From Coma to Comeback: 49-Year-Old Woman Survives Rare Brain Aneurysm Rupture
The woman was brought to the hospital in a critical condition—unresponsive, with oxygen saturation at a dangerously low 70%, blood pressure at 90/60 mmHg, and frothing at the mouth, likely due to fluid accumulation in the lungs. Initial assessments including ECG, echocardiogram, and chest CT pointed to severe lung involvement. However, a CT scan of the brain revealed subarachnoid haemorrhage, indicating a ruptured aneurysm.
'Aneurysms are balloon-like dilations in blood vessels that can rupture under increased intracranial pressure, sometimes triggered by coughing or even straining,' explained Dr. Pratham Byasani, Consultant Neurosurgeon at Vasavi Hospital. "Our patient was in shock—either due to a lung infection or a rare condition known as neurogenic shock, caused by a sudden surge of hormones following increased brain pressure."
The patient was placed on a ventilator and stabilised in the ICU with multiple medications to support her blood pressure. Over the next two days, a CT angiogram was performed to locate and assess the aneurysm. Once her condition allowed, she underwent a complex procedure involving Digital Subtraction Angiography (DSA) followed by balloon-assisted coiling of the aneurysm.
'Her case was extremely challenging,' said Dr. Byasani. 'Unlike the typical aneurysm presentation of high blood pressure and severe headache, she was unconscious with low blood pressure and signs of pneumonia. Aneurysms with a wide neck are difficult to treat, as coils can dislodge into the main artery and cause a stroke. In her case, we used a balloon to secure the coils and prevent such complications.'
Despite the odds, the patient made a full neurological recovery, surprising even the clinical team. The success, Dr. Byasani noted, was due to the combined effort of specialists in neurosurgery, pulmonology, intensive care, internal medicine, and anaesthesia.
This case underscores the importance of timely multidisciplinary care in managing rare neurological emergencies, and offers hope in situations that often carry high mortality.
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