A 43-year-old man was taken to MC Erebouni with a sudden severe headache and high blood pressure. Immediately after admitting to medical center all the necessary examinations were carried out: CT of brain, CT angiography and laboratory studies. The patient was admitted to the Intensive Care Unit. As a result of examinations, it turned out that the patient had two cerebral saccular (berry) aneurysms (dilation), in which the weakness of the vessel wall led to the rupture of the vessel and the occurrence of severe brain hemorrhage. In this situation, the patient's life was in serious danger, especially in the case of repeated hemorrhage.
The situation was further complicated when the COVID-19 patient tested positive. In order to save the patient from repeated hemorrhage the head of Cerebrovascular Neurosurgery Service Dr David Sahakyan decided to perform endovascular surgery to strengthen the damaged arteries. This intervention required high professionalism, skills and coordinated work of the surgical and anesthesiological team, because, based on the structural features of aneurysms, there was a very high risk of intraoperative hemorrhage or ischemic stroke. The presence of COVID_19 infection in the patient increased both the patient's risks in stroke treatment and put the entire surgical team at risk. The latter circumstance made it necessary to carry out this complex intervention in more difficult conditions, applying strict measures to prevent the spread of infection. In addition to the radiation protection clothing used in such surgeries, the crew also wore an antiviral protection suit and special masks. Thanks to the professionalism of the surgical and anesthesiological team the surgery was performed at a high level and without complications.
The treatment of the hemorrhage and COVID-19 were subsequently properly carried out thanks to intensive therapy, joint work of neurological, neurosurgical and therapeutic teams. As a result of such team struggle, the patient overcame all the problems, was discharged with recovery and returned to the family.
