Brain Stem Aneurysm


On August 24, 1995, at 2:30AM I woke from a sound sleep with a strange headache that I described to my husband, Bobby, as "like no headache I've ever had before." Bobby called 911 when he noticed I was highly agitated and walking funny. The paramedics gave me a brief examination and decided to take me to the hospital for a CT scan. I only remember bits and pieces of the next two days. I was very nauseous and remember throwing up several times. Bobby says I lay quietly most of the time with my eyes closed. I have no memory of pain after the initial incident but I feel certain I was in pain or I wouldn't have lay so still. The CT scan showed bleeding in my brain, so I was transported to a bigger hospital where an arteriogram revealed an aneurysm deep in my brain stem. I have no memory of this test. By that time my family had gotten there, but I don't remember them being there. Because the aneurysm was in the most difficult area of the brain to reach, and there were no doctors in Albuquerque, NM who could perform the necessary operation, it was decided to fly me to a specialist in Phoenix, AZ. I remember being put on the air ambulance and complaining about the light. I remember telling the paramedic I was going to throw up, but before I could finish, I threw up all over her. I know I opened my eyes then because I remember the color of her shirt. Bobby flew with me in the air ambulance. I remember the pilots talking about thunderstorms and saying they were approaching Phoenix. That's all I remember until that evening when a doctor told me about the operation he would perform.

The doctor who was going to do the surgery, Dr. Robert Spetzler, of the Barrow Neurological Institute at St. Joseph's Hospital in Phoenix, examined me and explained to my family that the place where the aneurysm was located was at the base of the brain stem. The brain stem controls all of your life functions (breathing, heart beat, etc.). There is an artery that goes right up through the center of the brain stem called the Basilar artery. That was where my aneurysm was. He explained the delicate surgery he would perform. I remember a man's voice that I knew to be a doctor's voice, telling me that the surgery would leave the right side of my face temporarily paralyzed and that the hearing in my right ear would be permanently lost. Bobby says we talked about the surgery in detail and prayed together, but, again, I have no memory of that. I was put in ICU through the night while preparations were made for surgery.

At 4:00AM they hooked me up to a heart bypass machine which circulated my blood while cooling it. My core body temperature had to be lowered to put me into a situation of hypothermia. This took several hours and while this was being done, a team of surgeons was opening up my skull and getting everything ready for the clipping of the aneurysm. A "C" shaped incision was made behind my right ear, and my inner ear was surgically removed because that was the most direct way to reach the aneurysm. When my core body temperature reached a certain level, they injected a drug that stopped my heart. Now the bypass machine took over. They continued to lower my body temperature until it was 63 degrees. At that time, the bypass machine drew the blood from my body and held it there. Dr. Spetzler was then ready to put a clip on the aneurysm.

To his surprise he found two aneurysms (one had bled and one hadn't). The one that had bled had scabbed over. It took him 19 minutes to clip the aneurysms during which I had no blood circulating in my body, my heart was stopped, and there was virtually no brain activity at all. Then the bypass machine again began circulating my blood, this time increasing the temperature. The surgical team began closing and sealing the incision in my head. They grafted fat from my abdomen into the space left where my inner ear was removed. My heart was started again. The whole procedure took eleven hours. I woke up the afternoon of the next day. I had tubes coming out of the top of my head and in my neck. I had a ventilator down my throat, a large bandage over my right ear and a plastic bubble over my right eye. I remember waking up with an overwhelming feeling of well being, of the knowledge that I would be okay.

I was in ICU for two weeks. My head miraculously didn't hurt. I was surprised at the lack of pain. I hurt everywhere else (due to laying in bed for so long) and I remember making jokes about brain surgery and hemorrhoids. The right side of my face was paralyzed because the nerves were traumatized. My right eyelid stayed wide opened so I had surgery to insert a gold weight in my eyelid to make it easier for me to close my eye. My voice was very weak and scratchy for several months. My mouth drooped on the right side and it was difficult to eat and drink. After being in the hospital for three weeks, I returned home to Albuquerque on a commercial airline.

My recovery has been miraculous. I had physical, occupational, and speech therapies for several months and began working again in November. It's been seven months now, and I'm working about 6 hours a day. My balance was affected because my right inner ear was gone. The left inner ear has taken over and I don't have problems with my balance any more. I can open and close my right eyelid now. They expect the paralysis to subside in the next few months. I have debilitating headaches every three to four days that are attributed to the healing process. They last about an hour and a half and nothing seems to affect the pain. But I'm learning to get through them and hope to quit having them soon. I'd like to hear from others who have had this same kind of pain (especially if you've found something that helps).

My personality has changed somewhat and I don't know whether to attribute it to the actual brain surgery or the knowledge that I'm very lucky to be alive. I used to be a very shy, reserved person who avoided speaking in public and was a wallflower at parties. Now you can't shut me up. I talk to everyone I see and have made several public speeches about my surgery. I love this "new" me.

I would love to correspond with others who have gone through these or similar experiences.


Update 30 Dec 96

It's been almost a year and a half since my aneurysm surgery. I have been working full time since October '96. My face is still partially paralyzed because the facial nerves didn't heal correctly but I'm learning to live with a somewhat crooked smile. My memory seems to be intact and I'm strong and fit once again. I have enjoyed corresponding with others who have contacted me on the Internet and welcome further correspondence.

Discussion, comments, or questions: Nancy Dytzel


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