To the Edge and Back: Defying a Deadly Condition
Eileen Wilhelm had just parked her car at a store near her home when her vision suddenly faded. The world around her washed into sepia tones, and Wilhelm couldn’t think clearly. "I was sitting there in a stupor," the 43-year-old woman said. "I couldn’t even think to call 911."
Wilhelm, of Valparaiso, Indiana, was suffering from a ruptured aneurysm, a weakened blood vessel that had burst in her brain. A gusher of blood was creating pressure inside her skull, squeezing off the brain’s normal blood circulation and oxygen supply.
Fumbling for her phone, Wilhelm called her boyfriend. "I’m not feeling good," she said, then told him her location. It was the last thing she would remember until she woke up in the hospital 48 hours later.
Her surgeon says she is lucky to be alive. "One in three patients with cerebral aneurysms dies before they get to the hospital," said Issam Awad, MD, director of neurovascular surgery at the University of Chicago. "The majority of survivors are typically disabled. They cannot go back to a normal life."
Wilhelm’s future was a distant question when she came into Awad’s care in May 2010. After her boyfriend found her slumped against her steering wheel, he called an ambulance, which took her to a northwest Indiana hospital. A CT scan showed a significant hemorrhage, and not one, but two, aneurysms; the other had not yet burst.
Immediately, physicians ordered her airlifted to the University of Chicago Medicine campus, where Awad, a world-renowned neurosurgeon, would stabilize the patient along with a team of neurocritical care physicians and specialized nurses.
They recommended endovascular coiling for the ruptured aneurysm. The procedure involves passing a catheter into the aneurysm, then inserting and releasing platinum coils that begin a thrombotic (clotting) action.
"Once the aneurysm was sealed, we could deal with the consequences of the original bleed … swelling, spasm, accumulation of fluid on the brain," Awad explained.
After the surgery, a shunt drained fluid from Wilhelm’s brain as she lay in the Neuro-critical Care Unit. Heavy medications helped mitigate the piercing headaches. "I had no appetite," she remembered. "I think all I ate was smoothies."
Eventually, she regained strength, and was cleared to go home. However, some effects lingered. Occasionally, lightning bolts of pain would shoot through her hips, spine, neck and head. "Blood had seeped into her spinal cord," said her nurse, Darlene Prusa, RN. "Basically, her body was feeling misfires." Steroids and painkillers helped ease the symptoms.
Finally, by week eight, Wilhelm was feeling better. However, another hurdle remained: the second aneurysm. Wilhelm had been far too frail to endure a second procedure to remove it. Now she was facing serious brain surgery again, or risking a rupture.
Still, "I wasn’t sold on surgery," she admitted. "I didn’t want anybody carving on me."
However, ruptured aneurysms run in Wilhelm’s family. Her aunt and cousin died of the condition, both in their late 30s. "With your predisposition and history," Awad told her, "it’s a ticking time bomb."
This time, Wilhelm had an opportunity to seek other opinions in the city. But she trusted Awad, and she knew his team of specialists had one of the best success rates in the world for treating serious neurological issues. She consented, and the surgery took place in July 2010. Awad pinched the affected blood vessel with a surgical clip designed to prevent it from rupturing.
When Wilhelm awoke, Awad told her: "It’s a good thing we got that done. That aneurysm was looking thin."
Her recovery took several weeks but was not as painful and disorienting as the first one. Since then, Wilhelm has returned to her work as an information technology specialist. She is a rarity among aneurysm survivors, a patient in excellent health with no long-term side effects.
"One would be hard pressed to tell anything has happened to her," Awad said. "Her treatment required a broad and well-trained multidisciplinary team. We’re very gratified to have been able to help her."
Wilhelm said the experience has left her more relaxed about life.
"I always was a Type A personality, but now I don’t get as upset about things," she said. "It knocked me down a notch. But not in a bad way."