What exactly just happened?
Hiya! In the last post I told you a bit about what had happened to Charlotte in April of this year and that although she has suffered major damage and still has huge problems and is a very poorly girl, she is making a remarkable recovery and stunning everyone she meets. I thought that this time I would explain things in a little more detail and if I haven't blown the laptop up due to eye leakage by that time, I'll try and explain how my amazing little girl has dragged herself (literally kickin and screaming sometimes!) to where she is today ...
Please bear with me throughout this. I am not in the medical profession so am giving you explanations as I understand them from asking 3 gazillion questions. And although it may be difficult reading, and you may want to gloss over it and skip to the warm fuzzy bits, I really need everyone to understand what happened to a normal little girl on a normal night at home. Rubbish things happen and awareness is key.
Cerebral Aneurism
An aneurysm is a weakness in the wall of a blood vessel which causes the weak part to bulge like a balloon. Remember watching cartoons where someone would block a hosepipe and the hose woud swell and swell until it burst? Well this is a bit like that. Over time, as the blood flows through the vessel, the weak area is put under increasing pressure and swells until it becomes so weak that it bursts.
A cerebral aneurysm is an aneurysm which forms in the brain. The brain has lots and lots and LOTS of blood vessels and arteries, some of which are near the surface, others buried deep within the brain.
At the back of the brain, where the back of your skull is, there is an artery which comes up through the spinal column and forks into two directions making a V shape at the base of your skull at the back. Charlotte being Charlotte and not doig anything by halves, didn't have a tiny little aneurysm in one of the little blood vessels. Noooo, Charlotte had a massive 12.1mm aneurysm on the artery which was branching off to the left.
Nobody had any clue that this was there and nobody could have known. It was explained to me that to have caused that size of aneurysm through trauma, i.e. if it wasn't there naturally, she would have had to have been hit by a car or something similar.
Subarachnoid heamorrhage
The subarachnoid space is the space between the brain itself and the membrane which covers the brain. When Charlotte's aneurysm ruptured (burst), it caused bleeding into this space which is then known as a subarachnoid heamorrhage. Because of the location of the bleed and because of the aneurysm being on an artery, there was a lot of blood lost very quickly, some of this is thought to have travelled down Charlotte's spinal column and clotted which was extremely dangerous.
So, Charlotte had suffered a subarachnoid heamorrhage caused by a cerebral aneurysm which had ruptured in her sleep.
Because of all of those factors such as where the aneurysm was and the amount of bleeding, the doctors were stunned that she had made it to hospital let alone into surgery. I emember one of her surgeons being speechless because she was alive.
EVD
An EVD is an external ventricular drain. This is used in neuro surgery to relieve and manage intercranial (inside the head) pressure. Under normal circumstances you and I can control the pressure in our heads by draining the fluid from inside down our spinal columns. Sometimes when you have a cold or the flu does your head feel like there's a lot of pressure in it? Well that's because your membranes swell with the infection and makes drainage harder. Because of the trauma going on inside Charlotte's head, she couldn't drain her own fluid and so developed encephalitis (a build up of fluid and therefore massive pressure). This is incredibly dangerous and so an EVD was inserted into Charlotte's brain to drain the fluid externally for her and to try and control the pressure inside her head. Or in the terms I used in hospital, Charlotte was plugged into the Matrix to drain her brain juice. Having this removed, believe it or not, was quite a funny experience which I'll tell you about another time...
Coiling
When Charlotte got to Leeds General Infirmary, she underwent emergency, life saving surgery at the hands of Ian Anderson & Chris Derham to stop the bleeding in Charlotte's head and insert the EVD. She then went into a second surgery where another amazing part of Charlotte's team, Tony Goddard performed a vey tricky poceedure called Coiling. This is where tiny little platinum coils are inserted into a blood vessel in the groin and passed along the vessel until they reach the affected area in the brain. This is done repeatedly until the 'balloon' left by the aneuysm is full of coils and therefore strengthened and blocked allowing the blood to flow past it and along the vessel as normal. This has its risks as the coils could nick the blood vessel on its way up or even tear the walls of the vessel at the aneurysm site. Fortunately and thanks to the outstanding skill of Mr. Goddard Charlotte has lots and lots of these coils and all of them went into the site with no tears and are still doing a fine job.
Vaso Spasm
OK, this is the hardest bit for me to explain but I'll do my best.
When there is bleeding into the brain, it takes a while to drain away, in fact the fluid coming through the EVD was pink for quite a while (it's supposed to be clear). The blood then irritates the surrounding blood vessels and causes them to spasm, known as a vaso spasm. This is a massive risk of what can happen after a subarachnoid heamorrhage but usually occurs between 3 and 21 days after the heamorrage and leads to ischemia which is the restriction of blood flow to the tissue, and death of that tissue from lack of oxygen. Charlotte started having massive amounts of these vaso spasms which caused a lot of ischemia and tissue death. So much so the doctors didn't expect her to survive at all and frantic phonecalls were made to get her sister to her quickly.
Stroke
A stroke is basically where there is a sudden loss of brain function caused by a lack of oxygen to the brain tissue causing damage and sometimes death. The outcome if a person survives a stroke depends on the cause of the stroke and the part of the brain affected but can have massive, long term repercussions to physical and mental self. Only 13% of strokes are caused by heamorrhages and childhood strokes or pediatric strokes (between the 28th week of pregnancy to ae 18 years) only happen to 5 in every 100,000 children in the UK.
So they're the major things that happened over a period of 3 days to a little, 7 year old girl who never got poorly, rarely even had a cold, exercised with her Mum most days, was extremely fit & healthy, loved her fruit & vegetables and was at the top of her class at school.
It can happen and it does happen but nobody seems to know about it, myself included up until April, and nobody seems to know what to do or where to turn afterwards. THAT is what I want to change.
Thanks for following Charlotte's story again and I promise, we're getting to the warm and fuzzy stuff :o)
xx
Please bear with me throughout this. I am not in the medical profession so am giving you explanations as I understand them from asking 3 gazillion questions. And although it may be difficult reading, and you may want to gloss over it and skip to the warm fuzzy bits, I really need everyone to understand what happened to a normal little girl on a normal night at home. Rubbish things happen and awareness is key.
Cerebral Aneurism
An aneurysm is a weakness in the wall of a blood vessel which causes the weak part to bulge like a balloon. Remember watching cartoons where someone would block a hosepipe and the hose woud swell and swell until it burst? Well this is a bit like that. Over time, as the blood flows through the vessel, the weak area is put under increasing pressure and swells until it becomes so weak that it bursts.
A cerebral aneurysm is an aneurysm which forms in the brain. The brain has lots and lots and LOTS of blood vessels and arteries, some of which are near the surface, others buried deep within the brain.
At the back of the brain, where the back of your skull is, there is an artery which comes up through the spinal column and forks into two directions making a V shape at the base of your skull at the back. Charlotte being Charlotte and not doig anything by halves, didn't have a tiny little aneurysm in one of the little blood vessels. Noooo, Charlotte had a massive 12.1mm aneurysm on the artery which was branching off to the left.
Nobody had any clue that this was there and nobody could have known. It was explained to me that to have caused that size of aneurysm through trauma, i.e. if it wasn't there naturally, she would have had to have been hit by a car or something similar.
Subarachnoid heamorrhage
The subarachnoid space is the space between the brain itself and the membrane which covers the brain. When Charlotte's aneurysm ruptured (burst), it caused bleeding into this space which is then known as a subarachnoid heamorrhage. Because of the location of the bleed and because of the aneurysm being on an artery, there was a lot of blood lost very quickly, some of this is thought to have travelled down Charlotte's spinal column and clotted which was extremely dangerous.
So, Charlotte had suffered a subarachnoid heamorrhage caused by a cerebral aneurysm which had ruptured in her sleep.
Because of all of those factors such as where the aneurysm was and the amount of bleeding, the doctors were stunned that she had made it to hospital let alone into surgery. I emember one of her surgeons being speechless because she was alive.
EVD
An EVD is an external ventricular drain. This is used in neuro surgery to relieve and manage intercranial (inside the head) pressure. Under normal circumstances you and I can control the pressure in our heads by draining the fluid from inside down our spinal columns. Sometimes when you have a cold or the flu does your head feel like there's a lot of pressure in it? Well that's because your membranes swell with the infection and makes drainage harder. Because of the trauma going on inside Charlotte's head, she couldn't drain her own fluid and so developed encephalitis (a build up of fluid and therefore massive pressure). This is incredibly dangerous and so an EVD was inserted into Charlotte's brain to drain the fluid externally for her and to try and control the pressure inside her head. Or in the terms I used in hospital, Charlotte was plugged into the Matrix to drain her brain juice. Having this removed, believe it or not, was quite a funny experience which I'll tell you about another time...
Coiling
When Charlotte got to Leeds General Infirmary, she underwent emergency, life saving surgery at the hands of Ian Anderson & Chris Derham to stop the bleeding in Charlotte's head and insert the EVD. She then went into a second surgery where another amazing part of Charlotte's team, Tony Goddard performed a vey tricky poceedure called Coiling. This is where tiny little platinum coils are inserted into a blood vessel in the groin and passed along the vessel until they reach the affected area in the brain. This is done repeatedly until the 'balloon' left by the aneuysm is full of coils and therefore strengthened and blocked allowing the blood to flow past it and along the vessel as normal. This has its risks as the coils could nick the blood vessel on its way up or even tear the walls of the vessel at the aneurysm site. Fortunately and thanks to the outstanding skill of Mr. Goddard Charlotte has lots and lots of these coils and all of them went into the site with no tears and are still doing a fine job.
Vaso Spasm
OK, this is the hardest bit for me to explain but I'll do my best.
When there is bleeding into the brain, it takes a while to drain away, in fact the fluid coming through the EVD was pink for quite a while (it's supposed to be clear). The blood then irritates the surrounding blood vessels and causes them to spasm, known as a vaso spasm. This is a massive risk of what can happen after a subarachnoid heamorrhage but usually occurs between 3 and 21 days after the heamorrage and leads to ischemia which is the restriction of blood flow to the tissue, and death of that tissue from lack of oxygen. Charlotte started having massive amounts of these vaso spasms which caused a lot of ischemia and tissue death. So much so the doctors didn't expect her to survive at all and frantic phonecalls were made to get her sister to her quickly.
Stroke
A stroke is basically where there is a sudden loss of brain function caused by a lack of oxygen to the brain tissue causing damage and sometimes death. The outcome if a person survives a stroke depends on the cause of the stroke and the part of the brain affected but can have massive, long term repercussions to physical and mental self. Only 13% of strokes are caused by heamorrhages and childhood strokes or pediatric strokes (between the 28th week of pregnancy to ae 18 years) only happen to 5 in every 100,000 children in the UK.
So they're the major things that happened over a period of 3 days to a little, 7 year old girl who never got poorly, rarely even had a cold, exercised with her Mum most days, was extremely fit & healthy, loved her fruit & vegetables and was at the top of her class at school.
It can happen and it does happen but nobody seems to know about it, myself included up until April, and nobody seems to know what to do or where to turn afterwards. THAT is what I want to change.
Thanks for following Charlotte's story again and I promise, we're getting to the warm and fuzzy stuff :o)
xx
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