When every second counts: Surviving a ruptured brain aneurysm at

For 26-year-old Reina Tan Cheng Hui, it was supposed to be just another Saturday afternoon in June 2024. She was on her way to meet her boyfriend when an intense headache struck her without warning, and everything changed.

By the time she arrived at their meeting point at Orchard MRT station, the pain had become so unbearable that it brought her to tears.

Along with the headache came other alarming symptoms — dizziness, nausea and stiffness on the left side of her body. Seeing her in a great deal of pain, her boyfriend rushed her to the nearest Urgent Care Centre at Mount Elizabeth Orchard Hospital.

There, resident physician Dr Bok Lu Swee evaluated her symptoms and recognised red flags that pointed to something serious. A CT scan confirmed their worst fears: Reina had suffered a ruptured brain aneurysm — a condition where a weak spot in a blood vessel wall balloons and eventually bursts.

This resulted in a subarachnoid haemorrhage, which is a type of haemorrhagic stroke. This causes bleeding in the space between the brain and the thin, protective membranes covering it (the subarachnoid space) due to a burst blood vessel like an aneurysm.

Emergency surgery: A race against time

This image is for illustration purposes only.

The immediate priority after diagnosis was to undergo emergency to remove the extra blood in her brain caused by the subarachnoid haemorrhage, relieve the pressure buildup and secure the aneurysm. Moving fast was crucial, as leaving a haemorrhagic stroke unattended could cause serious consequences: long-term brain damage, and even death.
Before the surgery, Dr Teo Kejia, a neurosurgeon at the hospital, ordered a digital subtraction angiography. This was done to better understand the shape, size and location of the aneurysm to ensure the surgery would be as effective as possible. During the angiography, a catheter was inserted through her groin and guided to the blood vessels in her brain, where a contrast dye was released to make the vessels visible on imaging.

"With the dye, the brain’s blood vessels light up like a Christmas tree," Dr Teo Kejia, a neurosurgeon at the hospital, explains. "We can then study the aneurysm and start planning the surgery."

Reina recalls the experience of going through the angiogram: “I started feeling very sleepy and unfocused. Everything felt blurry, and I couldn’t concentrate. I just lay there, drifting in and out of sleep."

Dr Teo explained the urgent need for surgery to her parents, and with no time to waste, Reina was rushed to the operating theatre. The surgery itself was a delicate procedure in which part of her skull was temporarily removed to access the brain, otherwise known as a left craniotomy. Then, the blood clot caused by the subarachnoid haemorrhage was removed, and the aneurysm was secured via a microsurgical clip to prevent further bleeding. After the procedure was completed, part of the skull that was removed was replaced and secured.

"By the time we finished the surgery, it was close to 2 a.m. All the necessary tests and treatment had been completed within hours," Dr Teo recalls.

The mystery behind Reina’s aneurysm

Dr Teo notes that aneurysms typically form when the walls of a blood vessel become weakened — often due to factors like high blood pressure, atherosclerosis (the thickening or hardening of arteries caused by plaque accumulation) or genetics.

Reina’s case, however, was particularly puzzling given her clean bill of health. "I have no pre-existing conditions like high blood pressure, no family history of aneurysms, and I don’t smoke," Reina says.

Reina wonders if the intense pressure from her freelance projects may have played a role, though doctors did not consider stress to be a major contributing factor in causing her aneurysm.

Dr Teo adds that aneurysms often develop and enlarge gradually over time — often without any symptoms — until they suddenly rupture.

"The first sign of a burst blood vessel in the brain is usually a sudden and intense headache, known as a thunderclap headache, which is what Reina experienced. This headache is often described as the worst headache of one’s life, and patients say it feels very different from regular headaches, such as migraines or cluster headaches. Some even compare it to being hit by a truck."

Other symptoms may include nausea, vomiting, and a stiff neck. Dr Teo adds, "If the bleeding puts too much pressure on the brain, a person may become drowsy, as Reina did."

Reina's aneurysm was treated through microsurgical clipping, where the surgeon will make a small opening in your skull and place a metal clip around the neck of the aneurysm to clamp blood supply and prevent further bleeding. However, depending on the size and location of the aneurysm, different treatments may be recommended to patients. For instance, endovascular embolisation, or blocking blood flow towards the anuerysm by inserting a coil in the aneurysm may also be considered as a likely treatment option.

While the surgery to secure the aneurysm was successful, it only marked the beginning of what would be a long and challenging road to recovery.

The road back: How reina fought to walk, talk, and live again

The aftermath of the surgery revealed the full extent of the damage caused by the ruptured aneurysm. Simple tasks had become monumental challenges.

"I couldn’t talk or walk properly for three months," Reina recalls. She remembers a particularly poignant moment when a therapist asked her to identify her mother, and she mistakenly referred to her mother as her "sister."

Tasks most take for granted — picking up a dropped object, washing her hair, holding a conversation, or speaking in full sentences — now required assistance or intense focus.

"During those initial three months of my recovery, I felt very anxious about the things I couldn’t do," Reina shares. That anxiety was compounded by the looming pressure of returning to her work as a freelance food stylist and chef — a career that demands not just physical stamina, but also creativity and precision under pressure.

Determined to regain her independence, Reina committed herself to therapy. She worked closely with the speech and physiotherapy teams at Mount Elizabeth Hospital, who helped her rebuild her brain’s neural connections and relearn how to form words, sentences, and physical movements. She also embraced technology, using speech therapy apps to retrain her brain's ability to process and articulate language.

Reina credits much of her progress to the unwavering support of her loved ones.

During her recovery, her mother stepped in as her primary caregiver, supporting her through daily routines and preparing nourishing soups. "My mum helped me so much, and my family and boyfriend were always there for me," she says.

Dr Teo explains that recovery from a haemorrhagic stroke depends on several factors, including the speed of medical intervention and the extent of the bleeding from the ruptured aneurysm.

"The younger you are, the better your chances of a near-full recovery," he notes. In Reina’s case, her youth, determination and social support have been powerful allies.

And a new chapter begins

Dr Teo now monitors Reina’s progress through regular follow-ups, focusing on two key areas: preventing secondary complications and ensuring the aneurysm doesn’t recur, which can happen in younger patients.

Reina’s progress has impressed both her medical team and family. "She’s doing amazing," Dr Teo says with evident pride. "She’s nearly back to her normal life. I know she’s pursuing her career as a chef, and her parents are praising her cooking now — they say it’s excellent."

For Reina, every day is a step forward. Her experience has given her a new appreciation for life’s simple joys: clear communication, creative freedom in the kitchen, and the ability to live independently.

With the prompt and skilled care of Dr Teo and his team, the steadfast support of her loved ones, and her own unwavering resolve, Reina is moving into a new chapter — one defined not by what she lost, but by everything she’s reclaimed.