NEUROSURGEONS/NEUROLOGISTS PLEASE ADVISE

Andy Goodwin andy at franticorang.freeserve.co.uk
Sat Sep 23 06:36:40 EST 2000


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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