Marcus Neuroscience Institute Swift Response to Patient with Ruptured Aneurysm Hemorrhagic Stroke

Marsha Teesdale and her sister Nacastia Teesdale, 43, both from Lindenwold, New Jersey, were on vacation in South Florida when Nacastia woke up one morning feeling odd, losing control of her muscles, and vomiting. She was able to tell Marsha that she felt something “pop in her head.” Marsha thought her sister was having a stroke, but the symptoms were not quite stroke-like.

“I didn't have any symptoms of a headache or anything until … three o'clock in the morning -- massive headache,” recalls Nacastia. “And then I heard a pop in my head, like someone blew a balloon. And my body began to shake and I said, ‘Sissy, something's wrong.’ She came in and saw me in the bathroom. I was checking my face … to see if I could see what happened. and I couldn't. And then in my mind, I just started to pray. And the next thing I know, she was by my side. And that was the last thing I really remember.”

Nacastia Teesdale was transported by paramedics to Boca Raton Regional Hospital, part of Baptist Health. Remembers Marsha: “Then the doctor came out and told me: ‘ Your sister has an aneurysm. It's ruptured. It's bleeding. She has to be operated on right now.’ So I'm like -- Okay, this is really, really serious.”

Nacastia’s condition was indeed serious – and rare. She was diagnosed with a subarachnoid hemorrhage, which may cause a type of stroke called a hemorrhagic stroke. This type of stroke causes bleeding inside the brain. It is different from an ischemic stroke, which is caused by a blood clot and is the most common type of stroke.

“Nacastia had what's called a subarachnoid hemorrhage, which is bleeding from an aneurysm that ruptures,” explains Brian Snelling, M.D., director of cerebrovascular and endovascular neurosurgery and director of the stroke program at Marcus Neuroscience Institute at Boca Raton Regional Hospital, part of Baptist Health. “That's one of the many types of strokes. It's certainly not the most common one, but it's one that typically affects younger patients. It affects women more commonly. They make up about 5 percent of all types of strokes.”

A subarachnoid hemorrhage is bleeding in the space between your brain and the membrane that covers it. Most often, it occurs when a weak area in a blood vessel (aneurysm) on the surface of the brain bursts and leaks. The blood then builds up around the brain and inside the skull. This increases pressure on the brain. It can cause brain cell damage, life-long problems, and disabilities.

Adding to the severity of Nacastia’s condition upon arrival at the hospital was the location of the aneurysm. “The particular type of aneurysm that Nacastia had, which was called a pericallosal aneurysm, is in a particular location in the brain that makes it even more rare,” said Dr. Snelling. “So, she had a rare type of aneurysm in a rare location.”

Marsha said she felt relief when she met with her sister’s care team, which responded quickly and explained the seriousness of her condition. “They came in and everyone who was supposed to be there was there,” she said. “I remember one of the people who with me there – that person looked up to see the name of the surgeon and they go: ‘Oh, his name is Dr. Snelling. He's like one of the best in the country. He's like the No. 1 guy to do this.’ Everyone was there. So it was from home to the hospital and right into surgery.”

Dr. Snelling explained to Marsha that her sister would undergo a cerebral angiogram, a procedure that uses a special dye, or contrast, and x-rays to see how blood flows through the brain. That was immediately followed by endovascular coiling to block blood flow into an aneurysm. This procedure is also called endovascular embolization.

“She was completely asleep under anesthesia,” explains Dr. Snelling. “Once that happened, we put a small catheter in the artery of the wrist. The arteries of the body are like a highway, so we put that catheter up into the arteries of the neck and took some pictures. From there, we diagnosed her as having a cerebral aneurysm as the likely source of her bleeding. Through the catheter, we placed small platinum coils into the aneurysm to embolize the aneurysm or to block it off, to prevent her from having any further bleeding into the brain.”

Nacastia: “When I woke up, I was not in any pain. I wasn't feeling any discomfort in my head or anything like that. Just confused because, again, no memory.”

Both a stroke and an aneurysm that bursts can come on suddenly without any warning. The symptoms vary. A ruptured aneurysm, as in the case of Nacastia, can cause a severe headache (worst headache of your life); weakness in one or both limbs; nausea, vomiting and hearing or vision problems. Stroke symptoms can be similar, with numbness or weakness in the arms, legs or face, especially on one side; trouble with balance or coordination, confusion and language issues or slurring of words.

“Everything happened at once, which is usually how strokes occur,” said Dr. Snelling, referring to Nacastia’s case. “Symptoms happen at the snap of a finger. According to her and her sister, around 3 o'clock in the morning, she woke up with a sudden onset severe headache. She had some nausea and vomited maybe once or twice.

Her sister noticed something was wrong and brought her to the hospital. What had had happened is that the aneurysm had ruptured. She then had bleeding in and around the brain that caused the her not to feel well, which led to the headache and the nausea and vomiting. Everything happened all at once.”

Reflects Marsha about her sister’s treatment and recovery: “She walks, she talks and I have my sister back. I am so thankful. I couldn't be happier.”

Adds Nacastia Teasdale: “I'm feeling very grateful. I don't feel any pain or anything like that, other than the normal things that I would feel after this event. But I'm so grateful, again, to the most high for this.”