July 16, 2013
Laurel Rosebush had a walnut-sized, wide-neck aneurysm. Within six weeks of treatment with the new, Pipeline stent, her aneurysm essentially disappeared.
What started as a trip to buy new eyeglasses led to one of medicine’s scariest diagnoses for Bridgman resident, Laurel Rosebush. Her journey took her to Bronson Methodist Hospital in Kalamazoo, where neuroscience specialists using minimally invasive surgery and new technology saved her life.
When she started making mistakes on the job, Rosebush, 56, thought it was time for a new eyeglass prescription. She had been employed at a casino near her home for years, working the slot machine floor without any problems. But in the space of just a few weeks, she wrote down an incorrect social security number for jackpot winners—twice. “I am not a person to make those kinds of errors,” Rosebush says. She was also having more headaches than usual—another problem she thought a new pair of glasses would fix.
Luckily, a vision technician at her optometrist’s office noted that Rosebush’s right pupil was dilated more than the left one and urged her to see a specialist for a CT scan. Rosebush’s scan results revealed a brain aneurysm arising from the carotid artery, pressing on her right optic nerve. “No one wants to hear, ‘You have a brain aneurysm,’” Rosebush says. “At first I couldn’t breathe.”
Rosebush next saw neurosurgeon Christian Sikorski, MD, with Lakeland Neurosurgery. He ordered a CT scan and other tests. Rosebush learned her aneurysm was very large—classified as “giant”—and it was also the “large-neck” variety, meaning it had a wide opening at its base. Both attributes would make treatment difficult and possibly cause problems to nearby brain structures.
Aneurysms are weak spots in blood vessels that are enlarged and stretched thin. Left untreated, they can burst. If they burst in an artery that brings blood to the brain, stroke or death is often the result. Every year, 30,000 people in the United States have a ruptured brain aneurysm. This condition is more prevalent in people ages 50 to 60 and three times more prevalent in women.
Aneurysms are most often treated by inserting tiny coils into the aneurysm to divert blood flow. But Rosebush’s aneurysm was so large that inserting many coils would cause problems from additional pressure. The other traditional treatment—clipping, or opening the brain to seal off the base of the aneurysm with a tiny clip—wasn’t an option either. At three centimeters, the size of the aneurysm made major, invasive surgery very risky.
Fortunately, Dr. Sikorski through his professional relationship with Dr. Jeffrey Miller, a neurointerventional surgeon with Bronson Neuroscience Center in Kalamazoo, was aware of a new stent technology called Pipeline. Approved by the FDA two years ago, Pipeline is a flexible mesh tube made of platinum and nickel-cobalt chromium alloy. It is attached to a catheter and inserted into an artery in the groin, then threaded up into the carotid artery inside the brain. It is expanded against the neck of the aneurysm to divert blood flow away from the aneurysm. The blood remaining inside the aneurysm forms a clot, making the aneurysm less likely to grow or rupture. Aneurysms treated with the Pipeline often shrink or even disappear over time.
Dr. Miller met with Rosebush and her husband to explain the new procedure. “We totally trusted him,” Rosebush says. “We could have gone anywhere—Mayo, or someplace like that—but we had heard so many positive things about Bronson’s neuroscience program that we were at ease before we even got there.”
Treating Rosebush’s aneurysm during surgery took a little longer than expected. As soon as the Pipeline stent was inserted, the aneurysm clotted against it so aggressively that blood flow was threatened. Dr. Miller used blood thinners and balloon angioplasty to make sure the artery stayed open.
The blood thinners made the incision in Rosebush’s groin slow to close. Over the next 24 hours, nurses took turns applying pressure to the site. “Dr. Miller even came in to take a turn, too,” Rosebush says. “Everyone was just phenomenal at Bronson. I never had to wait for anything. Every person we came in contact with was so caring and friendly.” After just two days at Bronson, Rosebush was able to go home.
Aneurysms treated with the Pipeline stent often shrink or even disappear over time. After just a few weeks, Rosebush’s brain scans were clear—her aneurysm was gone. Vision in Rosebush’s right eye is still impaired, but the blur that was once dark now appears lighter.
While she is hopeful that her eyesight will continue to improve, Rosebush is quick to point out, “I don’t complain about my sight.” She and her husband are enjoying each day—especially time spent with their grandchildren. “I’m just lucky to be here,” Rosebush says. “If it weren’t for Dr. Miller and this procedure, without a doubt I wouldn’t be here right now.”
Bronson is pleased to offer this new technology, making successful treatment, shorter hospitalizations and faster recovery possible for more patients. These innovations contribute to Bronson’s ongoing excellence in the neurosciences. Healthgrades ranks the neurosurgery program at Bronson Methodist Hospital as number one in the state for 2013.
About Bronson Neuroscience Center
Bronson provides one of the most comprehensive neuroscience programs in southwest Michigan. Together, their multidisciplinary team of highly trained specialists offers the most advanced diagnostics and the latest treatments in an environment that promotes healing. From treating stroke and providing minimally invasive spine surgery, to offering a pediatric neurosurgeon, the area’s only neurointerventional surgeon, and the area's only epileptologist, Bronson's neuroscience program offers services unique to southwest Michigan.
Some of the nation’s leading authorities on hospital quality have consistently recognized Bronson’s neuroscience program. For example, Bronson Methodist Hospital (BMH) has
been named a Certified Primary Stroke Center by The Joint Commission and a designated a Stroke Center of Excellence by NeuStrategy. BMH also received the Silver Plus Performance Award for Stroke Care (2012) from the American Heart Association and American Stroke Association.
Bronson has been ranked by HealthGrades as one of America's 100 Best Hospitals for Stroke Care (2012-2013), and ranked in the top five percent of hospitals in the nation for treatment of stroke (2012-2013), neurosurgery (2013) and for neurosciences (2012-2013). They were also a recipient of HealthGrades Stroke Care Excellence Award (2011-2013), Neurosurgery Excellence Award (2012-2013) and Neurosciences Excellence Award (2012-2013).