No stranger to migraines, David Shupe, 62, tried to ignore the headache that started in mid-December. It was the worst one he’d ever had, he was nauseous, and his pallor was ashen. But, it was a busy time for him playing Santa for area kids and he put off dealing with it.
For days, the severe headache and nausea a constant companion despite pain medications. Finally, Shupe went to the hospital near his home in St. Pauls, North Carolina.
His blood pressure was sky high – 195/103. A CT scan of his brain, which would normally show the problem, did not in Shupe’s case because he had waited so long the blood was no longer visible. But a spinal tap reveled evidence of old blood products, raising concern of a ruptured brain aneurysm that could lead to death or neurological impairment.
Shupe was flown to New Hanover Regional Medical Center; the only hospital in southeastern North Carolina to offer 24/7 neuro-interventional coverage to treat patients suffering cerebrovascular emergencies, including stroke and aneurysms. There another test, a cerebral angiogram, showed that Shupe did have a ruptured brain aneurysm.
An aneurysm is a weak area in the artery wall that bulges out and can burst spilling blood into the brain.
Dr. Jeffrey Beecher, NHRMC’s Director of Cerebrovascular and Endovascular Neurosurgery, performed a minimally invasive procedure to fill the aneurysm with coils, preventing the aneurysm from being able to bleed further causing neurological damage that could have killed Shupe if the aneurysm had not been repaired.
“Aneurysms are ticking time bombs,” Dr. Beecher said.
“I don’t know of anything more serious that has a curable path,” Dr. Beecher explained. “If treated in time, brain aneurysms can be completely cured. If not, they can be devastating.”
Fifty percent of those with a ruptured brain aneurysm die, and many of those who survive often suffer from memory problems, difficulties with speech, or other neurological issues.
But most people don’t know they have an aneurysm until it ruptures.
In Shupe’s case, the aneurysm started leaking before it ruptured, which gave him the headaches and more time. Generally, the excruciating headache comes once the rupture has happened, and the need for immediate care is critical.
It was Christmas Day, after Shupe hung up his Santa suit for the season, that his aneurysm was repaired.
Shupe understands how fortunate he is. He went home from the hospital on December 29 and was able to celebrate Christmas on New Year’s Eve with his wife Hilda, two sons, and four grandchildren. A month later, he was recovering well and following orders from Dr. Beecher and his wife, who he said wouldn’t allow him to do any of his usual chores on the farm, such as chopping wood.
He credits his recovery first to God and then to Dr. Beecher.
“If I had to go through everything again, I hope Beecher would be there to handle it,” Shupe said. “He was fantastic.”
Treating Ruptured Aneurysms
Once an aneurysm has ruptured, or is deemed likely to rupture, surgery is required to treat it. One procedure, endovascular coiling, is a minimally invasive surgery. A catheter is passed through the groin to the affected artery, and the aneurysm is filled with platinum coils. The coils fill the aneurysm and form a clot inside that seals the aneurysm off to prevent bleeding.
Another, more traditional treatment is microsurgical clipping. An incision is made into the scalp and a clip is placed on the aneurysm’s opening to block the flow of blood.
A number of factors go into determining whether the coils or a clip is best suited for the aneurysm, such as the patient's age and health and the aneurysm's size, shape, and location.
After surgery, the patient spends time in intensive care with monitoring for signs of stroke. Physical therapy or rehabilitation may be needed after the patient leaves the hospital.
About Jeffrey Beecher, MD
Dr. Beecher, a board certified neurosurgeon, trained in two fellowships: cerebrovascular and skull base neurosurgery as well as endovascular neurosurgery, allowing him to provide comprehensive care that only a dual trained neurosurgeon can provide.
What Causes Aneurysms?
While the causes of aneurysms are unknown, your risk increases if you:
• Have hypertension
• Are 40 or over
• Have someone in your family who has had an aneurysm
The symptoms of a ruptured brain aneurysm include:
• Excruciating headache
• Unrelenting, severe neck pain
• Sensitivity to light
• Loss of consciousness
• Any combination of the above
If you experience any of the symptoms of a ruptured aneurysm, call 911 immediately.