NEUROSURGEONS/NEUROLOGISTS PLEASE ADVISE

c_thomas_wild at my-deja.com c_thomas_wild at my-deja.com
Sun Oct 1 16:19:22 EST 2000


Here's an educational resource:
http://tbichat.org/

In article <8qi5mk$95k$1 at newsg3.svr.pol.co.uk>,
  "Andy Goodwin" <andy at franticorang.freeserve.co.uk> wrote:
> NEUROSURGEONS/NEUROLOGISTS PLEASE ADVISE
>
> QUESTION :   Is it possible for a cerebella artery aneurysm to
rupture or
> become more likely to rupture due to a 'whiplash' type, road traffic
> accident without being pierced by bone within the skull?- the artery
was
> deep within the brain (N.B. There was no external injury or loss of
> consciousness at time of R.T.A.)?
>
> My 40 year old wife, Denny, had no previous medical problems. Though
now
> 'disabled' she thankfully survived a major sub-arachnoid haemorhage
preceded
> by an undetermined number of smaller leaks/bleeds. Symptoms of
head/neck
> pain immediately after R.T.A.( in same location of  later major
aneurysm
> rupture) deteriorated within 36 hours to head /neck pain/nausea/3/4
days
> unable to get out of bed/disorientation. Painkillers where prescribed
by two
> doctors visted within three days of the accident. She improved enough
to to
> try unsuccessfully to return to her job as an I.T. manager though
still in
> pain.
>     It was thirteen days post R.T.A. when a brain haemorhage was first
> suspected. My wife experienced a more sudden and intense pain in the
same
> location(base of skull/neck) and subsequent continual vomiting.  A
hospital
> accident and emergency doctor sent her home with suspected  'whiplash'
> related 'muscle spasm' but later our G.P.suspected a brain haemorhage
> considering two more days of severe head/neckpain and vomiting.
>         Denny was admitted and discharged (still with severe back
> discomfort) from hospital after three days. A brain scan was negative
and
> three failed attempts at a lumbar puncture produced no spinal fluid
to test
> for blood.
>         Four days later, Denny was re-admitted with severe head/neck
pain.
> She was found having convulsions (x2) on the hospital floor the
following
> night. Again the brain scan proved negative but blood was found after
a
> lumbar puncture!  It was now 24 days after the accident and 14 days
since a
> bleed was first suspected. Denny was admitted to a neuro-centre of
> excellence fortunately located near by.
>         The following day an angiogram was negative but a fifth lumbar
> puncture indicated blood was still present. During the following
three weeks
> an M.R.I. indicated  small changes to brain. A
> convulsion/disorientation/agitation and extreme pain followed.  A 6th
lumbar
> puncture indicated high pressure. The search for the source of the
bleed
> moved to the spine.  An M.R.I. to spine was inconclusive.
Head/neck/back
> pain/nausea/weight loss continued. A  painful Myelogram (to spine?)
also
> proved 'inconclusive due to presence of blood'.Denny was discharged
> expecting to return for 2nd Myelogram.
>         Fourteen days later Denny felt the familiar warning pain at
base of
> skull and neck. She had a convulsion in the ambulance and was
fortunately
> being wheeled onto a neuro ward when her major bleed occured.  She
recieved
> immediate medical attention. A C.T. scan/angiogram indicated that a
> cerabella artery aneurysm had ruptured.  (It's now 62 days since the
> accident) A  drain was fitted to release pressure on the brain. A
week later
> two clips where fitted to the anyeursm.  Complications
> continued/trachyostomy/ left vocal chord paralysis/cross eyed-double
> vision/swallowing difficulty/ permanent posterior ventriculo-
peritoneal
> shunt fitted. The accident occured on 22/4/99, Denny was finally
discharged
> on 27/8/99 and still making a 'remarkable' recovery.
>
> QUESTION 2:    Would a neuro doctor be justifiably concerned if a
patient
> with a known pre-existing aneuyrsm had the same delayed symptoms
(before
> major bleed) as Denny after a whiplash road traffic accident?  If so,
why?
>
> Question 3:    Does anyone know of a similar case or case where
similar
> physical stress/vascular pressure preceded an artery anyeursm rupture
or
> delayed aneurym rupture.
>
> We would like to get on with our lives and your advice may help
either way.
> Thank you!
>
> Contact: paul at pgamble.fsnet.co.uk
>
>


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