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Laura Branigan, 47, dies suddenly from cerebral aneurysm

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The Grammy-nominated pop star, famous for her 1982 platinum hit “Gloria,” died in her sleep last Thursday night at her home in Quogue, New York.

Her brother Mark said she had complained of a headache for about two weeks before she died, but had not sought medical attention.

What to do about a persistent headache?

My best friend was troubled by a fierce, persistent headache for years; it got worse when he coughed, forcing him to bend over in agony.

Complicating things: he has high blood pressure, and is on medication for it.

Making things even more interesting: he’s a board-certified, practicing clinical neurologist, with training under one of the greatest diagnosticians ever in the field.

So if even I, a gas-passer, know that he should’ve gone to see someone about two years ago, you’d thing he’d have come to a similar conclusion himself, right?

You’d be wrong.

He never went in, because, like me, he’s petrified of doctors and medical work-ups.

We know what can happen when the rock starts to tumble down the hill.

So he waited to wake up dead one day, and lo and behold, the headaches went away a few months ago.

What were they?

Who knows?

Should Laura Branigan have gone in to see someone?

I don’t know.

Most headaches go away on their own, so why bother?

If everyone with two weeks of persistent headache that was worse with coughing went in for an exam and cerebral angiography, the country would come to a halt and be bankrupt.

What’s going on when you have a cerebral aneurysm, anyhow?

Well, it’s a stretching/bulging/thinning of the arterial wall, is the pathophysiology.

When it gets thin enough, it bursts, and blood pours out under high pressure.

The bleeding continues until the pressure inside the skull is so great that the brain is forced downward through the hole at the base of the skull (the foramen magnum).

When that happens, the brain stem stops working, the heart stops, breathing ceases, and you’re dead.

If you diagnose an aneurysm in time, it is an entirely curable condition.

The surgeon can clip it (isolate it from the main part of the artery); a radiologist can embolize it

(fill it with inert material that essentially isolates it from the main part of the artery).

These are tricky things: you can easily die during these procedures, or wake up hemiplegic.

I used to specialize in giving anesthesia for such neurosurgical vascular procedures, back when I was in academic anesthesia.

Nothing like taking the old blood pressure down to 60/35 and keeping it there so the surgeon can get a clip around the thing. Yee-ha!

Read my book if you need details on how to do it yourself.

When I was a med student at UCLA, the actress Patricia Neal came to the UCLA ER with complaints of an overpowering headache.

She was rushed to the angiography suite, where she became the unwitting star of one of the most stunning movies (medical diagnostic category) ever made.

As she lay on the table, the radiologists around her watched in awe as her brain aneurysm exploded in real time inside her unconscious head.

They rushed her to the operating room with their catheter still in her brain, and the neurosurgeon-on-call did a STAT craniotomy in record time, zipping off the top of her skull before the inexorable compression of her brain stem killed her.

She survived, and with intensive physical therapy recovered most of her capability.

Talk about luck.

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