Brain Aneurysm Awareness

Nicola Weems and Kirsten Roll Kosack.

Nicola Weems and Kirsten Roll Kosack.
Photo by Jay Marroquin.

By Vicky Russell –

September is Brain Aneurysm Awareness month. A brain aneurysm is a bulging, weak area in the wall of an artery that supplies blood to the brain. Around one to two percent of the population has them, and in most cases, they are asymptomatic. A person may have an inherited tendency to form them, and others develop aneurysms due to gender, race, high blood pressure, diabetes or smoking. If there is a family history, it is recommended to obtain an evaluation by a qualified physician.

The topic hits close to home for me. My two girlfriends and I have known each other since junior high and graduated from Katy Taylor together. All three of us are in the age bracket to have a ruptured brain aneurysm and we are women, which puts us at an increased risk compared to men.

Back in March, I received a message from a close friend that our friend Nicola had just been hospitalized due to a ruptured brain aneurysm. Nicola, who suffers from migraines, was under tremendous stress and was working on planning a wedding for a client when everything suddenly got blurry. The next thing she knew, she was on the ground. Her handyman, who was nearby, called 9-1-1. EMS arrived and took her to Conroe Regional. They immediately did a non-contrast computerized tomography (CT) and determined a bleed in her brain. Because they did not have the capabilities to treat her beyond imaging, they needed to transfer her to a comprehensive capable hospital.

Nicola was immediately transferred to Methodist. Surgery was performed by Dr. Richard Klucznik, an interventional neuroradiologist. Before she was put under, Nicola pleaded with the staff to make sure she survived for her three children. Their father had died a few years earlier due to brain cancer. Losing their mother too would be too much.

Nicola’s aneurysm was successfully treated by endovascular coiling, a procedure that uses advanced brain imaging and catheters to repair brain aneurysms by a small nick in the groin the size of an IV. Following her procedure, Nicola awoke neurologically normal. The first two weeks after a rupture is the most critical time. Of the 18,000 patients who survive annually, 3,000 either die or are disabled from rebleeding, with most occurring within the first two weeks. Nicola was at Methodist for three weeks after surgery.

At that time, I found out about another classmate, Kirsten. Kirsten’s ruptured aneurysm occurred back in January, two months earlier. It began as an excruciating headache that had been going on for nine days. She could also hear noise in her head and suddenly became extremely nauseated. Her mother picked her up, took her home, and 24 hours later, they called 9-1-1. Still coherent, EMS felt her symptoms were due to the flu. At that point, Kirsten felt embarrassed, so she stayed home.

At 46, being a female, having nausea and a sudden, severe headache, other possibilities should have been considered. Later, Kirsten went to a local urgent care clinic to get Tamaflu and a nasal swab. Her swab came back negative, and she was told to wait 14 days before she would feel better. Nine days later, she felt another sudden, severe headache in front of her mom, and she was taken to Houston Methodist West Hospital in Katy, where a CT determined she had a subarachnoid hemorrhage. She was transferred to Memorial Hermann in the medical center.

Dr. Mark Dannenbaum, a vascular and endovascular neurosurgeon, coiled her ruptured aneurysm. Doctors also discovered that she had three other aneurysms that had not ruptured and needed treatment later. Kirsten was lucky that after all of the delays, she had no complications or deficits. “Dr. Dannenbaum saved my life,” Kirsten said. In April, Kirsten had her second aneurysm coiled and most recently, she had her third one clipped, requiring a craniotomy, which is an opening made in the skull.

Dr. Dannenbaum recommends that anyone with concerns over diagnosis, management or even simple questions should reach out to a physician at a comprehensive stroke center for specific advice, and never be ashamed to seek evaluation in an emergency department.

Dr. Klucznik advises that a person having a sudden onset of “the worst headache of their life” should call 9-1-1. It’s the kind of headache that comes on immediately, like a thunder clap, not a headache that comes on slowly. Patients need to go to an ER at a stroke center for a CT and for evaluation by specialists who offer both coiling and clipping as opposed to an urgent care center.

I hope their story makes you aware of how precious life is and to recognize the signs and symptoms of this kind of stroke. Visit www.joeniekrofoundation.com to learn more about brain aneurysms.