‘How do you mourn the living?’ – Woman’s husband has rare stroke causing brain damage after removal of ruptured cyst

A woman whose husband had an “extremely rare” stroke causing catastrophic brain damage following the surgical removal of a ruptured cyst questioned how to mourn for the man he once was.

Natasha Demetriou, 33, described her husband of seven years, Assem Elshaer, 36, as “incredibly intelligent” and “the life of the party” – when in November 2024, around his 36th birthday, he started complaining of having “the worst headache of (his) life”.

The couple, who have a three-year-old daughter named Athena, went to hospital where it was found Assem had a ruptured dermoid cyst in his brain – a mass which had been “growing with him while he was in utero” – and they were informed the only course of action was to surgically remove it.

Natasha, a British woman who moved to Dubai in 2016, said the operation was seemingly a success but in the hours following, her husband had a stroke after “fatty tissue drops” seeped into one of the main arteries supplying the brain with oxygen – an “extremely rare” incident.

Assem, who spoke six languages and worked as a senior customer service trainer for an airline in Dubai, has now been left with catastrophic brain damage and Natasha said around 75% of his brain function is “completely gone”.

Over the subsequent months, Assem has started an “intensive” rehabilitation programme where he has made “microscopic progress” in his recovery – and Natasha says she must hold on to hope as she looks ahead to the future.

“You make a commitment to someone to spend the rest of your life with them – we planned to grow old together, we planned to have an army of children,” Natasha, head of post production for a media company, told PA Real Life.

“You go from making decisions with someone to all of a sudden making decisions alone… it’s not something we’re built for as humans, it’s not something we’re trained to do.

“How do you mourn for the life you built with someone? How do you mourn for someone who’s still here?

“My life was pretty perfect – I was thriving at work, thriving in my marriage, thriving as a mother.

“I’m now raising my child alone and my husband cannot live independently… things were looking good until they weren’t.”

Natasha said she and Assem met through a mutual friend in March 2016, before they were married in 2018.

“Assem is a hard person not to like, he’s very smiley and really bubbly, he’s always been the life of the party,” Natasha said.

“He’s incredibly intelligent, he spoke six languages and just absorbed information like a sponge.

“No marriage or relationship is perfect but he was perfect, he was perfect for me.”

On November 22 2024, the day after Assem’s 36th birthday, he complained of having “the worst headache of (his) life”.

Natasha said Assem “always had intense headaches”, which he treated with over-the-counter pain relief, but this time, it was to no avail.

“He suffered in silence all night long, it got progressively worse,” Natasha said, adding she suggested they visit a doctor the following day.

Assem put the pain down to needing more sleep, Natasha said, but a few hours later he told her: “This is too bad, we need to go.”

Once at the hospital, Natasha said Assem had a CT scan which revealed a ruptured dermoid cyst in his brain.

“The doctors expressed how rare it was to find one intracranially because dermoid cysts are usually found on women’s ovaries,” Natasha said.

“It’s something made of hair, tissue and nails that forms in utero – so it was something Assem was born with, it was growing with him while he was in utero.

“It’s known to rupture midlife, which is ironic as it was around his birthday.”

Natasha said doctors also told the couple the cyst had to be surgically removed as its rupture posed a health risk, and Assem spent a few days in hospital while waiting for the surgery – which was scheduled for November 27 2024.

“On the 26th, he asked to see Athena, on the 27th, he had his operation and on the 28th, he never woke up,” she said.

Natasha said she was initially told the procedure to remove the cyst – which was located in the centre of Assem’s brain at around nine centimetres deep – went “really well”.

He was placed on a ventilator afterwards, which operated at 50% power with Assem filling the other half independently.

“When they went to extubate him a couple of hours later, they realised he was fully dependent on the machine,” Natasha said.

Explaining the subsequent complications, Natasha said “fatty tissue drops seeped into Assem’s basilar artery” – one of the main arteries supplying the brain with oxygen-rich blood.

This caused an occlusion, or blockage, to the artery.

Assem then suffered with a “devastating” ischaemic stroke, which occurs due to a blockage in the brain and cuts off blood supply, according to the NHS.

Natasha added it was also found during the operation that a tangle of blood vessels, also known as a brain arteriovenous malformation (AVM), were attached to Assem’s ruptured dermoid cyst.

She said it is “impossible to know” whether the fatty tissue seeped into the basilar artery from the ruptured cyst or the AVM prior to the operation, or whether this occurred during the extraction.

“It’s so rare what happened to him, so extremely rare,” she said.

“We only found five other documented cases in written literature across the world of this specific incident.

“They said it must have been an event that lasted no more than half an hour, 45 minutes, but by the time they caught it, his brain had fried.”

Natasha said around 75% of Assem’s brain function is “completely gone” and MRI scans show his brain is now “dark” across the entire back and left side.

Assem then went into a coma for a couple of weeks, Natasha said, before he started experiencing “involuntary spasms”.

In the months following, Assem then started raising his arms and legs, clenching his fists and trying to pull himself up in bed.

He also “tracked” Natasha in his hospital room when a specialist from a rehabilitation programme held his eyelids open.

“I couldn’t believe it, that’s when we realised he was awake,” Natasha said.

Assem was “weaned off” a ventilator, moved out of the ICU and he is now going through a rehabilitation programme, where he has three “intensive” sessions a day.

His condition also means his eyelids no longer open spontaneously, and they must be held open by Assem or others, although his vision is still intact, Natasha said.

“Clinically, nothing has changed – he’s equally dependant on other people, he’s still bedridden unless he’s in a wheelchair, he can’t do anything himself and his eyes are still closed,” Natasha said.

“And yet, we have microscopic progress – he’s cognitively present, he’s responsive, he’s getting sharper.”

The road ahead is uncertain, but Natasha said she must hold on to hope.

“They really have no idea what direction this could go, what level Assem can recover,” she said.

“What keeps me going is hope and it’s the only thing I’ve got – if you lose your hope, you’ve lost it, there’s nothing to hold on to.”

Natasha’s family members have launched a GoFundMe page with the aim of supporting Assem throughout his recovery, raising over £40,000 far.

This includes financing his rehabilitation programme for the next 12 months and allowing him to access a range of therapeutic treatments, such as hyperbaric oxygen therapy.

To find out more, visit the fundraiser for Assem here: gofundme.com/f/support-assem-on-his-journey-towards-recovery