One Surgery, Two Deadly Problems: How Zhongshan Hospital Saved a Stroke Patient
Her Brain Was Bleeding and Blocked at the Same Time
At 2 AM on a February morning in 2025, 68-year-old Zhao Ayi suddenly lost her vision. Within minutes, she stopped breathing.
Emergency imaging revealed a nightmare scenario: massive subarachnoid hemorrhage — blood flooding the space around her brain — combined with cerebellar infarction on the left side. Her vertebral artery had torn from the inside, creating what neurosurgeons call a dissection — imagine an aging pipe whose inner lining peels away, simultaneously blocking flow and leaking from the weakened wall.
Two life-threatening conditions. One damaged vessel. And a patient whose heart had already stopped once.
She was rushed to the neurosurgery department at Zhongshan Hospital, Fudan University in Shanghai.
Why This Case Was Nearly Impossible
Vertebral artery dissection with concurrent hemorrhage and ischemia presents an extraordinary clinical dilemma:
| Problem | What It Means | Traditional Treatment |
|---|---|---|
| Subarachnoid hemorrhage | Blood leaking around the brain; risk of fatal re-rupture | Surgery to seal the leak — but this could worsen the blockage |
| Cerebellar infarction | Brain tissue dying from blocked blood supply | Blood thinners to restore flow — but this could worsen the bleeding |
The treatments directly contradict each other. Stopping the bleed risks worsening the stroke. Treating the stroke risks catastrophic re-bleeding. Most hospitals would be forced to choose one problem to address and hope the other resolves — or stabilizes — on its own.
The Solution: A Flow-Diverting Stent
Dr. Yang Zhigang, Deputy Chief Physician of Neurosurgery, led the intervention team. Rather than choosing between two bad options, they deployed a flow-diverting device (dense-mesh stent) — a technology that could solve both problems simultaneously.
How it works:
The device is a tightly woven mesh tube, thinner than a pencil, delivered through a catheter from the groin to the damaged section of the vertebral artery inside the brain.
- Seals the tear — The dense mesh covers the dissection point, redirecting blood flow away from the damaged wall and preventing re-rupture
- Maintains flow — Unlike a conventional clip or coil that blocks the vessel entirely, the flow diverter keeps blood moving through the artery, preserving supply to the brain
- Promotes healing — Over time, the body's own cells grow over the mesh, rebuilding the vessel wall from the inside
Procedure time: just over 1 hour. Blood loss: less than 10 milliliters.
Post-operative angiography confirmed the damaged vessel was repaired and blood flow was fully restored.
The Long Road to Recovery
Saving Zhao Ayi's life was only the beginning. The weeks that followed tested every department at Zhongshan Hospital:
- Neuro-ICU — Managing prolonged coma and respiratory support after tracheotomy
- Infectious disease — Fighting hospital-acquired infections during the critical care phase
- Neurorehabilitation — Rebuilding motor function and cognitive ability
A second procedure was later performed by Dr. Hu Fan's team: a ventriculoperitoneal (VP) shunt — essentially creating a drainage system to relieve dangerous pressure buildup inside the skull, a common complication after severe subarachnoid hemorrhage.
One Year Later
At her one-year follow-up, Zhao Ayi walked into the clinic on her own. Steady steps. Clear speech. Her daughter — who had been 36 weeks pregnant during the crisis — had since delivered a healthy baby.
Three generations, together.
Neurovascular Surgery Cost: China vs Western Countries
| Procedure | China (Zhongshan Hospital) | United States |
|---|---|---|
| Flow-diverting stent placement | $15,000 - $25,000 | $80,000 - $150,000 |
| VP shunt surgery | $5,000 - $10,000 | $30,000 - $60,000 |
| Neuro-ICU (per day) | $500 - $1,000 | $5,000 - $15,000 |
| Neurorehabilitation (per week) | $1,500 - $3,000 | $10,000 - $20,000 |
| Cerebral angiography (diagnostic) | $800 - $1,500 | $5,000 - $10,000 |
China prices include procedure, device, hospital stay, and post-operative imaging.
When Should You Seek Neurovascular Care in China?
This level of neurosurgical intervention is relevant for international patients with:
- Cerebral aneurysms — Bulging blood vessels in the brain requiring stenting or coiling
- Arteriovenous malformations (AVMs) — Abnormal tangles of blood vessels in the brain
- Carotid or vertebral artery dissection — Torn vessel walls causing stroke or hemorrhage
- Moyamoya disease — Progressive narrowing of brain arteries (relatively common in Asian populations)
- Complex stroke cases — Requiring both endovascular intervention and surgical management
About Zhongshan Hospital Neurosurgery
Zhongshan Hospital's neurosurgery department operates at the highest level of complexity in China:
- Affiliated with Fudan University — China's top-3 medical research university
- Full neuroendovascular capability with biplane angiography suites
- 24/7 stroke response team — Critical for time-sensitive neurovascular emergencies
- Located in central Shanghai, with international patient services
Need neurovascular care or a second opinion? Request a free consultation →
