Migraine or Aneurysm? Neurosurgeon Weighs in on Warning Signs to Watch Out for After Mom of Four's Shocking Death
"It's not surprising for someone to come into the emergency room and say they feel like they've been struck by lightening," Dr. Howard A. Riina tells PEOPLE
After a North Carolina mother of four suddenly died on April 3 following a ruptured brain aneurysm after thinking she had a severe migraine, a leading neurologist wants people to know the warning signs — and also keep in mind that the medical condition is extremely rare.
Dr. Howard A. Riina, professor and vice chairman of neurosurgery at NYU Langone Medical Center, tells PEOPLE that the pain associated with a brain aneurysm is described as the “worst headache of someone’s life. It’s not surprising for someone to come into the emergency room — even if they have a history of headaches or migraines — and say they feel like they’ve been struck by lightening or have a headache that brought them to their knees. It’s this severe, severe headache that’s out of the ordinary.”
“If you have a headache and nausea, I wouldn’t go running to the hospital,” Riina adds. “People who have migraines that are quite severe say that a headache [associated with an aneurysm] was worse than any they’ve ever had.
“People with migraines sometimes have auras, but they have routines and things they do to help relieve the headache — being in a dark, quiet room and taking medicine, things like that. But if that doesn’t help, it could be an aneurysm. It’s a very unique headache and really the main symptom is feeling like this headache is like none you’ve ever had.”
Dr. Riina also says that ruptured brain aneurysms are very rare.
“It’s somewhere between 30,000 to 50,000 cases a year,” he says.
Riina says that around 5-10 percent of the population is estimated to actually be walking around with an aneurysm without any symptoms.
“A lot of people get an MRI or CT scan and [the aneurysms are] picked up by our non-invasive imaging studies that are being done all the time,” he says. “These patients are then referred with unruptured aneurysms and, depending on the size and location, different recommendations are made of when to treat it and when to follow up.”
But not all aneurysms rupture, says Riina.
“Statistically, an unruptured aneurysm — depending on it’s size — might have a 1 to 2 percent chance of bleeding each year,” he says.
So who is at risk for a brain aneurysm? Dr. Riina says family history can play a role.
“If you had a parent, uncle, brother, sister or cousin that had an aneurysm, you should mention it to your primary care physician or your neurologist,” he says. “The same goes for certain conditions.”
Polycystic kidney disease and Ehlers-Danlos syndrome — a connected tissue disorder — are two conditions associated with aneurysms, according to Riina. He also says that certain lifestyle choices, such as smoking, can increase someone’s chances of getting an aneurysm.
“Unless you have a family history or one of these conditions, the likelihood that you’ll have [an aneurysm] is pretty low,” he says. “The average person doesn’t need to run off and get a screening.”
Lee Broadway, the mother of four who recently died of complications following a brain aneurysm, was told she was at a Grade 2 when she initially arrived at the hospital, her husband, Eric Broadway, told PEOPLE.
“We grade ruptured aneurysm’s by 1 to 5,” says Dr. Riina, who has no connection to Lee’s case. “One is someone who is wide awake and 5 is someone who is in a deep coma. [Lee] was in a good grade when she came in, and it sounds like they were treating her endovascularly, but something happened.”
Eric says his wife had bled out following a procedure and was considered brain dead.
Historically, says Dr. Riina, there are two ways to treat aneurysms.
“One involves an incision of the head, a window in the bone and putting a metal clip on the aneurysm,” he says, which is called clipping. “The other is called endovascular, where we go through the artery in the leg or arm. We bring a tiny plastic tube up to the aneurysm, we either fill it with tiny metal coils or we place a stent —just like a stent in the heart or a dense kind of stent called a flow diverter.”
The goal is secure the aneurysm to prevent it from bleeding again in the future and allow the patient to recover.
“People can be treated with variety of techniques that are minimally invasive and they do well,” he says.