Anxiety? Fatigue? Or something more serious?

She’ll be the first to admit it: Tera Teeple was stressed out. She was running her own hair and tanning salon in Gig Harbor and raising an energetic young son. So when Tera began to suffer episodes of blurred vision and dizziness, she easily dismissed them as stress and exhaustion. When the occurrences became more frequent and severe, she suspected something more serious was going on inside her head.

A brain scan with alarming results — an aneurysm

About four months after her symptoms began, Tera visited her doctor’s office for a CT scan. After studying the images, the radiologist gave Tera the frightening news: “You have a cerebral aneurysm — a bulge in an artery in your brain. It has not ruptured, but you need to take care of this right away.”

A tireless search for a top neurosurgeon

Although she didn’t know much about aneurysms, Tera was overwhelmed with fear. Eager to seek care before the rapidly approaching holidays, she became consumed with finding the best neurosurgeon available. The radiologist gave her a few names and she met with all of them, but didn’t feel totally comfortable with any. In a moment of near desperation, Tera called a physician who had treated her several years before. Without hesitation, he recommended Dr. David Newell of the Swedish Neuroscience Institute.

A call on Thursday afternoon — an appointment on Friday morning

Tera had hardly said good-bye before she was dialing Dr. Newell’s office. She left a long, urgent message and to her amazement, he — not a receptionist or nurse — returned her call later that afternoon. She was even more astounded when he asked if she could come in the following morning. He was heading out of town for the holidays and wanted to meet before he left.

The search ends; a treatment plan begins

When Dr. Newell and his staff arrived at their office bright and early the following morning, Tera was anxiously waiting, CT images in hand. A very few minutes later, Tera knew her search for the ideal physician was over.

“The moment I met Dr. Newell,” recalls Tera, “I felt at ease. I told him my story, he studied my records and patiently explained what an aneurysm is. He ran more diagnostic tests, and the more information he shared, the better I felt.”

“He explained that my aneurysm was pressing on my optic nerve, causing my blurred vision. More important, he assured me that he could repair it. He repairs hundreds of aneurysms every year. I still can’t describe my relief as I listened to those words.”

The choice of treatment: clipping or coil?

After reviewing her test results, Dr. Newell assured Tera that her risk of rupture in the upcoming weeks was slim, but encouraged her to be extra cautious. Then they scheduled her surgery upon his return, less than two weeks away. In the meantime, Tera had a cerebral angiogram to determine the exact size and location of her aneurysm and to confirm the physician’s choice of treatment.

“There are basically two treatments for cerebral aneurysms,” explains Dr. Newell. “The first is a microsurgical clipping. We remove a small piece of the skull to access the brain, and then use a very high-powered microscope to dissect the aneurysm. We place a tiny metal clip across its neck — where it attaches to the artery — and puncture it with a tiny hole so it collapses like a balloon. The clip prevents the blood from flowing into the aneurysm and creating a risk for rupture, and allows the artery to resume its original formation.

“The other method is called endovascular coil. We insert a long, narrow catheter into a major artery — usually in the groin — and thread it all the way up to the aneurysm. We then guide a very soft, pliable metal wire directly into the aneurysm, where it forms a ball inside, much like a ball of string. Once the aneurysm is filled with the coil material, the remainder is detached and the aneurysm clots off because the coil prevents any blood from entering.”

Microsurgical clipping is best for Tera

Although the coil is less invasive, Dr. Newell and his team recommended microsurgical clipping. “Tera is a very young woman, and clipping typically has a longer life than the coil. In addition, her aneurysm had a wide neck, which is less suited to a coil. And finally, we wanted to collapse the aneurysm to reduce the pressure on her optic nerve.”

Dr. Newell surgically repairs Tera’s aneurysm

On the day of her surgery, Tera was wheeled into the specially equipped neurological operating suite and placed under general anesthesia. Dr. Newell made a careful three- to four-inch incision just behind her hairline so it would not be visible after healing.

He used a special tool called a craniotome to remove a piece of bone and expose the aneurysm. With the help of a surgical microscope — 20 to 40 times power — Dr. Newell dissected the aneurysm and placed the tiny metal clip. He then used small titanium plates to put the bone back in place. At the end of the four-hour surgery, he closed the incision and Tera went off to recovery.

Tera sees a bright new world — literally

While Tera was understandably nervous at the thought of brain surgery, she wasn’t especially worried. “Everyone at Swedish was so helpful, calming and caring. Dr. Newell was just like a friend. There was never a moment that I doubted the outcome — I always knew I’d be fine.”

Today, Tera is indeed fine. The vision in her affected eye was blurry and unstable for several months after surgery while her optic nerve healed, but it’s now back to normal. Best of all, she feels great.

Dr. Newell’s prognosis makes her feel even better. “Her prognosis is excellent,” he reports. “We don’t expect the aneurysm to return. We can’t ever say there’s a zero percent chance, but it’s very near zero.”

Giving thanks where thanks are due

These days, Tera is the first to admit her aneurysm has changed her life — for the better. “I live every day to the fullest. I devote more time to my family and friends. And I’m just so thankful.”

Tera isn’t the only member of her family who’s grateful. “Every Thanksgiving,” she says, “my son thanks Swedish and Dr. Newell for taking such good care of his mom.”
top

 
 

Swedish Neuroscience Institute
Dr. David Newell

Dr Newell
Dr. David Newell is one of the co-executive directors of the Swedish Neuroscience Institute. Embracing a unique opportunity to help create a world-class center for neurological care, he joined Swedish in 2004 as the new institute’s co-founder. Prior to coming to Swedish, Dr. Newell was professor of neurological surgery at the University of Washington School of Medicine, as well as chief of neurosurgery at Harborview Medical Center.

What attracted Dr. Newell to join the team at Swedish? “Swedish was committed to building a state-of-the-art facility with the most advanced technology available — all aimed at providing the highest levels of patient care and comfort. To a neurosurgeon such as myself, that is the best of both worlds.”

Although the Swedish Neuroscience Institute itself is relatively new, Dr. Newell is quick to point out that the team they have assembled is the Northwest’s most experienced at treating cerebrovascular lesions such as aneurysms. “We evaluate more than 300 aneurysms per year, and treat — with direct surgery or interventional methods — between 100 and 200 patients per year,” explains Dr. Newell. “That’s very important, because it’s now well understood that patients who are treated at high-volume centers, with a comprehensive range of services, have the best outcomes.”

If it sounds like Dr. Newell could write a book about treating aneurysms, perhaps that’s because he did. He and two colleagues wrote Management of Cerebral Aneurysms, a top medical textbook, widely used in the study of the formation and treatment of aneurysms in the brain.