Beating the Odds
Lansdale woman thrives after life-threatening brain aneurysm
On a crisp autumn day last fall, Suzanne Singh of Lansdale noticed the text messages on her cell phone looked blurry. Her vision problems were an early indication that a brain aneurysm (a bulge in a weakened cerebral blood vessel) was pressing on her brain. A few hours later, emergency medical services and subsequently Abington Health’s Neurosciences Institute expertise saved Suzanne’s life.
In Lansdale Hospital’s Emergency Department, Gerald F. O’Malley, DO, ordered a CT scan for Suzanne, which showed a suspected aneurysm. Using the Telemedicine connection that links Abington’s specialists with emergency physicians at hospitals throughout the region, the LH team consulted with Qaisar A. Shah, MD, director of Neurointerventional and Neurocritical Care Services at our Neurosciences Institute. He viewed her CT images remotely from a secure laptop at Abington. Dr. Shah saw that Suzanne’s brain aneurysm had ruptured and blood was leaking into the subarachnoid space between her brain and the membrane covering it. Using the connection, which includes high-resolution imaging, Dr. Shah determined that Suzanne should be transported immediately to Abington Memorial Hospital, which has the advanced equipment and specialized neurocritical care she required.
At AMH, a CT angiogram showed a four-millimeter aneurysm in an artery on the right side of her brain. The neurocritical care team stabilized Suzanne, getting her blood pressure under control and managing her headache pain. Suzanne had swelling inside the ventricles – spaces in the brain that contain cerebral spinal fluid. “If this accumulated blood clots, it can block the drainage of spinal fluid,” explains Dr. Shah. “Spinal fluid must drain or it will accumulate, putting pressure on the brain, which can result in brain damage.”
To ensure Suzanne’s spinal fluid kept draining, a temporary external drainage system was created. Dr. Shah collaborated with Larami G. MacKenzie, MD, associate director, Neurocritical Care, to drill a small hole in Suzanne’s skull and insert a narrow tube into the ventricles. The tube was connected to an external drainage bag and monitor.
Then, from a tiny incision in Suzanne’s groin, Dr. Shah inserted a catheter (a thin tube) into the femoral artery. Using advanced X-ray guidance, he maneuvered the catheter through the blood vessel, to the precise area of the brain where the aneurysm was located. Next, he inserted a microcatheter into the aneurysm to place several tiny, platinum coils at the opening of the aneurysm. The coils sealed off the aneurysm, cutting its blood supply so it wouldn’t bleed again or grow.
Suzanne was admitted to the Neurocritical Care Unit, where the medical team monitored her closely while she recovered and regained her strength. Dr. Shah removed her external drainage tube on the fifth day after her procedure. She was discharged to her home and family on the eleventh day, with no signs of complications.
When I was feeling better, I spent a lot of time researching brain aneurysms,” says Suzanne. “So many stories ended tragically – with disability or death.” The statistics are grim. Nearly one-third of those who experience a subarachnoid hemorrhage never make it to the hospital. Of those who get to the hospital for treatment, nearly one-third experience some level of disability after the ordeal.
“I am so grateful to every person who cared for me…the paramedics, emergency doctors and nurses and all the staff at Lansdale and Abington hospitals,” says Suzanne. “Because of them, I am alive and well. I told my husband when I agreed to participate in this article, that my story would be one with a happy ending.” Spoiler alert! Suzanne was right.