From Shaping the MGH -- November 1994. Copyright the Trusteees of Massachusetts
General Hospital, 1994
a time bomb in the brain
Suzanne Kellogg thought it was stress. The headaches seemed to begin just about
the time she started a demanding new job two years ago. But they began to feel
different from anything she had experienced before. 'It felt like there was an
object inside my head, the 47-year-old registered nurse recalls.
What was inside her head was an aneurysm, a weak spot in a blood vessel that causes
it to swell like a balloon and possibly burst. Although Suzanne was fortunate
that her problem was diagnosed before a catastrophic rupture, she was in for an
arduous course of treatment.
'Suzanne's situation was very difficult to manage,' says neurosurgeon Christopher
Ogilvy, MD , director of the MGH Brain Aneurysm/AVM Center. 'Her aneurysm
was almost 4 centimeters in diameter -- anything larger than 2.5 centimeters is
considered a giant' aneurysm.
'Also, most aneurysms form a little sac off the main blood vessel that can just
be sealed off. Suzanne's involved the entire blood vessel wall. When we tried
to close the aneurysm in one area, within a few days another part of the artery
would start to expand.'
Dr. Ogilvy collaborated on Suzanne's care with Robert Crowell, MD, the former
director of the MGH center who is now at Berkshire Medical Center in Pittsfield,
Mass. Twice they operated to reduce the aneurysm by closing off the swollen portions
with tiny metal clips. Twice the aneurysm continued to grow.
A two-part strategy finally led to success. First the neurosurgeons constructed
a new blood supply for the part of her brain supplied by the weakened vessel.
They did this by attaching a graft to an artery that usually supplies blood to
the scalp, passing it through a hole in the skull, and connecting it above the
A few days
later, In Sup Choi, MD, MGH director of Interventional Neuroradiology, filled
in the aneurysm with tiny platinum coils. Inserted through a fine catheter threaded
through major blood vessels, the coils cause the aneurysm to be sealed off. Dr.
Choi is one of a few of physicians worldwide performing this procedure, which
currently is available at about 20 centers in the United States.
It is only with the most advanced facilities that skilled specialists like Dr.
Ogilvy and Dr. Choi can accomplish such delicate procedures. Plans are currently
in the works for four new neurosurgical operating rooms with the state-of-the-art
computers and imaging equipment required by today's surgeons. Generous donor support
can help make those plans a reality.
Once the aneurysm was obliterated, Suzanne could begin the process of recovery.
Just as any operation can result in discomfort, surgery on the delicate tissues
of the brain can disrupt normal functioning. As expected, Suzanne experienced
temporary problems with thinking, memory and emotional stability.
'No matter how much support you get from your doctors, nurses, therapists and
family, recovering from a brain injury is terribly frustrating,' she says. 'It's
hard to process new information; it's hard to express your thoughts. It's really
recovered, her participation in an MGH aneurysm patient support group inspired
Suzanne to tackle a need she recognized -- disseminating more information about
brain aneurysms to patients, their families and the general public. She wrote
a brochure about the recovery process, which has recently been published. Now
she is serving as president of the newly established Brain
Aneurysm Foundation , devoted to education and patient support on a national
'I'm a nurse, and it took me a long time to acknowledge that something was really
wrong with me. Headaches can appear to be so trivial, and denying that a problem
might be serious is natural. Getting out the word about aneurysms, their symptoms
and treatment can really save lives.'