Brain aneurysms develop when a weakened part of blood vessel wall begins to bulge outwards, which leads to blood flowing into the bulge. This forms the aneurysm. Most brain aneurysms are small, but some can grow to in excess of 25mm, compressing adjacent brain structures and causing symptoms such as blindness and double vision. The aneurysm can also rupture, which is more likely to occur in larger aneurysms, causing a life-threatening brain bleed called subarachnoid haemorrhage. Aneurysms cannot be prevented, but there are certain risk factors that are associated with increased risk of developing them, such as high blood pressure, smoking and it is strongly associated with a particular type of kidney disease called autosomal dominant polycystic kidney disease.

If an aneurysm does rupture, the overall mortality rates can go up to 40 to 50 per cent, even with treatment. Of those patients who survive, approximately half will have significant neurological deficits. After rupture, the aims of initial treatment are mainly neurocritical care related, for example, to manage a patient’s airway if the patient is in a coma, any resulting high blood pressure which frequently happens, and seizures if they occur. If there is an accumulation of cerebrospinal fluid in the brain, the patient will need emergency surgical drainage of this fluid.

If a patient survives the rupture, the next step would be to identify the aneurysm and its anatomical details by doing an angiogram, a type of scan which enables doctors to clearly visualise the blood flow through arteries. This is followed by a procedure to obliterate the aneurysm to prevent a re-rupture which could be fatal. The aneurysm can be obliterated either via open brain surgery with surgical clipping of the aneurysm, or via minimally invasive endovascular means to coil the aneurysm from within the blood vessel, which tend to be more commonly performed in recent years. The patient would subsequently need to be monitored in a neuro-intensive care unit for further complications from subarachnoid haemorrhage due to the ruptured aneurysm.

Dr Julian Han
Consultant, Department of Neurosurgery
National Neuroscience Institute

The Duke-NUS Conditional Admissions pathway is a programme-based partnership that we run together with a number of prestigious universities in and outside of Singapore. Leaning on the School’s pursuit to develop “Clinicians Plus”, the partnerships were strategically forged to provide a multidisciplinary learning environment with a focus on healthcare-related applications for students pursuing this pathway. They equip students who are keen to pursue graduate-entry medicine with the necessary knowledge and tools to prepare them for medical school and beyond.

If you are at the point of enrolment into Nanyang Technological University, Singapore (NTU Singapore), you can consider applying to the NTU-Duke-NUS Medicine Track. This track is offered only to prospective applicants who are keen to undertake the Bachelor of Science (Honours) in Biological Sciences and Psychology or a Bachelor of Science in Biomedical Sciences and BioBusiness as their undergraduate degree.

If you are keen on pursuing engineering and medicine, you can consider applying for the NUS Engineering & Medicine Track offered by the National University of Singapore (NUS) or the SUTD-Duke-NUS Special Track offered by the Singapore University of Technology and Design (SUTD).

Lastly, if you are already pursuing an engineering degree at NTU, you can simply apply to Duke-NUS once you have completed your undergraduate degree.

Applicant Days for the Conditional Admissions pathways begin in July each year and outcomes will be made known by early August of the same year. To find out more about the various admission schemes for pre-university students, please refer to the following link: https://www.duke-nus.edu.sg/admissions/pre-md-pathways.

If you are interested in applying to our MD programme, our application cycle opens on 1 June each year for all applicants, including those applying through the Conditional Admissions pathways. 

For a quick overview of the process and key application dates to take note of, please refer to the diagram below, or join us at our upcoming information sessions.