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WellSpan neurosurgeon repairs 'time bomb' in her brain

June 15, 2022

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Tabitha Finucan Pacheco looks at an image of her brain aneurysm with WellSpan neurosurgeon Dr. Michael Casey, who repaired the bulging blood vessel.

Tabitha Finucan Pacheco looks at an image of her brain aneurysm with WellSpan neurosurgeon Dr. Michael Casey, who repaired the bulging blood vessel.

The news kept getting worse. 

First, Tabitha Finucan Pacheco started having headaches – lots and lots of headaches, up to 15 a month. The 37-year-old Dover woman had a busy life with her husband and two daughters, two jobs as an outreach ministry worker and a waitress, and her extended family. She pushed through the pain but finally saw a doctor. 

Then Tabitha discovered she had a bulging blood vessel in the center of her brain, about the size of a large marble, which was in danger of bursting like a “time bomb waiting to go off.” 

Then Tabitha learned the traditional treatment option was brain surgery, which would entail sawing off the top of her skull, separating the two sides of her brain, and clamping off the aneurysm. The surgery could end up affecting her ability to walk afterward, due to the location of the aneurysm. 

Then, finally, Tabitha got some good news. 

WellSpan neurosurgeon Dr. Michael Casey offered Tabitha a groundbreaking way to treat her aneurysm, one that involved threading a tiny catheter through her wrist and up to her brain to treat the bulging vessel. He successfully did the treatment in April 2021. 

“I honestly still can’t believe they can go through your wrist to get to your brain,” Tabitha says. “It’s amazing. Really amazing. I feel so good now. I just started going to the gym. I feel like my life started again.” 

Dr. Casey is thrilled that Tabitha did so well with the procedure. 

“She had a very large aneurysm,” he said. “It would have ruptured and killed her. Now it won’t come back or rupture. This was a great outcome.” 

The treatment – called transradial endovascular repair – offers patients like Tabitha less risk, less pain, and a faster recovery than conventional brain surgery, for those who can find a hospital with the necessary technology and surgeons trained in the procedure. 

Fortunately, for Tabitha, WellSpan offers both. 

WellSpan York Hospital has three-dimensional mapping software and computer-assisted equipment that allow surgeons to do complex treatments. Dr. Casey completed a fellowship that trained him to do the transradial repairs before he arrived at WellSpan in 2020. 

The treatment is just one of the cutting-edge neurosurgery procedures being performed at WellSpan, including the latest version of deep brain stimulation treatment for patients with Parkinson’s disease and other movement disorders. 

“We have amazing technology to treat aneurysms and tumors of the brain and spine,” Dr. Casey says. “We are doing some high-acuity neurosurgery that is technically challenging. And we are doing it right here, in South Central Pennsylvania.” 

The technology and training allowed Dr. Casey to thread a wire, the diameter of a human hair, through a catheter, the diameter of a sewing needle, through a vessel in Tabitha’s wrist, up her arm, into her head and then “dance it” into her aneurysm. 

Dr. Casey then placed a stent, a tightly woven mesh tube, in the vessel that was feeding blood to Tabitha’s aneurysm, which directed most of the blood flow past the aneurysm. The neurosurgeon compares it to placing a roadblock (the stent) in the entrance to a cul-de-sac (the aneurysm). The stent eventually grows into the vessel and completely blocks off the aneurysm, which shrinks and dies off. 

Tabitha is grateful to have avoided brain surgery, to have her life back, and to feel so good, although she will have to be monitored for aneurysms for the rest of her life. 

The only visible reminder of the procedure are some tiny scars on her wrist. More enduring is the impact that dodging a ticking “time bomb” left on her life. 

“My work life is so busy, but I realized I don’t want to live my life just to work,” Tabitha says. “My father passed away in January from cancer. My grandparents are still living. I am making it a point to try to see them regularly. I want to enjoy my family and spend my time wisely because I don’t know when that all ends. I don’t want to wait. I want to do things that matter.” 

For more information on WellSpan's neurosurgery services, go here.