A junior doctor was left unable to recognise her own sister after a tangled mass of veins in her brain ruptured when she landed on her head in cheerleading practice.
Gwenllian Evans, 24, from Bedford, was left with memory issues, epilepsy and a condition called prosopagnosia, also known as face blindness. It means she struggles to recognise faces.
She was midway through a routine when she felt pain in her head. Hours later, the pain became ‘blinding’ and felt like a ‘gunshot’. She was rushed to hospital.
Tests revealed she suffered a stroke, as a result of an arteriovenous malformation (AVM) – where a web of blood vessels in the brain bypasses normal brain tissue and directly diverts blood from the arteries to the veins.
The AVM, which she nicknamed Ralph, had been silently growing in her brain for years, before rupturing. She has been warned it could explode again at any time.
However, despite her ordeal, which left her fearing she wouldn’t survive, her sheer determination allowed her to qualify as a doctor and achieve a life goal.
Gwenllian Evans, 24, from Bedford, was midway through cheerleading practice when she started to feel pain in her head
Recalling the incident for the first time since it happened three years ago, Miss Evans said: ‘I was at home after practice, I heard something in my head make a noise, and felt something pop, then there was a blinding headache. It felt like a gunshot.
‘I started vomiting immediately. I hadn’t vomited since I was a baby, so I knew there was something really wrong.’
Teaching herself how to learn again
Miss Evans, who was studying medicine at King’s College London, at the time,added: ‘I’ve had to teach myself how to learn again.
‘My concentration has been severely impaired. If I am concentrating for about 20 minutes, my brain will just reset – it’s like the blue screen of death on a computer.
‘I will turn on the hob, get distracted and completely forget that I turned it on, which is obviously quite dangerous.
‘I’ve had to teach myself how to recognise people by their hair, or something about them other than their faces.
‘I’ve found myself completely blanking people, because they have cut their hair. It’s hard to explain to people, because they think I’m being rude.’
When her nightmare began
Miss Evans’ nightmare began back in 22 March 2014, when she agreed to help her boyfriend and cheerleading coach Uri Verthime, now 32, out at practice after somebody else dropped out.
Hours later, the pain became ‘blinding’ and felt like a ‘gunshot’. The junior doctor was rushed to hospital and feared she wouldn’t survive
Tests revealed she suffered a stroke, as a result of an arteriovenous malformation – where a web of blood vessels in the brain bypasses normal brain tissue and directly diverts blood from the arteries to the veins
Halfway through the session, she developed a piercing headache.
At first, she thought it was dehydration, so took some paracetamol and drank water.
But as the pain continued to get worse and when she had a fall later in the session, she was worried that she had concussion.
Miss Evans, who became engaged to Mr Verthime a year after her ordeal, said: ‘I’d landed on my head on a gymnastic mat.
‘My headache was getting worse and I started to feel quite nauseous. I sat out and it wasn’t getting any better.
‘We still don’t know for certain if the fall caused my AVM to rupture. It had been slowly growing throughout my whole life, and would always have ruptured at some point.’
A life-saving decision
After the session, Mr Verthime drove her back to his house – a decision that she says saved her life because, had she been taken home, she would have been by herself when she collapsed.
When she deteriorated further, he took her to A&E at the Royal Free Hospital, Hampstead.
The AVM, which she nicknamed Ralph, had been silently growing in her brain for years, before rupturing during a routine practice
In June 2014, Miss Evans had a three-hour operation to stop the blood flow in the AVM
On the way, she began to think of similar symptoms she had seen in patients, as part of her medical studies and, remarkably, managed to diagnose herself.
She said: ‘I remember going through my symptoms and thinking I was having a subarachnoid haemorrhage, a type of stroke caused by bleeding on the surface of the brain. Then I told myself it was just medical student syndrome.
‘At hospital, I had a CT scan and then they came and told me that’s exactly what I’d had. I remember thinking, ‘Yes! I was right!’ and then I realised that wasn’t a good thing.
‘The first neurology case I ever saw was a woman in her 30s, who died from a subarachnoid haemorrhage, so when they told me, I was sure I was going to die.’
The lasting side effects
Miss Evans was kept in hospital for 10 days, while medics monitored the bleeding on her brain.
Eventually, she was allowed home – but the stroke had affected the part of her brain that controls her visual memory, leaving her with concentration and memory problems, which she still struggles with now.
Miss Evans has also developed epilepsy, which she manages with tablets a twice a day. But one of the biggest side effects of her stroke was prosopagnosia.
Also known as face blindness, it means she struggles to distinguish people.
In the wake of her ordeal, Miss Evans, a junior doctor, was left with memory issues, epilepsy and a condition called prosopagnosia, causing her to struggle recognising faces
Despite fears the AVM could explode again at any time, she is positive about the future – even getting engaged to boyfriend Uri Verthime, 32
Recalling the incident for the first time since it happened three years ago, Miss Evans said: ‘I was at home after practice, I heard something in my head make a noise, and felt something pop, then there was a blinding headache. It felt like a gunshot’
Miss Evans’ nightmare began back in March 2014, when she agreed to help cheerleading coach Mr Verthime at practice after somebody else dropped out (pictured before her stroke)
Now, it only affects her ability to recognise people she has met since becoming ill, but when she was first in hospital, she didn’t even know her own sister Sophie.
However, she recognised other members of her family, including her mother Lilly and father Peter.
Procedures to keep the web at bay
In June 2014, Miss Evans had a three-hour operation to stop the blood flow in the AVM.
WHAT IS FACE BLINDNESS?
own as ‘face-blindness’, the severity of the condition depends on the degree of impairment a person suffers.
Some people with prosopagnosia may only struggle to recognise a familiar face, while others will be unable to discriminate between unknown faces, and in more severe cases sufferers cannot distinguish a face as being different from an object.
Some sufferers are unable to recognise their own faces.
The condition is not related to memory loss, impaired vision or learning disabilities.
It is thought to be the result of abnormalities, damage, or impairment in the right fusiform gyrus – a fold in the brain that appears to coordinate facial perception and memory.
Prosopagnosia can result from stroke, traumatic brain injury, or some neurodegenerative diseases.
In some cases the condition is congenital, and present at birth.
It appears to run in families, which makes it likely to be the result of a genetic mutation or deletion.
Some degree of prosopagnosia is often found in children with autism and Asperger’s Syndrome.
Treatment of the condition focuses on helping sufferers develop compensatory strategies, including relying on voice recognition, clothing, or unique physical attributes.
Source: National Institute of Neurological Disorders and Stroke
But six months later, it began to regrow, leading to her having Gamma Knife radiation, where beams of radiation are used to remove lesions in the brain.
So far, it appears to have been successful, but she has had to make lifestyle changes, to reduce her risk of another stroke.
To stop her heart rate rising too high, she has cut down on sport.
Luckily, though, she joined the English Paracheer team – which works with both disabled and non-disabled cheerleaders – and she was delighted when they won the ICU cheerleading world championships in April this year.
Dreams of being a neurosurgeon
After their triumph, however, she has put her hobby on hold as, now qualified as a doctor, she wants to concentrate on fulfilling her dream of becoming a neurosurgeon.
She said: ‘It was great to get back out there and do what I love. I was restricted in what I could do, but the team were so accommodating and if I needed time out, it was never a problem.
‘But I have to choose my priorities. I have fatigue issues and often needed a full day and a half to recover afterward sessions.
‘I could get away with that when I was a student but now I have to go to work so for now, I’m concentrating on becoming a neurosurgeon.
‘Uri is still heavily involved as one of two head coaches. He wanted to get involved and improve accessibility after seeing how losing the sport I loved affected me so much. The team are amazing and they will keep going from strength to strength.
‘Before he proposed, he told me ‘I almost lost you once, I’m not going to lose you again.’ We’ve been through so much and that.
‘I had absolutely no idea the AVM was in my head but when it burst, it completely changed my life.
‘Everything that happened absolutely cemented the fact that I want to go neurosurgery. I can genuinely look my patients in the eye and say I understand what they are going through.’
For more information about Paracheer, visit here. For more information about AVM, visit here.
Miss Evans, who became engaged to Mr Verthime a year after her ordeal, said: ‘I’d landed on my head on a gymnastic mat’
Miss Evans was kept in hospital for 10 days, while medics monitored the bleeding on her brain. Eventually, she was allowed home – but the stroke had affected the part of her brain that controls her visual memory
Now, her condition only affects her ability to recognise people she has met since becoming ill, but when she was first in hospital, she didn’t even know her own sister Sophie. However, she recognised her mother Lilly (right) and father Peter (middle)