Brain Surgery Without the Incision: After a Stroke, Tiny Coils Save Beanie Ryan's Life
"It was the best care I've ever had. I had the best nurses. I could not thank them enough."
-Beanie Ryan (center), her daughter Colleen and husband Kelly, savor their time together.
Beanie Ryan of Burtonsville doesn’t remember having a stroke, but her family will never forget that day in early May. They knew immediately that something was very wrong.
“About 4:30 in the morning, she started kicking me in the back,” Beanie’s husband, Kelly, recalls. “She was moaning and I thought it was a bad dream. I tried to wake her up, but she was not responding. Our daughter called 911. The Emergency Medical Technicians rushed to get her to the hospital.”
When she arrived at Holy Cross Hospital, Beanie was confused and drowsy, with slurred, incoherent speech. On a stroke grading scale of 1 to 5 (5 is just before death), she was at grade 3. “Usually with grade 3, 50 percent of patients will die or have a severe stroke,” says James Jaffe, MD, medical director, Interventional Neuroradiology, Holy Cross Hospital.
CT scans showed that Beanie, then age 62, had suffered a hemorrhagic stroke, which occurs when an artery on or near the surface of the brain bursts and bleeds into the brain. In Beanie’s case, the bleeding was due to a ruptured aneurysm. A hemorrhagic stroke is much less common—and more devastating than an ischemics troke, which is caused by a blood clot. Fifty percent of patients with hemorrhagic stroke die before reaching the hospital. Only about 25 percent of patients with a ruptured aneurysm will regain full function.
Holy Cross Hospital specializes in minimally invasive procedures for stroke patients that allow physicians to treat conditions in the brain without making an incision in the skull. As an interventional neuroradiologist, Dr. Jaffe uses X-rays to guide catheters into the brain to either block bleeding aneurysms or remove blood clots.
For Beanie, Dr. Jaffe performed an endovascular coiling procedure.Through a ¼” nick in the groin, he inserted a catheter to navigate to the blood vessels to the brain. Contrast dye was injected into the brain to determine the kind and shape of the aneurysm. Then a smaller catheter was used to deliver and place soft platinum coils, into the aneurysm. The coils fit into the shape of the aneurysm and are meant to form clots so that it won’t bleed again.
Coiling is only the first step in treating a hemorrhagic stroke; monitoring is just as important. Blood that leaks into the brain can be irritating to other blood vessels and cause vasospasms, which narrow the blood vessels in the brain, resulting in decreased blood flow.
“This means there is a risk of patients suffering strokes for several days after surgery, Dr. Jaffe says. “Undetected vasospasms can be deadly if they are not monitored properly.”
That’s why Holy Cross Hospital’s Neuro Critical Care Unit (NCCU) is so important. The unit serves brain and spine patients and those with ischemic and hemorrhagic strokes.
“We have an extraordinarily dedicated team of medical professionals working in the NCCU,” says Zachary Levine, MD, medical director, Neurosurgery, Holy Cross Hospital.“Critical care physicians are on duty 24 hours a day, 365 days a year and they work along with the unit’s specially trained nurses, nurse practitioners and physician assistants who provide continuous patient assessment and monitoring.”
Beanie spent 11 days in the NCCU. “It was the best care I’ve ever had,” she says. “I had the best nurses. I could not thank them enough.”
Just three weeks after what could have been a fatal stroke, Beanie was able to be with her grandson to celebrate his first birthday.
To learn more about expert brain and spine care at Holy Cross Hospital go to holycrosshealth.org/neurosurgery.