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Neurosurgery for Brain Aneurysm Allows Man to Celebrate Life

Medical stories have the ability to defy belief. And then there’s the tale of Zach Valentine. Who in the course of a couple of weeks went from a romantic night with his wife to blinding pain in his head to a complex brain surgery in which his doctor, neurosurgeon John Wilson of Wake Forest Baptist Medical Center, had to work around the tenets of Valentine’s religion. Jehovah’s Witnesses do not accept blood transfusions.

Valentine, 31, of King, North Carolina, today recounts with boyish energy—“Here, you wanna see the video? You don’t get squeamish about blood, do you?’’ he enthuses to a visitor—the story of the extracranial-to-intracranial (EC-IC) bypass he had. And the full recovery he’s made, one that even allows him to be back riding his prized 2008 Kawasaki Vulcan Classic motorcycle.

“We have a tremendous love of life. But my faith in God surpasses that,’’ Valentine says of his ordeal. “So that helped comfort me a tremendous amount.’’

It was Valentine’s wife, Theresa, who forced him, three days into his searing headache—“Whenever I would cough or I would sneeze, it felt like my eyeballs were going to explode out of my head”—to visit his doctor, who sent him for an immediate CT scan.

From there, he was sent to the emergency department at Forsyth Medical Center, which diagnosed the aneurysm and recommended that he be seen by Wilson, an expert in dealing with complicated aneurysms at Wake Forest Baptist Medical Center.

Valentine had a “fusiform aneurysm,” in which the walls of one of his blood vessels, for unknown reasons, weakened and began to expand. If the vessel had ruptured, there was a good chance he would have died. There is no particular reason for such an aneurysm forming; there was no family history and Valentine had been healthy all his life.

Wilson describes an aneurysm as if someone is blowing up a balloon, when it takes a lot of blowing force to finally get the walls of the balloon expanding. An aneurysm, he says, is like that. As it expands, it can cause severe pain and be in danger of rupturing.

“It’s the hallmark of a ruptured aneurysm,’’ Wilson says, “the suddenness of which a headache comes on; an instantaneous, blinding headache.’’

Photo: Dr. John A. WilsonWilson, one of a handful of neurosurgeons in North Carolina who perform EC-IC bypass surgery, cut off the damaged blood vessel and took another artery in Valentine’s scalp, redirecting it to restore blood flow to his brain. The damaged vessel was then removed. The neurosurgery took more than eight hours.

The fact that Valentine is one of Jehovah’s Witnesses created the potential for problem during the surgery even though a transfusion is not typically needed. The problem is that there is always a chance during neurosurgery that an aneurysm can rupture, which would result in the rapid loss of blood and the possible need for replacement with a transfusion.

Wilson suggested use of a device called a cell saver, in which a person’s own blood is put in a centrifuge-like device that separates his red blood cells. Those could have been returned to Valentine had he needed them. Not all Jehovah’s Witnesses will agree to use the cell saver device.

Valentine says he agreed because “to my understanding, when there is bleeding, the blood is suctioned up into the machine to be cleaned and immediately recirculated back into the body. It basically continues an external circulation of my natural artery,’’ adhering to his religion’s faith against acceptance of stored blood whether the person’s own or anyone else’s.

“For those of us who aren’t of that religion, it’s hard to understand,’’ Wilson says. “You have to respect their wishes and their beliefs, even if you don’t understand them.’’

When it was over, recovery wasn’t always easy. Early on there was a great deal of pain, Valentine says, and in the following weeks, he battled bouts of anxiety. But his love of family—Theresa and their 9-year-old daughter, Lorelei—helped him through the difficult times.

He was back on his motorcycle for the first time one day late last fall, and though he’ll be subject to regular checkups on the condition of his blood vessels, Valentine says he’s grateful for all that’s happened and looking forward to the future.

“I can live my life the way I want to live it—fully.’’

Learn more about neurosurgery and neurology services at Wake Forest Baptist Health.

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Watch former neurology and neurosurgery patients from Wake Forest Baptist Health, in Winston-Salem, NC share their stories.

Last Updated: 10-31-2016
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