After aneurysm, Austin mom learned why you can’t put your health last

Doctors were able to use Pipeline Flex embolization device to prevent future brain bleed.

A year ago, on Sept. 3, 2016, Shamsah Momin was in her bedroom closet, helping her husband pick out a shirt before going out to dinner, when her eyes rolled backwards and she started to fall.

Her husband grabbed her hand so she wouldn’t hit her head as she fell and was on the phone with 911 when her breathing became irregular. She vomited.

A few days later she woke up in Brackenridge Hospital after doctors put a drain into her head to relieve the pressure caused by a brain bleed from very large wide-neck aneurysm. While she was unconscious, doctors also used a balloon-assisted coil embolization to divert the blood flow to that aneurysm.

After more than two weeks in the hospital, Momin was released, but Dr. Ramsey Ashour, a neurosurgeon at Seton Brain & Spine Institute, knew that the aneurysm would likely bleed again. Doing another coil embolization wasn’t a good option because of the aneurysm’s size; the coils might go somewhere they shouldn’t and cause a stroke.

Instead, after Momin healed for a few months, she returned to the hospital in December. There, Ashour used a Pipeline Flex embolization device, which is a piece of wire mesh that goes into the blood vessel with the weakened wall (aneurysm). The mesh strengthens the vessel while cutting off the blood flow to the aneurysm. The aneurysm shrinks after a few weeks and won’t bleed again.

“It’s really a game changer with wide-neck, large aneurysms,” Ashour said. “We never had a good solution before.”

This device was approved by the Food and Drug Administration in 2015; an earlier version was approved in 2011. Ashour had to become trained on it and approved to use it.

Momin has a good idea of why this happened to her. She, like many moms, didn’t take care of herself. When she was pregnant with her second child, she had high blood pressure that never really went away, she says. “After it became normal after delivery, I stopped taking medication and stopped monitoring it,” she says. “I didn’t know it was going back up again.”

The last well-check she had had was when her daughter was a few months old. At the time her aneurysm bled, her daughter was 3.

“High blood pressure does run in my family,” she says. Her uncle, dad and grandfather all have had it.

What high blood pressure does is put chronic stress on the vessels, which could be the reason why one of them weakens and then ruptures. Other risk factors include smoking, being African-American or Latino, and drug use. Aneurysms are more common in women than men in a 3-to-2 ratio, which might be related to hormones.

Ashour estimates that about 3 percent to 5 percent of Americans have an aneurysm right now and about 30,000 rupture each year. About half of those people will die from it. About two-thirds who do live will have some sort of permanent damage.

“Those are sobering numbers,” he says.

An aneurysm is often described by patients “as the worst headache in someone’s life,” Ashour says. “It’s a severe, stabbing, sharp headache.” They also become disoriented and have neck stiffness. They could have vision problems or seizures. “It’s very memorable.”

Momin is lucky. She doesn’t have any permanent damage, but she does tire easily. At first she had trouble with her vision because of the bleed pressing on her optic nerve. Her family had to help her for a while, doing everyday things like taking her daughter to school and other activities. “I really became dependent,” she says. “I had always been supermom.”

Her advice is to not put off regular checkups. Because she’s only 36, she’ll now be monitored regularly to look at this spot as well as for future aneurysms developing.

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