Successful minimally invasive thrombectomy saves woman on verge of brain bleed

Brittany Ricks had a chronic illness and had new a headache symptom in June. Read about her emergency treatment for the life-threatening cause of her pain.

For Brittany Ricks, Thursday, June 8, started just like the previous day.

She was preparing for a neighborhood yard sale with family and friends, working in her garage to organize and price items. She was a bit more fatigued than usual and had some aches and pains on the right side of her body, but chalked that up to her multiple sclerosis (MS) diagnosis she’d had for a decade.

But there was one major difference from the day before. She woke up that Thursday with a splitting headache. Not only did it not subside, but it got worse throughout the day.

And the symptoms were peculiar.

“I had that headache just on one side of my head,” Brittany said. “From the top, side, back and down just on the right side. The pain was more than anything I’ve ever had.”

Nothing she did could kick the headache. She tried to lie down, sleep it off, and even tried her sister’s migraine medication. But still, the pain in the right side of her head wouldn’t stop.

She woke up Friday morning feeling even worse.

“I could barely stand up,” Brittany said. “I could barely walk, and I was starting to tilt my head because it hurt so badly. So I called my mom and told her what was wrong.”

Brittany’s mother, Debbie, wouldn’t let her daughter wait any longer. She drove her straight to the emergency department at Norton Brownsboro Hospital. Brittany’s nausea was so bad, she vomited both on the way to the hospital and inside the waiting room.

The staff at the hospital knew they needed to act quickly.

After several scans and tests, Brittany was diagnosed with arterial dissection with a pseudo-aneurysm and subarachnoid hemorrhage. Essentially, two of Brittany’s four brain-feeding arteries had been injured. One was closed off, while the other was torn, forming an aneurysm. That aneurysm was on the verge of bursting, causing a brain bleed.

“The doctor comes in and says, ‘Brittany, you have a brain aneurysm,’” she said. [But] I was so ‘out of it’ that I wasn’t even correlating what was going on. I don’t think I even had a chance to [process what happened]. They literally rushed me into the OR right then.”

She was taken into emergency surgery with Mahan Ghiassi, M.D., endovascular neurosurgeon at Norton Neuroscience Institute.

“Unfortunately, a lot of patients who do not recognize the severity of what’s going on, end up showing up to the ER [emergency room] with very large hemorrhages in the brain, and some of them don’t make it,” Dr. Ghiassi said. “That aneurysm that had formed off of that artery can burst in the brain and be fatal in some cases. So it was important that we acted fast.”

Dr. Ghiassi performed a minimally invasive thrombectomy, an endovascular procedure that allows a doctor to avoid open surgery, entering the body and repairing the arteries through a thin tube inserted through a small puncture in the arm.

The surgery was successful, and Brittany needed just one night in the intensive care unit (ICU) before she was discharged from the hospital.

“Being able to go in through a little puncture site in someone’s wrist and treat the same issue that would’ve taken you eight or nine hours to treat in open surgery is a dramatic difference,” Dr. Ghiassi said. “That patient is up and walking around the same day, whereas in the old days, 15 to 20 years ago, they would’ve been in the ICU probably for an entire week. So this has dramatically changed recovery times for patients, and the outcomes have significantly improved as well.”

Now two months out from surgery, Brittany continues to progress. She sees headache specialists at Norton Neuroscience Institute for her residual headaches and continues to take small steps forward each day. She credits her improvement to listening to her body, listening to her mother and the great care she received at Norton Brownsboro Hospital.

“When things happen, we don’t always pay attention to our bodies,” Brittany said. “We sort of brush it off and think that it’ll go away. Had I not gone [to the hospital], I probably would not be here today.”

Fortunately for Brittany, her instincts to call her mom — and Debbie’s insistence they head to the emergency department — put Brittany under the care of Dr. Ghiassi and the Norton Brownsboro Hospital team. “It’s the No. 1 reason why I went into medicine,” Dr. Ghiassi said. “I feel it’s the most rewarding field there is. There’s definitely a lot of work that goes into becoming an endovascular neurosurgeon, but it’s by far the most rewarding thing that I could ever imagine doing in my life. To be able to significantly and dramatically change someone’s life by providing a service like surgery is definitely fulfilling, but also I feel like it’s a blessing.”

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