Silvia’s Story: Defying Brain Aneurysm Odds

What loan underwriter Silvia Buceta remembers about the morning of Sept. 13 comes only from what others have told her.

It was the day an aneurysm burst deep within her brain. It was the day she nearly died.
 

It was Monday and Buceta was upstairs in her Stroudsburg home. Because of the COVID-19 pandemic, she normally worked from home. Her husband, Al, heard a thump and a short time later, after Silvia crawled to the bedroom door, he heard her yell to him for help.

Al rushed to Silvia’s side and his first thought was the migraines she ceased having a few years earlier had returned. Silvia was screaming; her back was drenched in sweat. This was no headache, he thought.

Emergency medical crews arrived and quickly took her to Lehigh Valley Hospital (LVH)–Pocono, where a scan showed bleeding in her brain from a ruptured aneurysm.

Silvia soon became unresponsive. Intubated and on life support, she was flown by MedEvac helicopter to the neuroscience intensive care unit (NSICU) at LVH–Cedar Crest where a critical care team was waiting.

Neurosurgeons began to drain the buildup of blood and fluid that was causing the tremendous, painful pressure that had caused her to become unresponsive. Then it was into interventional neuroradiology, where a coil embolization was performed on the aneurysm to prevent re-rupture. The minimally invasive technique involves inserting a catheter through the groin and threading it into the blood vessels in the brain. Platinum coils, about the thickness of a human hair, are packed into the aneurysm to prevent rebleeding.

For several days, on a ventilator and a feeding tube, Silvia said she was in pain. Al was fearing the worst. Would his wife be disabled, or die? Then she started to wake up and subsequent brain scans showed enough improvement that the drain in her brain and her breathing tube were able to be removed. Silvia was rapidly improving.

About a week after arriving in intensive care, Silvia was taking a walk. Two weeks later she was doing so well, she was discharged home straight from the NSICU.

“They could not believe I was walking,” says Silvia, who attributed her recovery in part to an active lifestyle that included kayaking and biking. A non-smoker and a breast cancer survivor, she said she focused on getting better and on the target date for her potential release home. She was anxious to get home and recuperate there.

“They were amazing, all the doctors and nurses,” she says. “My husband never saw anything like it. They were constantly there for me.”

“We have an amazing team of very dedicated individuals from the intensivists, to the advanced practice clinicians and the nurses and therapists. These patients are truly a team effort, and we all play an important role,” says neurologist Christopher Melinosky, MD, one of those who treated Silvia.

Surviving a large brain hemorrhage isn’t guaranteed. Melinosky says about 20 percent of patients with a subarachnoid hemorrhage die before they reach the hospital. Overall, 30-day mortality is as high as 35 percent. Survivability is variable, but better at a comprehensive stroke center (CSC), a high-volume center with a dedicated neurological intensive care unit like the one at LVH–Cedar Crest.

“Based on Silvia’s initial severity, she did remarkably well,” he says.

Not a big believer in miracles, Silvia says the remarkable treatment she received shows there’s hope for patients like her.

Bleeding in the brain like Silvia experienced is considered a stroke, though not what most people likely think of when they think stroke. About 85 percent of strokes are caused by blockages in blood vessels. The other 15 percent, the kind Silvia had, are hemorrhagic, from bleeding into the brain.

“Not all patients with severe brain injury do well or even survive, so when we put an incredible amount of work and effort into saving our patients it’s wonderful to see them survive and do well,” says Melinosky. “We rarely have the opportunity to discharge a patient directly home, which makes this case so special. It really is the most rewarding part of this career – seeing a patient come in comatose and walk out of the NSICU with her family because of the efforts of my team.”

Silvia says she’s looking forward to getting back to work and driving. She and Al are avid travelers, so there’s that to get back to as well. However, one of the biggest reasons she wanted to get well and come home was for her three granddaughters. Because of her health scare, she couldn’t take them to the corn maze this fall as in prior years.

“I have hope that all of this is over and behind me,” she says. “I want to be there for my grandkids and be there when they get married.”