0.74-3.26) |
4.11 （2.22-7.66) |
16.87 （2.38-119.77) |
|---|---|---|---|---|---|
| Anterior cerebral artery aneurysm | 0.90 (0.45-1.80) |
0.75 (0.28-2.02) |
1.97 (0.82-4.76) |
5.24 (197-13.95) |
39.77 (9.95-159.00) |
| Internal cerebral artery aneurysm | 0.14 (0.04-0.57) |
0.00 (-) |
1.19 (0.30-4.77) |
1.07 (0.27-4.28) |
10.61 (1.49-75.3) |
| Internal carotid-anterior communicating artery aneurysm |
0.41 (0.15-1.10) |
1.00 (0.37-2.66) |
3.19 (1.66-6.12) |
6.12 (1.66-6.13) |
126.97 (40.95-393.68) |
| Basilar artery aneurysm | 0.23 (0.03-1.61) |
0.46 (0.06-3.27) |
0.97 (0.24-3.89) |
6.94 (3.74-12.90) |
117.82 (16.60-836.43) |
| Vertebral artery aneurysm | - (-) |
- (-) |
- (-) |
3.49 (0.87-13.94) |
- (-) |
| Others | 0.78 (0.25-2.43) |
1.37 (0.34-5.50) |
- (-) |
2.81 (0.40-19.99) |
- (-) |
| Total | 0.36 (0.23-0.54) |
0.50 (0.29-0.84) |
1.69 (1.13-5.93) |
4.37 (3.22-5.93) |
33.40 (16.60-66.79) |
Brain tumors that are likely to be found in a brain check are mostly benign, such as meningioma, pituitary adenoma, schwannoma, etc. Other tumors that originate from the brain, called gliomas, can also be found. There are a variety of treatment options, such as follow-up observations using only images, surgery, and radiation therapy.
The possibility of finding asymptomatic strong stenosis is less than 3%, and the frequency increases with age. Although there is a high possibility of stroke in future, the chances of occurrence are low at less than 1% per year, due to advances in medical treatment. In addition to stroke, the risk of developing myocardial infarction and peripheral arterial disease is also high; therefore, medical management is necessary. Advanced stenotic lesions may require surgical treatment.
