Sharon Stone was dying right before doctors' eyes.
The giant cerebral aneurysm that had ruptured and bled into her brain was one of the most complicated cases doctors in the Neuroscience and Spine Institute at the Wyoming Medical Center had ever seen.
She wasn't a candidate for any of the normal treatments for brain aneurysms, so doctors had to come up with some different ways to save her.
Sharon entered the emergency room around 5 p.m., Aug. 21. Two of the main doctors on her case were neurosurgeon Dr. Brian Wieder and interventional neuroradiologist Dr. Boris Karaman.
On Aug. 22, Wieder spoke with Karaman to determine if Sharon was a candidate for coiling, a complex nonsurgical procedure.
Coiling is a fairly new option, Karaman said, and it had never been done before at the Wyoming Medical Center, though Karaman had preformed the procedure on various occasions at MetroHealth Medical Center in Cleveland.
During the six-hour surgery, Karaman placed tiny platinum coils into the aneurysm through a catheter, or a small plastic tube.
Karaman filled the aneurysm with about 40 coils to block the pathway of blood to the aneurysm and cause the blood to clot, which effectively destroys the aneurysm. On an X-ray, the coils in the aneurysm look like a ball of string.
In a normal case, Karaman said he would use about 10 to 12 coils to fill the aneurysm.
These coils will likely stay in Sharon forever to prevent the aneurysm from rupturing again, Karaman said, but they may need to be replaced in 10 to 15 years.
The coiling stopped the bleeding but didn't alleviate the extremely high pressures. Doctors still needed to drain the fluids.
The blood in the brain was too thick, according to Wieder. It kept clotting inside the catheter and obstructed the flow of the fluids.
"It was a picture of unbelievable odds stacked against her," Wieder said. "We thought it reasonable to try something rare."
On Aug. 23, Wieder told Sharon's husband, Gary, he wanted to try a risky, controversial treatment to try to break up the blood clot in the ventricles of the brain and allow the catheter to drain the fluid.
Wieder wanted to administer a clot-busting medication called tissue plasminogen activator, or tPA.
He said the drug is used frequently at the Wyoming Medical Center to reduce damages in heart attack and stroke patients. There are only a handful of cases across the world where tPA has been used in the treatment of aneurysms.
The risk is the medication could bust the blood clot formed in the aneurysm, causing it to rupture and bleed again, which could kill Sharon.
Wieder consulted with other doctors around the country who had used tPA in aneurysms before.
Gary Stone said he understood the risks and thought it was the only option to save his wife.
"Dr. Wieder told me, 'We've done all we can. Now we're going into heroism,'" Gary said.
The tPA was administered directly to the blood clot in the ventricles in a small dose, about the size of a water droplet, each day for 10 days.
Each day the catheter was able to drain more and more fluid out of the brain.
By the end of day 10, pressure in the brain had returned to near normal levels. By day 15, Sharon started to move.
Doctors were still guarded as they described the prognosis to the Stone family, but Sharon continued to make progress.
After about 30 days in the hospital, Sharon Stone was moved out of the intensive care unit to the neurology floor, where she spent another two weeks. Then, she was moved to the rehabilitation unit to undergo therapy to regain some of her life skills.
"They really watched her close," Gary said. "Sharon almost got to be a fixture there and they missed her after she left."
At first, Sharon had paralysis in her right side. It has since diminished, but Sharon still has some balance issues.
Her memory experienced the most damage.
Her husband said her memory from the past 10 years is fragmented.
Karaman has worked on hundreds of aneurysm cases but had never seen one such as Sharon's. "She was as close to death as can get without meeting St. Peter," Karaman said. "It took experience, knowledge and, frankly, the guts to save her."
His colleague, Wieder, said they had the guts to try the new, risky and controversial techniques because the alternative of not trying them was worse.
"It's a fear of not being able to do anything that drives us," Wieder said. "When faced with a patient like Sharon, we are more scared of not being able to do anything to make sure she can see her grandchildren again."