When pain turns deadly

A day and a half after the pain first struck, Brothers was lying awake in bed, tormented by a relentless headache and racing thoughts.

“I don’t know if this is part of being a woman and what we deal with with our bodies, but I wondered, ‘Am I blowing this out of proportion? Am I crazy?’” she recalled.

By 1:45 a.m., she’d had enough. Weak, dehydrated and desperate, she called another Uber — this time to the ER at Mount Sinai Morningside.

She sat in the backseat as the driver blasted club music, the smell of his air freshener making her queasy as she fought to keep from vomiting all over the car.

When she staggered through the hospital doors and described her symptoms, the ER staff sprang into immediate action. They quickly checked her vitals, administered fluids and pain medication through an IV and rushed her in for a brain scan.

The diagnosis was terrifying: a ruptured aneurysm, roughly the size of a marble, had been leaking blood into the space around her brain. It was sitting at the base of her skull, lodged in the wall of her posterior communicating artery.

A silent killer

A brain aneurysm is a weakened, bulging area in a brain artery. If it ruptures, blood leaks into the space between the brain and skull, causing a life-threatening type of stroke known as a subarachnoid hemorrhage, according to the BAF.

An estimated 6.8 million Americans — about 1 in 50 — are living with an unruptured brain aneurysm.

Every year, 30,000 of those ticking time bombs explode, or one every 18 minutes. Half of those patients die within three months. Among survivors, two-thirds are left with permanent brain damage, per the BAF.

“It’s very important to get assessed and treated quickly,” Dr. Christopher Kellner, a cerebrovascular neurosurgeon and director of Mount Sinai’s Intracerebral Hemorrhage program, told The Post.

When Brothers arrived at the hospital, Kellner had one mission: stop the bleeding, repair the aneurysm and manage the damage that had already been done.

“When the aneurysm bleeds, the blood spreads very quickly and causes inflammation throughout the whole brain and in the arteries around the brain,” Kellner said. “That can cause seizures, increased fluid buildup and increased pressure.”

The inflammation can even trigger another stroke days later by squeezing arteries shut and choking off blood flow.

Just three hours after calling her Uber to Mount Sinai, Brothers was in surgery. Kellner performed an endovascular embolization, a minimally invasive procedure in which he threaded a catheter from an artery in her thigh up to her brain.

Through that small tube, he dropped a soft wire coil into the aneurysm, forming a clot that sealed off the leak and stopped the bleeding.

After that, recovery kicked off fast.

Two days post-op, Brothers was already sitting up and standing. With physical therapy, she trekked down hospital hallways, cheered on by nurses who high-fived her with every step.

“Even walking just a little bit would wear me out quite a bit,” Brothers said, adding that she was also struggling with light sensitivity, brain fog and trouble focusing.

Brothers expected to miss only a few days of work. Instead, she stayed in the hospital for three weeks — and it took three months before she was back on the job.

Four months after discharge on May 13, she completed the BAF’s annual 5K — with Kellner right by her side.

“He was floored to see me,” she said.

More than a year after the rupture, Brothers is living independently, traveling and back to work full-time. But the health scare changed her perspective.

“Life is for the living,” she said. “It’s not for the constant grind.”

Beware a “thunderclap headache”

Most brain aneurysms don’t cause problems — in fact, up to 80% stay intact for a person’s entire lifetime, according to the BAF.

Unruptured aneurysms usually go unnoticed, Buckley said. But when they grow, they can press on nearby nerves and tissues, which can trigger symptoms like pain behind one eye, vision changes, facial numbness or weakness, headaches and trouble concentrating.

More often, though, these aneurysms are found by accident during brain scans for unrelated issues. Most of those patients just need routine monitoring to check for any new growth or changes.

“Risk factors for developing an aneurysm are being female, having high blood pressure, having high cholesterol, smoking cigarettes and having other family members who have had aneurysms,” Kellner said.

“In Julie’s case, she is a young woman who is very healthy, and her aneurysm probably occurred spontaneously,” he added.

Kellner said Brothers’ initial misdiagnosis isn’t an isolated event — but there are key indicators that could tip off doctors and patients alike.

“When you hear someone has had a sudden, severe headache, that’s a sign to go down the route of figuring out if it’s an aneurysm,” he said, noting that kind of pain is often referred to as a “thunderclap headache.”

If you’re sent home with no testing like Brothers was, don’t be afraid to push back.

“Even though the walk-in clinic agreed with me that it was a migraine, I knew something wasn’t right,” she said. “I think that gut instinct is there for a reason.”