Get This Thing Out of My Head!
For some time Donna had been having intermittent bouts of double vision, but she didn’t think anything of it. Then the headache started. “It was just behind my right eye,” Donna says. “It kept getting worse, but I didn’t want to go to the hospital for a headache. That seemed silly. But finally my family made me.”
Donna eventually got to St. Vincent’s Hospital near her home in Connecticut where an MRI was performed. “I had already been to two hospitals and seen a few doctors by the time I got there. I had pretty bad double vision, I was vomiting and I could hardly walk,” says Donna.
After the MRI, Donna says, “The doctor came to me and said, ‘The bad news is that you have a giant aneurysm. The good news is that it is not in your brain. It is behind your right eye, below your skull’.” They couldn’t perform the surgery she needed there, so they sent her by ambulance to Columbia Presbyterian where she met Dr. Lavine.
Donna says, “When I met Dr. Lavine, I hit the lottery. The whole team was amazing.”
The first thing Dr. Lavine had to do before he could operate on the aneurysm was to see if the operation itself would be too dangerous. He did this by performing a balloon test occlusion. In this procedure, using endovascular techniques, a deflated balloon is brought through an artery in the groin all the way up to the main artery feeding Donna’s aneurysm (in this case, the right internal carotid artery). There, Dr. Lavine inflated the balloon temporarily to make sure that if this artery was blocked, as it would be during the surgery, there would be enough blood flow to Donna’s brain. She passed this test.
The only problem that remained was Donna’s high blood pressure. Donna says, “My pressure has always been a little high, but when I got to Columbia they told me it was sky high. They said they had to get it down before they could safely operate on me.”
Five days later, her pressure was still high, but her symptoms were rapidly getting worse. Donna says, “I was in such pain, despite the medicine they gave me. I could hardly sleep and I couldn’t see at all through my right eye. I kept crying, ‘Just get this thing out of my head’.” Dr. Lavine worried that Donna could suffer permanent blindness, and the aneurysm could fatally burst, so he decided he had to operate immediately.
Donna says, “Everyone got really busy. Dr. Lavine held my hand. He was so warm and personable. He had my heart and I knew I was in good hands.”
He performed a two-step endovascular procedure on Donna called a stent-assisted coiled embolization. (To learn more about endovascular surgery see our featured article, Endovascular Neuroradiology; The New Frontier)
The first step was to place a stent, or mesh liner, at the base of the huge aneurysm. Dr. Lavine did this because the aneurysm was so big and irregularly shaped that a physical barrier needed to be created between the aneurysm and the artery from which it stemmed.
Next, he performed the embolization, by placing a number of tiny flexibly coils within the aneurysm. These coils collectively take up space in the body of the aneurysm, giving it a solid structure that prevents it from bursting.
Dr. Lavine had gotten to the aneurysm in time. Donna’s symptoms immediately began to abate. She says, “My vision was back in 2 months, and I don’t have any headaches anymore. Now I get to see my first grandchild, and I appreciate that every day.”
About her experience at Columbia, Donna says, “Every time I go there, they treat me so professionally. They care, right down to the people who carry you on the gurney. This one lady who cleaned the room; We got to talking and she came over and gave me a big hug. I am just so glad I ended up at Columbia.”
Originally posted Jul 21, 2010
Updated March 5, 2017
In Aneurysms, Blog, Cerebrovascular Blog, Endovascular Blog Tags: , balloon test occlusion, coil embolization, Donna Ainsworth, Dr. Lavine, Giant Aneurysm, headache