Joe Biden’s mental and cognitive functions have been the fodder for significant commentary and controversy during the 2020 presidential election. In February and May, 1988, then a Senator from Delaware, Biden underwent two brain surgeries to remove “berry” brain aneurysms, one was leaking blood; the second, asymptomatic, was discovered during the first operation. It remains speculative whether these surgeries imposed either acute or chronic mental consequences for the ex-vice president.
An aneurysm is an out-pouching or ballooning of the wall of an artery. The arteries at the base of the brain occasionally are the site of this defect. In 10-15% of cases, the defects can be multiple. They are described as “berry’ since they protrude “berry-like” from the artery. Hypertension is a risk factor. Its consequences are variable, usually none, a slow leak (Biden’s case), or a sudden rupture into the space between the brain and its thin arachnoid membrane covering. The latter results in a subarachnoid hemorrhage, a variant of a hemorrhagic stroke, and is often fatal.
In early 1988, the 46 year old Senator had just withdrawn from the Democrat presidential nomination race due to charges of plagiarism. Headaches had become an increasing concern, that required him to carry around a big bottle of Tylenol. He also was complaining of neck pain. Biden recorded in his autobiography, “Promises to Keep,” that he passed out in his Rochester hotel room. The pain was rip-like that he never previously experienced. He flew back to Delaware where he was rushed to St. Francis Hospital. CT scan and a bloody spinal tap confirmed a subarachnoid hemorrhage. A craniotomy was performed at Walter Reed National Military Medical Center in Washington. He rested for six months.