Heart Matters: Quick action from Beacon specialists saves patient from life-threatening brain aneurysm

What seemed like an early-morning sinus headache turned into a life-threatening emergency for Denise Beilman — one that came without any warning signs.

Denise Beilman

One Tuesday in late October 2023, Denise woke up earlier than usual with a headache. She took some sinus medicine, but it didn’t touch the pain. By 7 a.m., nausea had set in, and she knew something was different about this headache.

“I got in the shower about 8 a.m., and then it hit me,” she recalls. The pain suddenly grew so severe that she dropped to her knees, clutching her head. She managed to exit the shower and called her mom, then dialed 9-1-1.

“I don’t know why I called 9-1-1 other than I felt like something’s really wrong,” Denise says.

Looking back, she feels she had semi-cohesive thoughts for about 10 minutes after the worst pain hit. “After that, I don’t remember getting in the ambulance. I hardly remember anything.”

The ambulance initially took her to the closest hospital, where the CT scanner wouldn’t be available for 60 to 90 minutes. “It was actually a blessing,” Denise says, because she was then transferred to Memorial Hospital.

And it likely saved her life.

The next thing she remembers is waking up two days later.

Denise’s life-threatening diagnosis

When Denise had reached Memorial Hospital, a team of physicians and nurses were waiting to perform a CT scan, which revealed bleeding.

“This type of bleeding, when it happens spontaneously, is very frequently related to an aneurysm,” says Dr. Michael Hall, neurovascular interventional radiologist, Beacon Medical Group Interventional Radiology and Vascular Specialists.

The situation was very serious. Bleeding into the brain causes intense pain and can lead to dangerous fluid buildup, or hydrocephalus, which puts dangerous pressure on brain tissue. A drain was quickly placed in Denise’s brain through a small hole in her skull to relieve the pressure.

However, the CT scan did not show a definite aneurysm. “Because a CT can sometimes miss a small aneurysm, and because of our strong suspicion for presence of an aneurysm, we quickly brought Denise to one of our hybrid OR/interventional suites,” Dr. Hall says.

A catheter angiogram, in which the physician navigates a catheter into the arteries supplying blood to brain, gave the team an even better view of Denise’s blood vessels.

Dr. Hall and Dr. Wei Huff, Beacon Medical Group North Central Neurosurgery South Bend, determined that Denise did in fact have a cerebral aneurysm, a “ballooning” in a weak part of an artery in her brain.

The statistics are sobering. Most aneurysms are small and don’t cause problems, although larger ones can press on nerves or brain tissue. The real danger is when an aneurysm ruptures, or begins bleeding. Once an aneurysm ruptures, the chance of death is about 40%. Brain damage is even more likely for survivors.

“The great benefit that we have is the ability to discuss and tailor a treatment plan for what we feel is best for the patient,” Dr. Hall says.

While many aneurysms can now be treated with minimally invasive procedures, even if they’ve ruptured, Denise’s case required a different approach.

Dr. Michael Hall

“Although this was a possibility in this case, Dr. Huff and I felt that based on her health status, aneurysm location and aneurysm size that a surgery to clip the aneurysm might lead to a better outcome,” he says. “By having neurosurgeons like Dr. Huff and neuro-interventionalists like myself, we were able formulate a treatment plan that we felt best for Denise.”

Dr. Huff performed a craniotomy the next morning, temporarily removing part of Denise’s skull to reach her brain and repair the rupture. Denise would need intensive monitoring.

“My family told me that from the moment I got there, the care team was right on top of things. They took all the right steps and did it quickly to find out what was going on with me,” Denise shares. “Dr. Huff would explain things to my family, even drawing things out on a piece of paper so they could get a visual. She made sure my family knew what was going on and would talk to them several times throughout the day.”

A challenging recovery

Thursday morning, Denise woke up before her family arrived to check on her. Denise gave her daughter a phone call.

Not realizing she just had surgery, she told her daughter, “I think I’m going to leave, because you guys aren’t here and they aren’t doing anything for me.”

Reflecting on this today, Denise says, “I think that was key, that right after surgery I was able to remember her phone number.” Her daughter quickly let her know she needed to stay in the hospital, and it would be for weeks, not days.

The care team informed Denise’s family that the road ahead would prove difficult. Denise underwent neurological exams every hour to check her strength and orientation. Weakness or confusion at these daily checks would indicate that Denise had gone into a vasospasm phase, a dangerous condition where brain arteries narrow, reducing blood flow. This can appear four to 14 days after aneurysm repair.

“The team communicated really well and had a plan, monitoring Denise very carefully in the intensive care unit,” Dr. Huff says.

Dr. Wei Huff

Their vigilance paid off. During one of these checks, they discovered that Denise had sudden weakness on one side of her body, and imaging confirmed it was vasospasm. Fast diagnosis and immediate action to raise her blood pressure enabled her to push through.

Denise remained in the ICU for more than three weeks, needing assistance even to sit up or lie down. The pressure in her brain from excess fluid continued, so Dr. Huff implanted a shunt, a tube to carry cerebrospinal fluid from her brain to her abdomen, where her body could safely absorb it.

She walked around the unit every day, though her body didn’t always cooperate. “There were times when my legs weren’t working,“ she says. “Sometimes I would get down the hall and not be able to walk straight as my body would veer to one side. ”

The cognitive effects were equally challenging. “There were times when I couldn’t find my words and was frustrated,” she remembers. “There were times when my daughter would call me and say, ‘Have you ordered your lunch yet?’ She’d call back in two hours and I had forgotten to do it.”

Anti-seizure medication added another layer of difficulty, causing her to fall asleep even while sitting up. Then, she would sleep so hard that she didn’t know if it was day or night when she woke up 20 minutes later.

Beating the odds

Dr. Huff notes that only a third of patients with ruptured brain aneurysms go on to recover without serious disability. She’s grateful that Denise is part of that fortunate minority.

More than a year later, Denise feels incredibly grateful.

“When you look at the statistics of people who have had an aneurysm, and how many don’t make it to the hospital, how many pass away even after making it to the hospital,” she says, “I am very blessed. I really give all the glory to God, because I feel like it’s a miracle that I’m alive.”

She appreciates the compassionate care she received from the Beacon team. “They were caring for the whole person,” she says. “Having gone to Memorial with the staff there, including all the nurses, I think that was the best outcome for the worst set of circumstances.”

Today, Denise feels good. “I feel like I’m back to normal. I have my memory back. I started to drive again,” she says. “I don’t take any day for granted.”