The Challenge: A Brain Aneurysm
Dr. Mark Roberts had no idea there was an aneurysm in his brain. When it burst two years ago, he could have been on an airplane or attending a convention in another country — as a professor at the University of Pittsburgh, he often travels internationally. Or, he could have been in the middle of a lecture. He shudders to think of all the possibilities.
"Every step of the way, I got just fantastic care. I have a second lease on life." — Robert
Instead, his aneurysm burst at 5:30 in the morning, when he was at home showering. It felt "exactly like what the textbook says," recalls Dr. Roberts — excruciating pain in his head that came all at once and out of the blue.
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"It was a thunder-clap headache — like a bolt of lightning went off in my brain," Dr. Roberts says.
The Path to Brain Aneurysm Treatment at UPMC
Dr. Roberts knew something was wrong and woke up his wife right away. The two drove from their home in Pittsburgh to the closest hospital, UPMC Presbyterian. Fifteen minutes later, they were in the Emergency Department where a CT scan confirmed bleeding in Dr. Roberts' brain. Hydrocephalus had already set in, which meant fluid buildup was causing increased pressure in his head and squeezing his brain.
Within an hour, Dr. Roberts was in the Neurosurgery ICU having the fluid drained while a team of doctors searched for the source of his brain bleed.
"It was incredibly fast," Dr. Roberts says. He believes that UPMC truly saved his life.
The Solution: Brain Surgery, Twice
Robert. M. Friedlander, MD, chairman of the UPMC Department of Neurological Surgery, quickly found the burst aneurysm at the back of Dr. Roberts' brain. It was an unusual and very dangerous dissecting aneurysm. He performed an open clipping surgery, which involved placing a small metal clip at the base of the aneurysm to control the bleeding. But, the day after the surgery, an angiogram revealed a blood vessel continued to dissect beyond the clip, which presented the possibility for a new bleed.
Dr. Friedlander knew there were two options. He could operate a second time and sacrifice the affected blood vessel in the back of Dr. Roberts' brain, or he could forego surgery. The operation could lead to a cerebellar stroke and cause significant neurologic deficits. However, the second option of foregoing the surgery would likely mean that Dr. Roberts would not survive.
With no other options, Dr. Friedlander moved ahead with a second surgery to completely control the bleeding.
The Results: Back to 100 Percent Health
After a second surgery, Dr. Roberts spent three-and-a-half weeks in the ICU, a week in the neurosurgery wing, and a week in rehab. But now, thanks to Dr. Friedlander's expertise and the team of doctors' fast reaction time, Dr. Roberts has no deficits.
"I'm essentially 100 percent," he says.
Dr. Roberts says he received amazing care at the hands of all the UPMC staff he worked with. As a doctor himself at UPMC Montefiore, he admits he was probably a more difficult patient than most. But although he doesn't remember much from his time in the ICU, the flashes of memory he does have bring forth two feelings: compassion and competence.
"The nurses knew exactly what they were doing, and they cared about how I was doing," Dr. Roberts says. "You can't ask for more than that."
His rehab doctors also impressed him. Unlike most neurosurgery patients in acute rehab, Dr. Roberts wasn't suffering from serious neurologic dysfunction. Thus, standard therapy exercises — such as naming and matching shapes — weren't difficult for him and weren't helping him get back to his normal life.
Dr. Roberts' occupational therapist knew he worked at the University of Pittsburgh Graduate School of Public Health. He borrowed the most recent issue of the American Journal of Public Health from the library, copied three papers from it, and brought them to the hospital. He asked Dr. Roberts to read the three papers and give a summary of each from memory. Through the creation of an original, individually tailored therapy exercise, Dr. Roberts was given the confidence that he would be able to return to his life and job.
"I was phenomenally impressed," Dr. Roberts says. "Talk about personalized care — it was outstanding."
Following his experience at UPMC, Dr. Roberts thought about how different things could be if he hadn't received the care he did. The mortality rate for brain aneurysms is high, a fact that was scary for him and his family.
"But I'm fine, and I think it was just the incredible speed and efficiency UPMC operated with," Dr. Roberts says. "Every step of the way, I got just fantastic care. I have a second lease on life."
Our patient stories profile a number of patients who have had minimally invasive brain surgery at UPMC. Although everyone's care experience is unique, we hope that sharing these stories will help other prospective patients and their families better understand these procedures and their potential benefits.
Dr. Roberts' treatment and results may not be representative of all similar cases.
