Alison's story

    ruptured aneurysm

 

She has completed medical school, has won the Flying Pig Marathon and has reached the summit of two of Colorado's 14,000-foot peaks. During the last year and a half, Dr. Alison Delgado has been tackling a mountain of a different kind. Step by hard-earned step, word by remembered word, the young pediatric resident has come back from a bicycle accident that caused serious physical and neurological injuries and once again is working full-time at Cincinnati Children’s Hospital Medical Center. Physicians at the Mayfield Clinic and UC Neuroscience Institute helped her through a series of procedures and treatments, while her husband, Dr. Tim Delgado, has been her No. 1 cheerleader and coach.

Alison Delgado was being stabilized at a community hospital following the cycling accident in October 2010 when Tim, an emergency department resident at University Hospital, arrived via Air Care. Tim was to provide assistance to a "Jane Doe cyclist in her 20s" during her transport to University's trauma center. When Tim realized that the accident victim was his wife, a second helicopter and physician were summoned.

Alison Delgado, who was wearing a bicycle helmet, did not suffer the kind of traumatic brain injury normally seen in bicycle accidents. Although she suffered numerous fractures to her neck and body, her skull was intact. Inside her brain, however, the impact created significant problems. It caused a blood vessel to tear and spill blood into the space around her brain, a subarachnoid hemorrhage. Further, the injury either led to the development of a dangerous aneurysm – a bulge in the blood vessel wall -- or aggravated an existing aneurysm. The discovery of a second aneurysm on the other side of her brain, said Lori Shutter, MD, a Mayfield neuro-intensivist, suggested that a genetic abnormality had elevated her risk of developing aneurysms.

During a series of procedures, Mayfield’s neurosurgical specialists worked to treat the aneurysm and stop the bleeding. But the aneurysm ruptured a second time, four days after Alison had returned home from her rehabilitation at Drake Center. Mario Zuccarello, MD, Chairman of the Department of Neurosurgery and a renowned cerebrovascular surgeon, finally neutralized the aneurysm. He rerouted the blood flow around the damaged artery in a delicate procedure known as an intracranial-extracranial bypass and then shut off blood flow to the aneurysm once and for all with a clip.

The worst behind her, Alison was able to focus on rehabilitation and recovery. She progressed rapidly from her lowest point, when she had trouble remembering Tim's name. They played Uno, Life and Scattergories. Using an iPad, Tim showed her photos and prompted her to search her memory for the words to describe them. Certain words, including "helicopter," proved elusive at first.

Recovery also meant daily workouts at the gym, with work on the elliptical, weight lifting, and plyometrics to improve her balance. At first Alison had to hold Tim's hand to do lunges; eventually she could do them with weights.
Reading came slowly at first, then more and more quickly. Sometimes Alison would have trouble finding the words she wanted to say, but her improvement and determination never ceased. Her speech therapist asked her to read a medical article and then write about it. She began attending rounds at Cincinnati Children's and, by February 2011, only four months after her initial injury, she had presented two cases at bedside rounds. "Everyone has been great and supportive," Alison said then.

Dr. Zuccarello wouldn’t let Alison run again until after she had recovered from the surgical clipping of the second aneurysm, which he performed in early March 2011. But Tim was keeping her motivated. "We are focused on one goal: getting her back to work and to where she feels normal," Tim said. "She will feel normal when she gets back to work."

Finally, in April, Alison began working part-time. In May she was back full-time. 

“I have been back at full speed over the past year,” she said in March 2012. “I'm always asking for feedback from my attendings to make sure my performance is the way it should be, and everyone has given me good feedback. Over the past year I actually wrote a case report with two of the emergency department attendings, and we have submitted it to the journal Pediatrics.”

Alison will have to make up extra time in residency but is expecting to finish in December 2012. “After that, I plan to do primary care, but I have also been thinking about a sports medicine fellowship,” she said. “Right now, I'm actually training for the Flying Pig Marathon, which is happening on May 6. I've been in pretty good shape since I was able to start running again last year.”

And then there are those mountains. There are 54 peaks in Colorado over 14,000 feet, Tim noted. “She wants to get the last 52.”

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Hope Story Disclaimer -"Alison's Story" is about one patient's health-care experience. Please bear in mind that because every patient is unique, individual patients may respond to treatment in different ways. Results are influenced by many factors and may vary from patient to patient.

 


Tim was to provide assistance to a "Jane Doe cyclist in her 20s" during her transport to University's trauma center. When Tim realized that the accident victim was his wife, a second helicopter and physician were summoned.



A subarachnoid hemorrhage caused by a ruptured aneurysm. As blood fills the space between the brain and skull, a blood clot forms, causing increased pressure on the brain.

 

Alison, Tim and feline friend Kevin.