Game of Thrones star Emilia Clarke revealed in a new essay that she experienced a harrowing health emergency—including two aneurysms and multiple surgeries.
In an essay for The New Yorker, Clarke detailed her experience with two brain aneurysms and multiple surgeries, the first of which occurred in 2011, not long after landing the role of her dreams.
Clarke said she first realized something was off while working out with a trainer at her gym shortly after finishing filming on the first season of Game of Thrones. She first developed a bad headache and a feeling of fatigue while getting dressed.
While she was doing a plank during her workout, "I immediately felt as though an elastic band were squeezing my brain," she wrote. "I tried to ignore the pain and push through it, but I just couldn’t." She told her trainer she needed to take a break and became "violently, voluminously ill" in the bathroom. "Meanwhile, the pain—shooting, stabbing, constricting pain—was getting worse," she said. "At some level, I knew what was happening: my brain was damaged."
A woman from the next stall helped her and "then everything became, at once, noisy and blurry. I remember the sound of a siren, an ambulance; I heard new voices, someone saying that my pulse was weak. I was throwing up bile." Clarke, then 24, was taken to a hospital where she was diagnosed with a subarachnoid hemorrhage, a type of stroke that can be life-threatening, that’s caused by bleeding into the space around the brain.
"I’d had an aneurysm," she wrote.
She learned later that many patients with her type of aneurysm-related stroke—a subarachnoid hemorrhage (SAH)—die immediately or soon after. About 25 percent of patients don’t survive the first 24 hours, while another 25 percent die from complications within six months, National Institute of Neurological Disorders and Stroke (NINDS).
"For the patients who do survive, urgent treatment is required to seal off the aneurysm, as there is a very high risk of a second, often fatal bleed," Clarke wrote. "If I was to live and avoid terrible deficits, I would have to have urgent surgery. And, even then, there were no guarantees."
Clarke underwent a three-hour surgery in which a wire was put into one of her arteries through her groin. It went up into her brain, where it sealed off the aneurysm. "When I woke, the pain was unbearable. I had no idea where I was," she wrote. "My field of vision was constricted. There was a tube down my throat and I was parched and nauseated. They moved me out of the I.C.U. after four days and told me that the great hurdle was to make it to the two-week mark. If I made it that long with minimal complications, my chances of a good recovery were high." After her surgery, she struggled with aphasia, the loss of the ability to understand or express speech, but it passed in a week.
Eventually, she recovered but was told that she had another small aneurysm on the other side of her brain that could "pop" at any time, although her doctors said it could remain dormant. Clarke says she struggled with pain after her surgery and had difficulty getting through filming on season two of Game of Thrones. "If I am truly being honest, every minute of every day I thought I was going to die," she said.
After filming the third season of Game of Thrones, Clarke had a brain scan that revealed that the other aneurysm had doubled in size. She was told it was supposed to be "easier than last time" but "when they woke me, I was screaming in pain. The procedure had failed. I had a massive bleed and the doctors made it plain that my chances of surviving were precarious if they didn’t operate again," she said. "This time they needed to access my brain in the old-fashioned way—through my skull. And the operation had to happen immediately." She left the surgery with a drain in her head and parts of her skull had been replaced with titanium. She also spent a month in the hospital recovering.
What is an aneurysm?
An aneurysm is a bulge or ballooning in a blood vessel in your brain that develops due to a weakness in the artery wall. The weakness tends to get worse over time, leading to the formation of a bulge that may leak blood or even rupture.
They can leak or rupture and cause a hemorrhagic stroke, i.e. bleeding into the brain, the Mayo Clinic says. These aneurysms usually happen in the space between the brain and thin tissues covering the brain, which is known as a subarachnoid hemorrhage.
Both a leaking aneurysm and a ruptured aneurysm cause sudden and severe headaches. "Most people describe it as the worst headache of their life," Matthew Potts, M.D., a neurosurgeon at Northwestern Memorial Hospital, tells SELF. "It comes out of nowhere."
But if an aneurysm has ruptures, the Mayo Clinic says there may be other symptoms as well, such as:
- Nausea and vomiting
- A stiff neck
- Blurred or double vision
- Sensitivity to light
- A seizure
- A drooping eyelid
- Loss of consciousness
It’s possible to have an unruptured aneurysm without any symptoms. But a large unruptured aneurysm may press on brain tissue and nerves, possibly causing pain above and behind one eye, a dilated pupil, changes in vision or double vision, and numbness on one side of your face, the Mayo Clinic says.
How common are aneurysms in young women?
In general, people who are over 40 (aneurysms are most common between the ages of 30 and 60), and have untreated high blood pressure or kidney disease, smoke cigarettes, and have a family history of brain aneurysms are more likely to experience them, according to the NINDS. Brain aneurysms are also more common among women than men, especially postmenopausal women.
Among younger people, "the most likely cause would be a congenital weak spot" in the wall of a brain artery, George P. Teitelbaum, M.D., interventional neuroradiologist and director of the Stroke and Aneurysm Center at Providence Saint John’s Health Center in Santa Monica, California, tells SELF, adding that he’s even treated children with brain aneurysms. That’s why, if you have a family history of brain aneurysms, it’s perfectly OK and even recommended to undergo a screening test like an MRI to see if you have any early warning signs, Ciaran Powers, M.D., Ph.D., program director of neurosurgery at the Ohio State University Wexner Medical Center, tells SELF.
Still, brain aneurysms can form sporadically in younger people and "there may not be a reason," Omar Choudhri, M.D., codirector of cerebrovascular and endovascular neurosurgery at Penn Medicine, tells SELF.
That said, brain aneurysms are "very uncommon in the young," Amit Sachdev, M.D., an assistant professor and director of the Division of Neuromuscular Medicine at Michigan State University, tells SELF. Dr. Choudhri agrees. "Less than five percent of the people we see in our busy aneurysm practice are in their 20s," he says.
What to do if you think you're having an aneurysm
If you think you may be experiencing an aneurysm, call 911 immediately. Getting diagnosed and treated ASAP increases the chances that you’ll make a full recovery, the NINDS says.
Once you get to the ER, you’ll likely be run through a series of tests that can include a CT scan to look for bleeding in your brain, a test of your cerebrospinal fluid (to look for red blood cells in the fluid), an MRI, and a cerebral angiogram, which takes X-ray images of your arteries, the Mayo Clinic says.
If you are diagnosed as having an aneurysm, you’ll likely need surgery. Some people who experience a subarachnoid hemorrhage have permanent neurological damage, while others, like Clarke, recover with little to no issues afterward.
Afterward, you’ll need to be monitored for the rest of your life. "Having one aneurysm means you’re at greater risk of developing another one," Dr. Potts says. "But even if someone has one, it’s very rare to develop another one. We just recommend getting lifelong follow-ups so that if an aneurysm develops, we can be on top of it."
Whether you’ve had a brain aneurysm or have a family history of them, it’s generally recommended that you do your best to keep your blood pressure under control and avoid smoking, since both increase your risk of having an aneurysm in the future, Dr. Powers says.
Overall, aneurysms are incredibly serious and come with a significant risk for death or serious complications. Clark is "definitely one of the lucky ones," Dr. Choudhri says.