It was 2008, a chaotic time for Maria Ross, a 35-year-old marketing expert who had just started a new job and moved into a new house in Seattle. She ignored the headaches that had been plaguing her and just attributed them to stress.
"Suddenly, a migraine hit me after a theater audition," said Ross, an amateur actress. "One minute I was fine and the next I was grabbing on to a pole. It was like my brain was shooting out of my head and rushed to my feet."
"I pulled myself together, thinking it was nerves," she said. "I have a history of high blood pressure and a type A personality. We'd had a lot of stress in our lives."
It wasn't stress, but the symptoms of a brain aneurysm that would hit her a month later when Ross's husband found her unconscious on the bathroom floor. She suffered blindness and depression before she was back on her feet again.
Today at 39, Ross is back at work, running her own business, Red Slice Branding. She has mostly recovered from the aneurysm that nearly killed her and has self-published a memoir, "Rebooting My Brain," which offers hope and humor to others with brain injuries.
"There are people in rehab who can never go back to their jobs again," said Ross. "Some can't speak or walk. I wrote the book for them."
"Is not a medical book, but I cite information and resources that worked for me," she said. "The biggest advice I give to people is get therapy. That's what helped me get into life again."
A brain aneurysm or cerebral aneurysm is a weak bulging spot on the wall of the brain artery, much like one on a balloon or an inner tube. Over time, the artery pounds against the thinning wall and an aneurysm silently forms. The pressure may cause it to rupture.
An estimated 6 million Americans -- or one in 50 people -- have an unruptured brain aneurysm, according to the Brain Aneurysm Foundation. About 30,000 of them suffer a rupture each year, nearly half of them fatal. An estimated 10 to 15 percent never make it to the hospital, and those who do can have permanent neurological damage or other disabilities.
Ross suffered a subarachnoid hemorrhage, which caused bleeding into the compartment surrounding the entire brain. In the most serious cases, the bleeding can cause brain damage, paralysis or a coma, and often death.
Doctors don't fully understand what causes a person to develop an aneurysm, but suspect a genetic tendency that is exacerbated by environmental factors like smoking and high blood pressure.
After Ross's migraine-like headache at the theater, more headaches came and went. She saw a doctor, but he didn't know her patient history because she had just moved to Seattle, and only monitored her blood pressure and recommended yoga and acupuncture.
But a month later, another headache struck, one so severe she began vomiting and collapsed, slipping into a coma.
"My husband had decided to come home early that day," said Ross. "He called the ambulance right away to the hospital, and as fate would have it, I was only five miles from one of the best in the country."
When Ross arrived at University of Washington's Harbor View Medical Center , she was comatose and had the lowest possible score to evaluate her chances of survival, according to Dr. Raj Ghodke, co-director of the Brain Aneurysm Center and an neurointerventional surgeon.
"In the other classification system for aneurysms, she had a grade 4 out of 5 and had a very big bleed from the aneurysm," he said. "Based on that grading system when it was written, 80 percent would die, but with medical advancements it was down to 30 to 40 percent. She did beat the odds."
Survival Means Getting Help Fast
Survival depends largely on how quickly a patient gets to the hospital for treatment. "But she was healthy and young and those things were in her favor," said Ghodke.
He performed a coiling procedure, entering Ross's artery through her groin and winding a coil through the carotid artery and eventually inside her cranium to essentially plug up the artery and stop the bleeding.
Ross was in an induced coma and hooked to a breathing tube and on ventilation so her organs didn't shut down. "They told my husband, 'We saved her life,' but we had no idea I would be brain damaged, unable to walk or talk," she said.
The aneurysm had caused her retinas to hemorrhage, a condition called Terson's syndrome, which happens in about 13 percent of all cases of subarachnoid hemorrhage, according to the Brain Aneurysm Foundation. As a result, Ross was blind for six weeks.
"Combine this with no short-term memory and a mix of ICU sedatives, and I actually do not recall the entire month of August 2008, except for snatches here and there," said Ross, whose sight was restored within about a year.
Doctors operated on one eye so she could see during rehabilitation and the other eye cleared on its own, she said. After a year, she was good enough to begin driving again.
Ross said keeping a sense of humor and acceptance were the key to her survival.
"We humans need to use humor to get us through the tough times," she said. "It lightens the load and clears our heads from the stress. There was some gallows humor in the ICU ... A lot of people are afraid to laugh or smile in a dire situation, but you should embrace that."
In-patient rehabilitation consisted of physical, occupational and speech therapy, followed by an out-patient group in cognitive and psychotherapy. "There is a lot of emotional fall-out from a brain injury," Ross said.
Ross was able to return to work within six to eight months, but she has had some residual cognitive deficits.
"I did have brain damage," she said, without a hint of verbal or cognitive stumbling. "I saw the black spot of the scan where the cells died."
Today, Ross can be "overwhelmed" by too much stimulus, which she said is common in a brain injury.
"The filter in your brain gets broken, like at a bouncer at club in the brain being replaced with someone new and green," she said. "You can have too much information come to you at the same time."
When Ross recently went to Times Square in New York City, she had difficulty because of the lights, the sounds and the people -- "Five hundred things going on at the same time," she said.
She has difficulty concentrating on tasks and her short-term memory is not what it used to be.
"I have note pads and sticky pads all over the house and in my purse," she said.
"I may have to ask the same question over and over again in conversation. My husband says that at time I get a lot more confused when he tries explaining something to me."
Ross is so grateful for the rehabilitation that she received, that she now volunteers at University of Washington Medical Center as a patient adviser and speaker.
"It's a way for me to give back for their amazing care," she said.
Attitude plays a huge role in recovery, according to Ross. "I found a way to adapt around the deficits -- accepting rather than keep fighting it. I was trying to get back the old me. Now, I deal with the new me and work around it and my recover got faster. I was my own worst enemy."
Her goals were modest. "My dog was crucial to my recovery -- he gave me a goal. People say, I almost died, I want to travel the world. All I wanted was to walk the dog for a half hour every day."
Ross said at first people told her to write a book about her experience, but she resisted. "No one will care about me," she said. "I'm not a celebrity."
But after meeting others in rehabilitation, she changed her mind. "A lot of people with brain injuries can't articulate what they went through," she said. "I am blessed enough to still have my gift of gab and writing."
Ross's doctor, Ghodke helped edit the book and now recommends all his aneurysm patients read it. "It's the first time I got so much on what someone goes through," he said. "This is so important that people know about it. We have a rare insight into this condition from someone who writes so well and made this phenomenal recovery."
Since writing the book, she has been heartened by hearing from brain injury survivors from around the world. And she has learned to accept her limitations."
"The new me is definitely more patient," said Ross. "I definitely try to be more present. I am definitely more thankful. And I work in a healthier way because I have to. It's really enriched my life and I am lucky I see it as a gift."