Jhonny Mercado’s life at 46 was very busy and full of stress. As co-chairman of JAE Restaurant Group, he oversees more than 7,000 employees at more than 210 restaurants in Florida, New Mexico and Tennessee. His company is among the top five franchisees in the Wendy’s fast-food empire.
So, when he started getting very painful headaches, he figured they were due to stress or even a side effect of wearing face masks during the COVID-19 pandemic. Mr. Mercado says he’s never faced a serious health issue and had no underlying condition, except for the sudden onset of new headaches.
“I was experiencing these severe headaches that would not go away,” he recalls. “I consulted with a doctor thinking I had a sinus issue from wearing a mask. They thought it could be sinusitis and I was sent medication for that. But the headache pain persevered and I went to a South Florida hospital that I had gone to before.”
The hospital that Mr. Mercado went to initially, and the doctors he first consulted, were not part of Baptist Health. He was diagnosed with a cerebral aneurysm, a bulge that forms in the blood vessel of the brain that could lead to severe health issues, such as a stroke, and possibly death. But he was told they could not arrange a procedure to remove his aneurysm for a couple of weeks, and that worried him because the bad headaches persisted.
Then, Mr. Mercado made contact with Barry Katzen, M.D., the founder and chief medical executive of Miami Cardiac & Vascular Institute.
“Mr. Mercado’s story is a great example of how innovative technology, innovative physicians and a caring service-oriented environment come together to produce this type of benefit for patients,” said Dr. Katzen.
Dr. Katzen would immediately refer Mr. Mercado to Italo Linfante, M.D., medical director of Neuroendovascular Surgery at Miami Neuroscience Institute and Miami Cardiac & Vascular Institute, both part of Baptist Health South Florida.
“The patient was referred to me by Dr. Katzen, who was very worried about Mr. Mercado,” recalls Dr. Linfante. “He mentioned that Mr. Mercado has never had headaches, but recently developed unusual and severe headaches and has a brain aneurysm on MRI. So, I called him, took his medical history and I immediately saw the patient.”
Dr. Linfante stresses that even in an otherwise healthy patient, a severe onset of headache is a worrisome sign. “Typically, when an aneurysm ruptures and bleeds, patients report that all of a sudden they have the worst headache of their life,” explains Dr. Linfante. “So, whenever a physician hears a patient reporting this symptom, it always raises a huge red flag.”
Fortunately, Mr. Mercado’s aneurysm did not seem to have clearly ruptured, said Dr. Linfante. When an aneurysm ruptures, it releases blood into the subarachnoid space around the brain and potentially causes a stroke. Usually, one may see some blood on imaging to make a definitive diagnosis, he added. “But there is also the possibility that it could have been a small rupture days prior resulting in a very small amount of blood — called ‘sentinel hemorrhage’ — that may be missed on imaging,” he added. “And that’s very worrisome. In addition, when I looked at the imaging feature of Mr. Mercado aneurysm on MRI, there were some features of the lesion that looked troubling.”
“I got an answer very quickly (from Dr. Linfante),” says Mr. Mercado, who is from Venezuela and moved to South Florida about eight years ago. “Within an hour or two, I got several emails from Dr. Linfante and his team. He called me on the cell phone and I explained to him everything that happened and I had an appointment with him the next day.”
Mr. Mercado was told by Dr. Linfante that he was a candidate for stent-assisted coil embolization, a minimally invasive procedure – also referred to as endovascular surgery — to treat an aneurysm by filling it with material that closes off the sac and reduces the risk of bleeding. It is performed from “within” the artery (endovascular) through a steerable catheter inserted into the blood stream at the groin and guided to the brain.
“He (Dr. Linfante) was very clear and he answered all my questions,” recalls Mr. Mercado. “His recommendation was for me to stay here (at Baptist Hospital) overnight because he didn’t like what he saw with the aneurysm. The following morning, I went through the procedure.”
Dr. Linfante and his team performed stent-assisted coil embolization of the aneurysm. The procedure was successful. The aneurysm was secured.
Dr. Linfante stresses that anyone diagnosed with an aneurysm should be referred to a so-called high-volume surgical center, such as Miami Neuroscience Institute, “where we do a high number of these cases. Multiple data published in peer-reviewed scientific literature clearly shows better patient outcomes in high-volume surgical centers”
More Minimally Invasive Techniques
The Institute treats the majority of aneurysm cases with this endovascular approach. “This is a strong trend nationwide –- using more and more minimally invasive techniques in all specialties and particularly in vascular neurosurgery,” Dr. Linfante says. “We are definitely on the cutting edge here, using the latest technology and devices. I am really grateful to Miami Cardiac & Vascular Institute and Miami Neuroscience Institute for providing us with the latest technologies so we can help all patients that come to us for help.”
Mr. Mercado said his recovery was swift he was discharged home without any symptoms — no more headaches and a new outlook on life filled with gratitude.
“Everyone was amazing before, during and after the procedure,” the patient says of Dr. Linfante’s team. “Everyone was amazing. I manage more than 7,000 employees in more than 200 restaurants. I know all about service. And service that I received from Dr. Linfante and all his team was five-star service. It was incredible.”