11 December 2012
It was the most severe headache he ever felt in his whole life. His BP was normal but the headache was worse than any pain he had ever experienced. He didn't want to be moved as the slightest movement caused so much dizziness and protracted vomiting. He does not recall having had bouts of hypertension nor dizziness this severe, and no analgesic, nor anti-vertigo could relieve the distress he felt.
When I had him undergo a CAT Scan, my worst fear was confirmed. Because aside from an infarct (blocked circulation) inside the right part of his brain, his vein outside it was oozing blood (Subarachnoid Hemorrhage). His skull was like a tire attached to a compressor slowly pumping air into it. At least the tire being rubber had some room to expand, and would explode upon reaching the threshold of the strength of its material. The skull, on the other hand, being bone, would not budge a millimeter, leaving the soft brain to take the brunt of the pressure increase, that an emergency decompression must be done ASAP.
Our circulatory system is the highway or drainage network of our body. It is responsible for bringing nutrients to and waste products from our organs. It brings oxygen from and carbon dioxide to the lungs, ensuring a highly efficient transport system that keeps us alive and kicking.
It is a system of flexible tubes that begin from over 1.4 inch in diameter near the heart, to 8 µm in the peripheral organs. It is composed of muscle and elastic tissue capable of changing the diameter. It is able to constrict when we lose blood (to maintain pressure) and expand when we need the circulation to run away from a threat.
As we grow older, however, we start to lose the elasticity that keeps everything running smoothly. This is a natural process that occurs whether we like it or not. However, with today's modern lifestyle of sedentary living, our blood vessels harden at an earlier age. With today's dietary habits, our arteries tighten with hardened fat. It's not much different from a sink drain that gets clogged with grease, just that we can't pour liquid sosa into our blood.
As the hardened fat invades the arterial walls, the muscular and elastic layer, are actually thinned out, making them vulnerable to leaks and clogging. The increase in blood pressure further thins out the already thinning muscular and elastic wall. And it is this leak that slowly made my patient's waking hours a living hell. Although congenital aneurysms are the usual cause of subarachnoid hemorrhage, atherosclerosis does contribute to its incidence.
So it is not just the salt, or the fat, or the blood pressure, or the emotional stress that causes events like these. It is the combination of all these factors. And with all these elements acting as one, the injury reaches the tipping point wherein there is nowhere else to go but down. Down into what others might call a living hell. And the ones who die quickly are sometimes the lucky ones.
The brain can only take so much. And the earlier surgical intervention is done, the less the permanent damage would likely be. On an island like Catanduanes where neurosurgical interventions have to wait for a 4 to 6 hr travel to the mainland, it is of paramount importance that events like these are immediately diagnosed. Or better yet, with a healthy lifestyle, altogether prevented.