Brain aneurysm changes life forever

Lana Hall remembers pulling the cord to start her chain saw that March day in 2014. She remembers grabbing the saw in her left hand and an ax in her right hand. And she remembers walking across the yard of her Yacolt home toward the large tree she planned to cut down.

She remembers the sudden pain in her hand. She remembers hearing her heartbeat, slowing to the point Lana was sure she was dying. She remembers feeling the most severe pain in her head that she’s ever experienced.

“I remember Leanne walking up to me, walking me to the porch, and then I blacked out for the next seven months,” Lana said. “Gone.”

Lana and her wife, Leanne Hall, would later learn that a massive aneurysm in Lana’s brain had ruptured when she pulled that chain saw cord — a movement she had performed dozens of times before.

After a stop at Legacy Salmon Creek Medical Center for a scan that confirmed the ruptured aneurysm, Lana was taken to Oregon Health & Science University in Portland. When Lana arrived, the prognosis wasn’t good.

“They thought I was gone,” said Lana, who was 54 years old at the time.

“I knew we were in trouble,” Leanne added, “but I didn’t know how much trouble.”

Dr. Justin Cetas, the OHSU neurosurgeon who treated Lana, was surprised to see her pull through.

“She was very sick when she came in, and she actually had a really good recovery,” Cetas said. “It’s pretty remarkable.”

‘That was the start’

An aneurysm is a dilation, like a blister, on a blood vessel in the brain. The aneurysms, which look like berries, tend to rise where the vessels branch and form smaller vessels.

“They can be dangerous,” Cetas said. “They can hemorrhage spontaneously, and when that happens, it can be fatal.”

About 30 percent of ruptures will result in sudden death, Cetas said. The rest of the patients make it to the hospital but can be in varying conditions. Some are in a coma, some just have a bad headache and are confused. The severity is based on the amount of bleeding and other factors, Cetas said.

Those who survive the initial bleed can go on to have secondary problems in the days following the rupture. Among those problems are accumulating spinal fluid and vasospasms, which is when large or small arteries constrict and can cause strokes and seizures, Cetas said. Patients are also at risk of re-bleeding, which can be fatal, he said.

Lana suffered from a subarachnoid hemorrhage and, subsequently, a stroke. Cetas performed surgical clipping on the aneurysm, using a metal clip to stop blood flow to the aneurysm, and left a section of her skull off to allow her brain to swell.

“Dr. Cetas, he saved her life,” Leanne said.

But Lana wasn’t in the clear yet. She had a long road to recovery, and surgeons had found more aneurysms on Lana’s brain.

“That was the start of it all,” Leanne said. “And after that, it was whatever could go wrong did go wrong.”

Surgery required

In the days after the rupture, Lana was incoherent. She couldn’t breathe on her own. The stroke had paralyzed the muscles necessary for breathing, as well as her limbs. A feeding tube provided nourishment. Lana’s physicians also suspect she suffered a seizure in the days after her surgery.

After a few weeks at OHSU, Lana was transferred to Kaiser Sunnyside Medical Center to complete her recovery and receive treatment for the other aneurysms. Not all aneurysms need treatment, but Lana was at high risk for future ruptures, so surgery was necessary, Cetas said.

On April 11, 2014, Lana had surgery to replace the piece of her skull that had been removed after the rupture. On April 22, Lana underwent surgical treatment for a second aneurysm and suffered another stroke — this time damaging the opposite side of her brain.

During another surgery to treat a third and fourth aneurysm, surgeons discovered the two aneurysms were actually fused together. The surgeons clipped the aneurysms to prevent the possibility of future ruptures.

“It’s not typical to have multiple like that — or it’s not as common,” Cetas said. Lana’s physicians suspect her aneurysms were caused by genetic issues.

Two months after Lana’s aneurysm ruptured, she was transferred to a skilled nursing facility, where she stayed for nine days before returning to the Yacolt home she shared with her wife. The couple have since moved to Vancouver.

Lana faced months of occupational, speech and physical therapy. She needed help learning how to get up when sitting on a chair or the floor. Her speech was severely compromised from the strokes; she could barely speak after the rupture. And she needed guidance in staying safe, such as tasks to complete before going outside — dress appropriately for the weather, take a water bottle, have a cellphone in your pocket.

“She was home, but she wasn’t really there,” Leanne said.

Lana doesn’t remember anything until September of that year.

Slow recovery

Slowly, though, Lana began to recover.

Today, Lana still struggles with her speech. She has a condition called aphasia, caused by the stroke. The aphasia means Lana sometimes has difficulty finding the right words when speaking. And when talking, words sometimes come out differently than how Lana hears them in her head.

Lana has been able to resume driving, passing a stroke and seizure driving assessment. And the paralysis she experienced is gone, leaving behind only minor numbness in some spots.

Despite the progress, Lana, 56, won’t be able to return to her job at Toyota; it was a physical job that required long hours.

Though Lana was disappointed, she and Leanne, 47, found a silver lining. The couple of 24 years had always wanted to adopt a child. But with both women working long hours at demanding jobs, they felt it would be selfish to adopt.

With Lana home full time, however, they decided it was time to pursue adoption. They passed all required classes, and doctors felt Lana was capable of being a stay-at-home parent.

One month ago, the couple welcomed a 14-year-old daughter into their family.

“You don’t know why these things happen,” Leanne said, “but it just does.”

“You look at our daughter, she wouldn’t be here,” she added. “I just think it’s the path our life was supposed to take.”