Heading Off Disaster

Mitchell Smith and his wife, Elena, celebrated his recovery at the 2015 Brain Aneurysm Awareness Walk at Jones Beach State Park.

Before setting out to go blue fishing in Reynolds Channel near Jones Beach last August, Mitchell Smith invited his 28-year-old nephew, Richie Sensale, at the last minute. It turned out to be the best decision of his life.

“The day was warm, bright and clear,” said the 52-year-old retired New York Police Department detective from Wantagh. “We were catching lots of fish. Then, suddenly, I got hit by the worst headache imaginable.”

Suspecting a stroke, Mr. Smith asked his nephew to call 911. Since Mr. Sensale didn’t know how to pilot a motorboat, Mr. Smith drove their boat toward Jones Beach with his nephew’s support.

“I was hanging off the steering wheel and fighting to stay conscious,” Mr. Smith said. “Richie poured cold water on me and held me up in my seat.”

At the dock, an awaiting ambulance transported Mr. Smith to Nassau University Medical Center. “I told the ambulance driver, ‘Please don’t let me die,’” Mr. Smith said. “I didn’t know what was wrong with me, but I knew it was bad.”

After magnetic resonance imaging (MRI) scans revealed a ruptured brain aneurysm, Mr. Smith was transferred to North Shore University Hospital. “It felt like my head was bursting,” Mr. Smith said.

Cataclysmic Headache

He wasn’t wrong. A brain aneurysm is an abnormal bulge or “ballooning” in the wall of an artery in the brain. Aneurysms often produce no symptoms until they become large, begin to leak blood or burst.

“A ruptured brain aneurysm is a major medical emergency that causes a tremendous increase in pressure inside the skull,” said David Chalif, MD, chief of neurovascular surgery and neurosurgery and co-director of the Northwell Health Brain Aneurysm Center. “Patients perceive it as a cataclysmic headache.”

Brain aneurysms can be associated with smoking, high blood pressure and kidney disease. They can also run in families. “Aneurysms also appear out of the blue in relatively healthy people, like Mr. Smith, who are in their 50s,” Dr. Chalif said. Over 30 percent of patients die from ruptured brain aneurysms.

Mr. Smith quickly underwent an operation to divert the cerebrospinal fluid that was causing pressure in his brain. His MRI showed that his aneurysm was in the most common location, near the base of the brain. Dr. Chalif then performed a second, larger operation to place a clip at the aneurysm, which cut off the blood flow to the abnormality while allowing normal circulation in the surrounding areas to continue.

It takes years of advanced clinical experience to determine which treatment option is best for a brain aneurysm patient. At the Brain Aneurysm Center, Dr. Chalif and co-director Avi Setton, MD, determine which approach is optimal.

Good as New

Mr. Smith’s procedure did the trick. After spending nearly four weeks in North Shore University Hospital’s Neuro Intensive Care Unit, he went home to celebrate with his wife of 30 years, Elena, and their three sons, Nick, 25; Patrick, 23; and Joe, 19.

“That’s the beauty of aneurysm surgery,” Dr. Chalif said. “If patients do well and a postoperative angiogram shows that the aneurysm is gone, they’re 100 percent cured and there’s essentially no chance of recurrence.”

Mr. Smith was glad to have his nephew with him that day. “If he had been out on the boat alone, he would have died,” Dr. Chalif said.

Mr. Smith was also fortunate to receive the highest quality, specialized care possible.

“I thank God that I found myself in Dr. Chalif’s hands. He was awesome and so were all the doctors and nurses at North Shore University Hospital,” he said. “It feels so good to be alive.”

Know the Symptoms

Besides an excruciating headache, other possible signs of brain aneurysm are:

  • nausea;
  • blurred or double vision;
  • stiff neck or neck pain;
  • pain above or behind an eye; and
  • numbness.

If you or someone you know has any of these symptoms, seek medical attention immediately. To learn more, see Dr. Chalif's blog post about brain aneurysms.

Find more news about health, wellness, medical discoveries and community programs from LIJ Medical Center and North Shore University Hospital in Vitality magazine.

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