Answering the call
"Laurie, are you with me?"
At first, Vicki Dennis thought her friend’s screen had just frozen – another momentary blip in this pandemic life. But then Laurie held up a finger.
“Are you OK?” Vicki asked.
After getting no response again, she said firmly: “Laurie, you either need to talk to me or I’m going to call 911.”
So, Vicki reached for her phone and punched in the numbers, keeping an eye on her computer screen. Laurie started to weave in and out.
“Stay with me!” Vicki yelled.
It was Aug. 11, 2021, and Laurie’s husband, Dan, had taken their two daughters (ages 10 and 11) to the first day of school and then headed to work. Laurie was home alone. Their family had recently moved to a new house in Irving, so when the 911 operator asked Vicki for the address, she froze for a second. She had Laurie's old address, but not the new one.
“Laurie,” Vicki said, no panic in her voice. “I need your help. I need the first number of your street address. I’m going to count up from 1, and when I hit the right number, try to let me know.”
Off-screen, Laurie had started to make a few sounds but she still couldn't form any words.
"One ... two ... three..."
When Vicki landed on 7, Laurie grunted.
With 911 on speaker, Vicki patiently repeated the process until they were able to lock in the full street address. Then the operator came up with a list of potential street names in Irving, and Vicki said each one clearly until Laurie grunted again.
“Getting the address felt like it took forever,” Vicki said recently. “But it was probably less than a minute and a half total. Once she hit the floor, I just kept saying, ‘Laurie, stay with me. 911 is coming.’ I was scared to death I was going to lose her.”
Clock ticking, Vicki texted O’Donnell Brain Institute leaders to alert them. Then she called Dan, who works in human resources at nearby Parkland Memorial Hospital, and told him to get to the ER at William P. Clements Jr. University Hospital. Somehow, she also coaxed Laurie to crawl to the front door and unlock it so the emergency crew wouldn't have to break it down.
Finally, she had to persuade the paramedics to take Laurie to UT Southwestern rather than the nearest hospital. We work there, Vicki explained, and there will be a team waiting to treat her the moment she hits the door.
“I’ve always been so proud to work at UT Southwestern,” Vicki said. “But that takes on a whole new meaning when you’ve watched your friend fall to the floor and you have to be the one to call the team to say, ‘We’ve got one of ours coming into the ER, we need everybody on standby, and I don’t know what’s wrong with her.’”
A picture that didn't add up
"Subarachnoid hemorrhage. Aneurysm."
Those words, and the flurry of activity surrounding Laurie at Clements University Hospital’s ER, conveyed the gravity of the situation to Dan Enright. So did a CT scan that doctors showed him indicating there was a lot of blood in the space between his wife’s brain and the thin tissues covering it.
“Looking at that picture and then looking at Laurie, it didn’t seem to add up,” he said. “She was a bit shaken, but otherwise by the time I saw her, she seemed fine.”
Dr. Jonathan White, a Professor in the Neurological Surgery and Radiology Departments at UT Southwestern, explained that preliminary tests showed Laurie had an aneurysm on her left middle cerebral artery, and the bulging blood vessel had most likely burst.
“When an aneurysm ruptures it raises pressure inside the head and causes a traumatic brain injury – it’s almost like getting in a car accident,” Dr. White explained. “The aneurysm will continue to bleed until the pressure inside the head exceeds your systolic blood pressure (the top number in a BP reading). Then a clot can form.
“About 50% of the time, the patient doesn’t get to the hospital in time, and the aneurysm is fatal,” he added. “But in some cases, a protective measure in the head causes the blood to clot and the body will try to seal off the aneurysm like a scab.”
That’s what the medical team was hoping would happen in Laurie’s case, but only time would tell. She would be closely monitored in the Neuro ICU and, in about a week, she would have another CT angiogram, the test that initially confirmed the ruptured aneurysm. This time, it would be able to show whether the aneurysm had clotted, Dr. White said, and if it “was durable enough to stand the test of time.”
A week of what-ifs
Meanwhile, the first CT angiogram also discovered Laurie had three smaller, unruptured aneurysms. Being diagnosed with one aneurysm can feel as if you’ve been told there’s a ticking time bomb in your head. Now Laurie knew she had four.
“There was no immediate explanation why she had multiple aneurysms,” said Dr. White, whose team embarked on an extensive series of tests. “All of the aneurysms were located farther out on the branches of the blood vessels than a standard aneurysm, which raised concerns they might be caused by an infection, or a noncancerous tumor of the heart called atrial myxoma.”
That news touched off a nerve-jangling week of waiting and what-ifs for Laurie, Dan, and the family, friends, and UTSW co-workers who rallied around them.
“I felt frightened and relieved at the same time,” Laurie said. “I was grateful to be alive, first off, and I was glad the ruptured aneurysm might be clotting. But I understood they might have to open my skull to operate at any time if the aneurysm started bleeding again. And there were so many unknowns and potential risks associated with having multiple aneurysms. For me, that may have been the hardest part – the unknown.”
Ultimately, Laurie did what she has always encouraged patients to do: Put her trust – and her life – in the gifted hands and medical minds of the O’Donnell Brain Institute.
“The entire team of neurosurgeons came together to discuss what the best course of treatment would be for me. Seeing their faces and hearing their determination, I found that very comforting,” she said. “I was a UT Southwestern loyalist before this, but you don’t truly realize how impressive they are until you’re the one lying in the hospital bed.”
A complex case of multiple aneurysms: What the neurosurgery team saw
A somber, seated conversation
In Room 399, Laurie and Dan played cards and watched TV, trying to distract themselves as they waited for the results of her latest CT angiogram. That morning, Dr. White had threaded a catheter up through an artery in Laurie’s leg and into the blood vessels in her brain to see if the clotted aneurysm was holding steady.
In previous visits, Dr. White had stood at Laurie’s bedside to share test results. Now, he sat on the couch and delivered difficult news: Laurie’s aneurysm was filling with blood again. She would need surgery the next morning.
"As (Laurie and I) talked to each other in the room that night, we couldn’t help thinking: This may be the last time we can converse like this."
He had hoped endovascular coiling, a minimally invasive technique that uses a catheter to reach and repair the aneurysm, would be an option. But the shape and location of the aneurysm, plus concerns about infection, made craniotomy – opening the skull – the best chance for a complete recovery.
“I remember we had a somber conversation about the implications of the surgery,” Dan said recently. “I wanted everything quantified. Dr. White made it clear he believed the surgery would be a success, but he told us there was a risk she wouldn't survive it and a 10% chance the surgery could impact Laurie’s neurological abilities.”
The aneurysm was located near the speech center of her brain. There was also a chance the motor skills on Laurie’s right side might be affected.
“That night was definitely the most acute worry or fear we had felt,” Dan said. “Now we knew what we were marching toward – and it was coming in only a matter of hours. As we talked to each other in the room that night, we couldn’t help thinking:
“This may be the last time we can converse like this.”
Waiting to exhale
Vicki Dennis brought muffins.
Shelley Brown, M.S.N., R.N., Director of Neurosciences for the O’Donnell Brain Institute and floor general for the Neuro ICU, stayed nearby to answer any questions that Dan, who was pacing in Laurie’s room, might have.
Together, they tried to soften the edges on a grueling six-hour wait.
Inside one of the hybrid OR/angiography suites at Clements, Dr. White and his team got to work. A nationally recognized leader in the field of aneurysm repair, he is a quietly confident neurosurgeon with 20+ years’ experience at UT Southwestern. In the operating room, he is truly in his element.
Dr. White began by opening Laurie’s skull and the brain’s protective layers. Then he gently split the frontal and temporal lobes – the blood vessels are not actually located in the brain but between the lobes. Using a neurosurgical microscope and 3D imaging studies, he identified the damaged blood vessel.
One of the cardinal rules of aneurysm surgery is to get control of the blood vessel that feeds the aneurysm – pinching it off like a hose at points above and below where it burst. That stops the potential for excess bleeding, Dr. White said. Once he established “proximal and distal control,” he isolated the ruptured aneurysm and rolled it into a shape so he could put a clip on it. That seals off the weakened part of the vessel and preserves natural blood flow to vital parts of the brain.
Before closing the skull, the neurosurgery team did three separate tests to confirm that blood was flowing properly through the repaired vessel.
UT Southwestern is a specialty center for aneurysm surgery, performing more than any medical center in the region. OBI’s team of neurosurgeons are among the most experienced and respected in the nation.
Laurie and Dan knew all of that. Still, when they wheeled her out, Dan felt like he couldn’t breathe.
Her head was swollen, and she looked like somebody who had just endured a six-hour brain surgery. He grabbed her hand.
She curled her fingers around his. Laurie was there.
“That’s when the dam broke,” Dan said. “I was just so worried she would be unresponsive. She wouldn’t be herself. So, when she was able to whisper a few things to me, I just began weeping and telling her how proud I was of her.”
It was the purest form of relief he’d ever felt: “I knew then we were on the path to recovery.”
Perseverance, with a capital ‘P’
In many ways, Aug. 11, 2021, the day Laurie was saved by a video call, now feels like a lifetime ago. She returned to work on October 11, exactly two months after that harrowing day – a walking, talking, and thriving testimonial to the expert care patients receive at UT Southwestern.
She spent 19 days total at CUH and left to cheers from the OBI team. Her recovery has gone “remarkably well,” said Dr. White – no neurological injury and no walking weakness.
More than a few colleagues have joked with Laurie that perhaps she took her job as Marketing Director one step too far.
“I can definitely see things through the eyes of the patient,” she said. “I’ve walked in their slippers and experienced their full range of emotions. I was overwhelmed at times, scared, and confused. But I was also truly grateful for the care and compassion of every person who watched over me. It really was incredible.”
Following surgery, Laurie spent four more days in the Neuro ICU, where the team monitored her for potential complications, such as vasospasm, the narrowing of large and medium-sized intracranial arteries. Eventually she moved to the ninth floor, where she underwent physical, occupational, cognitive, and speech therapy.
When one therapist challenged her to come up with as many words as she could think of in 60 seconds that started with the letter ‘p,’ the therapist expected to hear the usual: pen, pencil, paper, etc.
Laurie’s mind leapt to words like “perseverance,” “possibility,” and “promise.” They just felt right after all that had happened.
Unsettling moments, breathtaking gratitude
As for the other three aneurysms, Dr. White and the OBI team decided, after careful consideration, to recommend an active surveillance plan that would include CT angiograms at 30 days and then every 3-6 months. Blood cultures and an echocardiogram ruled out infection or heart problems as a cause.
So, for now, waiting and watching is the best course.
Laurie admits she’s had some sleepless nights and unsettling moments, particularly whenever she gets a headache. And she always keeps her camera on during video calls. But mostly, she focuses on her incredibly good fortune.
“If I had not been on that Wednesday morning call, there’s a good chance I might’ve crawled to the sofa to see if the headache would pass,” she said. “In that regard, my job and my co-workers saved my life.
“Without that call, without Vicki, without Dr. White, without the entire team at UT Southwestern, I wouldn’t be here to tell my story.”
Vicki, who initiated the dramatic rescue, quickly deflects any suggestion of her heroics.
“The heroes are the EMTs who were there and the 911 operator who stayed with me on the phone. The ER docs, the neurosurgeons, the nurses – they are the heroes because they do this all day, every day,” she said. “I stepped into this accidentally, and I just did what she would have done for me. But when I watched her leave the hospital 19 days later, it felt truly amazing.”
In October, Laurie celebrated her 48th birthday. And in late March, she and Dan toasted their 14th anniversary, holding each other a little bit tighter than the year before.
She’s back to doing yoga a couple times a week, taking short runs and walks with the girls, and trying to savor every moment. Surviving a ruptured aneurysm has an unsubtle way of putting life in perspective.
“It takes my breath away when I think about how lucky I am, and how the circumstances, the people, and the fateful events all fell into place to keep me alive and on this journey of recovery,” Laurie said. “The love and support of my incredible family and friends has carried me through some difficult moments.
“And in the expert care of those at UT Southwestern's O’Donnell Brain Institute, I found deep comfort in knowing that I was in the best possible place, the best possible hands.”
Understanding aneurysms: The causes, symptoms, and severity
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