Treating Linda’s Brain Aneurysms and Advancing Neurosurgical Care

Linda L. was overwhelmed with the worst headache she’d ever experienced as she worked at her husband Gene’s office.

The pain was so bad all she wanted to do was hold her head.

When she fainted, Gene caught her before she fell to the ground and rushed her to the local hospital. From there she was medevaced to a regional medical center where scans revealed an AVM – an arteriovenous malformation – and several brain aneurysms.

The recommendation was for Linda to undergo treatment right away.

But Linda and Gene weren’t sure. They wanted a second opinion and perhaps a third.

So Linda returned to her South Jersey home to do some research. She soon found Jefferson Hospital for Neuroscience, the region’s only hospital dedicated to neuroscience that has pioneered many of the state-of-the-art treatments and technologies to treat Linda.

At Jefferson, Linda came under the care of vascular neurosurgeon L. Fernando Gonzalez, MD. After an evaluation with Dr. Gonzalez, Linda and Gene wanted more time to think through her treatment options.

“He looked me in the eye and said, ‘whatever you decide, do something, don’t wait too long’,” she recalls him saying.

The tests had revealed Linda actually had five aneurysms – two on the right side of her brain near the AVM and three others on the left side. The concern was that if Linda waited too long to treat the aneurysms, one might rupture and likely kill her.

Dr. Gonzalez recommended a two-pronged approach: use Gamma Knife to treat the AVM and neuro-endovascular techniques to treat the aneurysms starting with two giant bulges in vessels on either side of her brain.

While various technologies can be employed to treat brain aneurysms through a patient’s blood vessels as well as with open brain surgery, neurosurgeons are not now armed with great tools to determine the likelihood of success using one or another of those treatment techniques.

One of Dr. Gonzalez’s research interests include developing new neurovascular modeling capabilities that would allow neurosurgeons to better plan treatment for complex patients like Linda.

Based on a 3-D angiogram of Linda’s brain, Dr. Gonzalez created a physical model of one of her giant aneurysms. Ultimately, the goal is to use this neurovascular modeling technology to create a mechanism to test different treatment approaches before the patient is actually treated.

Three months after her visit with Dr. Gonzalez, Linda opted for the treatment approach he suggested – using Gamma Knife on the AVM and various techniques including coils and a specialized brain stent called a Pipeline™ Embolization Device on another before addressing the three smaller aneurysms.

“She’s doing well,” Dr. Gonzalez says of Linda. “Now we just have to keep following her.”

As for Linda, she couldn’t be more pleased that she found Dr. Gonzalez and Jefferson, both for herself and her husband. It turns out that when she was going in for her first treatment at Jefferson, a nurse noticed Gene taking some pills before she was wheeled into the procedure room.

It turns out he was experiencing some chest pain and had taken some Nitroglycerin. Linda refused to go ahead unless Gene went to the emergency room to get checked out. It turns out that was a good decision, as he needed a couple of stents to open up a blood vessel in his heart.

So as Linda recovered from her procedure, she learned that Gene was in the cardiac care unit a block and a half away at Jefferson University Hospital.

“My nurse said, ‘how would you like to go see your husband?’” Linda recalls.

Of course she wanted to, so the nurses got her “wrapped up” and in a wheelchair for the short trip to visit Gene as he recovered.

“Dr. Gonzalez and his team … I don’t have words,” Linda says. “I’m just so glad I found him as a doctor.”

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