When a ‘Migraine’ Can Be More: One Nurse Shares Her Story

More than a complicated migraine

Donna Larsen, a busy professional and mother of four, was enjoying a quiet night at home with her then-boyfriend when suddenly, she suffered a migraine. The migraine also had come with an "aura," where a person may have symptoms including seeing wavy lines, flashing lights, or distorted objects. Donna had suffered from these conditions since she was a child, but it was the first time she had a migraine with the aura, which gave her a reason to pause. "I went to take my regular medication," Donna says, "when my boyfriend asked me a question, and I had trouble forming a sentence." Donna, a registered nurse, was currently Nursing Supervisor for Bon Secours Community Hospital in Port Jervis, NY, and no stranger to the warning signs for a possible stroke. "My boyfriend called my colleague, who told him to bring me to the ER immediately."

When admitted, the team did a CT scan that showed a large aneurysm, though at the time a stroke was still being ruled out and Donna received TPA (AKA the Clot Buster) and then transferred to the Neuro ICU at Westchester Medical Center. It was ultimately determined that the Donna was suffering from not one but two aneurysms, as there was also a smaller one on the other side of her brain. This was a completely surprising diagnosis for Donna as she did not have any characteristics that would have put her at a higher risk for an aneurysm (let alone two of them). She had no family history and was not a smoker, although women in their 50s, like Donna, can also be considered more at risk without these other elements.

Donna's local care team advised her to see a neurosurgeon immediately. As she talked to her friends and family, luck would have it, her father was well-acquainted with Columbia's Dr. Donald Quest, who had recently retired. "My father plays in the Rockland Community Band with Dr. Quest. When he explained my situation, Dr. Quest immediately requested my records.”

Things were able to move quickly, and Donna was seen by Dr. Sean Lavine, Director of Columbia Neurosurgery’s Cerebrovascular Division. “Ms. Larsen was one of the fortunate patients who had her aneurysm discovered before suffering an intracranial bleed. Most brain aneurysms, unfortunately, are found only after they rupture, causing, in many situations, irreversible brain injury or death,” says Dr. Lavine. “Donna was suffering from a “complicated” migraine headache that can be associated with a temporary neurological deficit. Her symptoms were speech difficulty, numbness and tingling, which are signs that mimic a stroke.”

Dr. Lavine continues, “Due to an intracranial aneurysm of both carotid arteries just behind her eyes, we deemed an endovascular treatment was most appropriate, meaning the aneurysms could be treated through the blood vessels through tiny catheters. This type of surgery is done through a small needle puncture in the blood vessel in the leg or arm and requires no opening of the skull. We use a flow-diverting stent to reconstruct the normal blood vessel in the area of the aneurysms. Donna had no side effects from the procedures, which required only an overnight stay in the hospital.”

Both aneurysms were successfully treated and in less than a year, Donna is back to normal functioning. "Directly after the surgery, it felt like I was wearing a tight football helmet.” Despite it being a complex procedure, Donna's peripheral vision has also fully returned. "Now I'm feeling great. I've taken a new role as Bon Secours Community Hospital OR Manager for Perioperative Services, and I'm enjoying the position and back to my normal life."

Dr. Lavine said, “I was very glad to meet Donna who is a lovely person with excellent medical knowledge being an operating room nurse. She made the right move to be immediately evaluated in an emergency room where her aneurysms were discovered. Donna has returned to her important work with the peace of mind that her aneurysms are gone and that she and her family no longer must worry about what could have happened.”

Donna is thankful she was connected with Columbia Neurosurgery for the excellent care she received and her overall experience, " I will be forever grateful for every single one of them.”