Brain aneurysm coiling now available in Monterey County 

Pictured above: Anastacia Mendoza and her youngest son, Pablo

When Seaside resident Anastacia Mendoza complained of a headache that wouldn’t go away, even after a night’s sleep, her youngest son and primary caregiver, Pablo, took it seriously. His mother isn’t one to complain, though she had been tested throughout her 71 years — raising five kids, mostly on her own, while alternating between seasonal jobs in the fields and hospitality. Five years of dialysis, then a kidney transplant. Diabetes. Multiple surgeries.

Ultimately, Anastacia was diagnosed with three brain aneurysms — bulging blood vessels that can rupture and cause a stroke. To resolve the threats, Anastacia became the first person to undergo minimally invasive coiling procedures in Monterey County.

While aneurysms are relatively common, most go undetected because they don’t cause problems. Diagnosis usually comes after “the worst headache of your life,” says Daniel Raper, MD, the neurosurgeon who performed the procedures. “You may have nausea and vomiting, difficulty with bright lights, you might pass out.”

Anastacia’s headache didn’t rise to that level, but it persisted. Then numbness in her face and slurred speech prompted Pablo to call 911. At Montage Health’s Community Hospital of the Monterey Peninsula, an unruptured aneurysm was detected as the cause. A follow-up that checked Anastacia’s blood flow through her arteries revealed two more unruptured aneurysms.

Pablo shared the news with his older siblings, and they talked about how to proceed.

A minimally invasive approach

We’re fortunate to have a state-of-the-art hybrid operating suite that is specially designed for neuro interventions at Community Hospital.
— Daniel Raper, MD, neurosurgery, Montage Health

Raper says there are generally three approaches. First is monitoring growth, bleeding, or other changes, which is considered when an aneurysm is small or treatment would be risky. The second is open surgery; a piece of the skull is removed to access the aneurysm, then a clip is used to cut off its blood supply. More recently, minimally invasive, endovascular (through the blood vessels) treatments such as coiling have been used.

With coiling, a flexible tube called a catheter is inserted in an artery through a small incision in the groin or wrist. The tube is guided to the aneurysm to implant tiny metal coils inside of it. The coils block blood from coming in and causing the bulge to grow and rupture.

Coiling allows for faster treatment and recovery, usually with a one-night hospital stay, and complication risks can be lower compared to open surgery.

Anastacia and her family chose coiling and Raper did two sessions, first addressing the larger aneurysm on one side of her head and then the two smaller ones on the other side.

A positive outcome

“She did great,” Raper says. “She’s very lucky to have an attentive son who helps take care of her.”

Raper says area residents are fortunate to now have advanced neurosurgical procedures at Community Hospital, including coiling, thrombectomies to remove blood clots blocking blood flow to the brain, and repairs for tangled arteries and veins that can cause brain bleeds.

“You can travel and get these things addressed at a center in the Bay Area, but it’s really nice to have the expertise in our community,” he says. “We’re fortunate to have a state-of-the-art hybrid operating suite that is specially designed for neuro interventions at Community Hospital.”

Pablo is grateful that the program was here for his family.

“We only have one mom,” he says.

Comprehensive neuroscience services

Coiling is just one of the advanced neurosurgical procedures now available locally under a partnership between Montage Health and University of California, San Francisco, made possible by a significant philanthropic gift from David and Joan O’Reilly through Montage Health Foundation.

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