A young mother who was 36 weeks pregnant when she suffered “irreversible brain damage” died as a result of a ruptured brain aneurysm, an inquest has heard.
Saoirse McElvaney, a 26-year-old from Crumlin, Co Dublin, was taken to St James’s Hospital in an acute condition having suffered seizures in the early hours of October 5th, 2022.
A sitting of Dublin District Coroner’s Court heard on Wednesday that Ms McElvaney was one week away from reaching a full-term pregnancy when she began to vomit at about 2am.
Ms McElvaney’s partner Peter Lawrence recalled hearing “gurgling noises” soon after and saw she was having a seizure.
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Ms McElvaney had two further seizures, one when paramedics arrived and another when descending the ramp of the ambulance at the emergency department, the inquest heard.
“Once we were there, Saoirse was taken into the back. After a short period of time, I was told to say my goodbyes,” Mr Lawrence said.
An emergency caesarean section was carried out that day. Her baby daughter Isabelle was delivered safely and transferred to the Rotunda Hospital’s neonatal unit, though she did not require an extensive stay as she was nearly full-term.
Earlier, a scan showed a large intracranial haemorrhage that caused a midline shift, or displacement of the brain.
Ms McElvaney, whose bleed was described as “extensive” by Dr Orsolya Miskolci, a consultant in critical care, was transferred to the intensive care unit following the delivery. However, it was deemed there was no potential benefit of neurosurgical intervention.
The next day her condition progressed to “irreversible brain damage” and, on October 7th, scans confirmed the status of “brain death”, Dr Miskolci said.
Ms McElvaney was pronounced dead at the time of the scan and was transferred for organ retrieval on October 8th.
A postmortem carried out by pathologist Dr Muna Sabah recorded the medical cause of death as hypoxic brain damage with haemorrhaging due to an aneurysm.
The inquest heard Ms McElvaney had brain imaging carried out in 2017 due to neurological symptoms, which showed no presence of the aneurysm then. Her symptoms were associated with migraine with aura.
Although aneurysms can grow and rupture in a short period, Ms McElvaney’s could have formed at any stage since the imaging in 2017, said consultant neurologist David Bradley.
Aneurysms generally do not cause symptoms at all until they bleed, with the exception of aneurysms that press on nerves, which is “which is a different situation here”, he said.
Coroner Dr Clare Keane recorded a verdict of death by natural causes. She said Ms McElvaney left a “remarkable legacy”, having donated organs to six people.
