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PITTSBURGH (KDKA) — Migraines can be debilitating, but sometimes, severe headaches can signal a more serious problem.
It could mean there’s a problem with a blood vessel in your head.
Melissa Sleppy had the classic symptoms.
“A really horrible headache. One that just stopped me in my tracks. It was a burning feeling up my neck,” Sleppy said. “I thought it was a migraine. I don’t get migraines, so I assumed, this must be what a migraine feels like.”
But, it wasn’t a migraine. She had a life-threatening brain aneurysm.
A few days later, she had another excruciating headache, and her eyelid started drooping. Her husband took her to the closest hospital, and she lost consciousness on the way there as the aneurysm ruptured.
“I think it’s hard on him. It was just scary. It was a really scary moment,” she said. “When we got there, the next thing I remember was being in a helicopter.”
Aneurysms can develop with smoking, high blood pressure, and genetics. They often have no symptoms until there’s a problem.
“The most common symptom is what we call the worst headache of your life,” Dr. Alexander Yu, of Allegheny Health Network Neurosurgery, said. “Usually brings most patients to their knees.”
When people come to the emergency department with symptoms, they’re stabilized and then pictures of the blood vessels are taken to look for the thin-walled ballooning out of a blood vessel in the brain.
“If it bleeds again, it’s usually fatal,” Dr. Yu said.
An important consideration is size. Doctors will watch those less that 5 millimeters. If they’re bigger than that, this risk for rupture goes up, making the need to do something more urgent.
“Blood all over the brain can irritate the brain, can cause what we call vasospasm, which basically can cause strokes,” Dr. Yu said.
There are two options for treatment. The older technique — around for about 100 years — is clipping.
“Part of the skull is removed, we access the aneurysm, and put something that looks like a paper clip across the aneurysm to close it off from the rest of the circulation,” Dr. Yu said.
A newer technique, around since the 1990s, is coiling. A platinum wire is threaded up through the arteries to the brain and into the aneurysm where it is coiled to clot off the bulge.
With both these is a risk of bleeding, and stroke. But, both offer good long-term outcomes. The decision often comes down to location and age and how well someone will tolerate surgery.
In Melissa’s case, her doctors went with the older approach because the aneurysm was in the front part of her brain circulation, and she was young and a good surgical candidate.
“Although clipping seems to be more invasive, and the recovery can be a little bit more lengthy, it was the way to go,” she said. “I was just thankful that they found it.”
Because she is at risk for more aneurysms, she will need checkups for the rest of her life.
“It’s always something that’s going to be in the back of my head,” she said. “For my own kids, too. They’ll have to be monitored and screened as they get older.”