THE SILENT WITNESS
Persistent Headaches And Brain Aneurysm
By Dr . Johansen Oduor
Three cases , same month , same presentations . Persistent headaches , high blood pressure , and brain aneurysms .
Case Number One
Michael was a 40-year-old male of African descent . He was a bank executive and was living with his family in Runda within Nairobi . He was a typical middle-class Kenyan with a good job , good salary and benefits including a good health insurance cover . Michael was a seemingly healthy Kenyan , though obese and his social life was that of a middle-class Kenyan , with occasional drinking of fine whiskey , although at times he could overdo it . He also used to hit the gym regularly .
One year prior to his death , he was diagnosed with high blood pressure and after a thorough physical and laboratory examination , he was put on antihypertensives . Initially he used the drugs religiously but after 6 months , he stopped , only using the medication occasionally when he felt that his blood pressure was high . He also never used to monitor his blood pressure . He reported having frequent headaches which were relieved by use of paracetamol . This made him reliant on paracetamol to such an extent that he never failed to have paracetamol tablets nearby .
One day , as he was preparing to give a presentation , Michael started convulsing and foaming from the mouth and from the nose . His breathing also became laboured . He was rushed to the nearest hospital where he was pronounced dead on arrival . Post mortem was performed and it revealed that he was bleeding in the brain . In addition to this , there was a swollen blood vessel ( an aneurysm ) in the brain which had ruptured , spewing blood into the brain , thus causing his sudden demise .
Case Number Two
Daniel was a 59yrs old male of African race . He worked as a county government official in Mombasa . He had travelled to Nairobi for an official county business and had been in Nairobi for one day . On the day that he passed on , he had chaired a meeting the whole day . After the meeting , he went back to his hotel and retired to his room to sleep after having dinner . During the day , he had been seen taking paracetamol by his colleagues after complaining of headaches .
The following day , after he failed to turn up for the ongoing meeting , his colleagues found him dead in bed . On further enquiry , it was revealed by his spouse that Daniel had been
“ An aneurysm is a bulge on the wall of a blood vessel . This is caused by weakness on that part of the wall leading to it forming a bulge like a balloon . In the brain , the section of blood vessel affected by an aneurysm appear like a berry hanging on a stem .” diagnosed with high blood pressure by a clinical officer based in Mombasa three months prior and was put on anti-hypertensives . A month later , the clinical officer put him off the medications , claiming that his blood pressure was now stable and there was no need of further medication . His wife further revealed that he had been having persistent headaches , almost daily and had been using paracetamol to relieve the pains . Post mortem performed on his body revealed extensive bleeding in the brain . There was also a ruptured aneurysm in one of the arteries in the brain .
Case Number Three
Richard was a 46year old male of African race . He was a businessman based in Nairobi and had a family which he was living with in Kilimani , Nairobi . One week prior to his death , Richard had attended a funeral in the outskirts of Nairobi in company of his friends . While the funeral was going on , he experienced a sudden convulsion . The paramedics who were on standby in an ambulance gave him a first aid and he recovered .
His blood pressure was also found to be elevated . Richard was surprised because he had been of good health , and had also never convulsed before . Also , as far as he was concerned , he had never been diagnosed with hypertension before , although he had been having headaches every other day , which he had attributed to stresses of life and which was being relieved by painkillers . His wife however later revealed that he had been drinking whisky daily . He was advised to seek medical attention as soon as he reached Nairobi .
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MAL 47 / 22 ISSUE