As an emergency department nurse at Rush University Medical Center, Anna Candoleza Muglia, BSN, RN, has spent more than 20 years helping people through their worst health crises.
Trained to stay calm under pressure, recognize subtle warning signs and act quickly when there’s a problem, Anna instinctively knew that something was critically wrong when she got struck with a sudden, severe headache one Saturday morning.
"I’ve had headaches my whole life, but this one was different," she remembers. "I knew I was in trouble."
She immediately called her husband, Jason, and asked him to come home from her son’s haircut. She told him she needed to get to Rush right away.
When Jason arrived, he realized Anna was in far worse shape than he’d imagined. That’s when he made the life-saving decision to call 911. The paramedics took Anna to the closest community hospital near their home in Harwood Heights. By the time they arrived, Anna was unresponsive and in critical condition due to a massive brain bleed.
Stabilized and transported
The community hospital’s emergency team stabilized Anna by placing an external ventricular drain (EVD), a temporary tube used to relieve the pressure in her brain that was caused by the bleed.
As the team worked to stabilize Anna, Jason couldn’t ignore Anna’s initial request to get her to Rush. "My husband doesn’t work in health care, but the one thing he knew was that I had to go to Rush," Anna says.
Not only is Rush "home" to Anna as a nurse, but it is also home to one of the top neurology and neurosurgery teams in the country. Jason knew that the Rush team’s extensive experience treating complex brain bleeds would be critical to saving Anna’s life.
Once Anna was stable, the team mobilized around the goal of transferring Anna to Rush. The community hospital providers coordinated with the Rush team to safely transport her directly to Rush’s neuro intensive care unit at the Chicago campus, where specialized teams were ready to care for her.
Back to life
Anna was intubated and unconscious from the time she was in the community hospital through her transfer to Rush. She remained in critical condition for several days at Rush.
During that time, Jason was facing devastating uncertainty as Anna’s care team prepared him for the possibility that she may not recover from this.
"It was a scary time for my family," Anna shares. "But Jason never felt more supported than he did at Rush. They explained and guided him through it all. He felt so much love from the entire team. He knew I was in the right place."
Meanwhile, Rush’s neuro ICU team, which consisted of neurocritical care physicians, neurosurgeons, neuro ICU nurses, advanced practice providers and others, focused on stabilizing Anna, protecting her brain and preventing further brain injury.
Neurocritical care doctor Rajeev Garg, MD, MS, led Anna’s care, which included constant monitoring and round-the-clock care. Slowly, Anna began to regain consciousness and started to move out of the most critical phase of her ordeal. As she became more aware, Anna recognized just how serious her situation was.
"I knew I was in bad shape and that I wouldn’t remember things," she says. "So I started taking pictures of the wall that listed who my nurses and doctors were so I could remember it all later."
Throughout her time in the ICU, her colleagues from the emergency department took turns checking on her. Her ICU nurses, meanwhile, remained a constant, grounding presence at her bedside.
Although she was growing stronger by the day, Anna still had a long road ahead.
Recovery is not a straight line
As Anna continued to recover, she began facing lasting effects of a massive brain bleed. She experienced cognitive decline, brain fog, mobility challenges and speech setbacks.
Once she was stable and strong enough to leave the hospital, Anna’s providers referred her to outpatient rehabilitation so she could continue her recovery.
At the rehab facility, Anna participated in physical therapy, occupational therapy and speech therapy. She started walking with a walker and eventually transitioned to a cane. However, about a month into rehab, her gait started to worsen. At the same time, her speech-language pathologist noticed that Anna was starting to backslide cognitively as well.
"I began wondering what was happening and why I wasn’t getting better, and my team said, ‘Anna, you’re declining,’" she says.
Frustrated and scared, Anna returned to see her neurosurgery team at Rush. After further evaluation, they discovered that she had developed hydrocephalus, a buildup of cerebrospinal fluid (CSF) in the brain that causes pressure and can lead to permanent brain damage if left untreated.
"It made sense that I was having gait instability because after a subarachnoid bleed, the pathway for CSF fluid to drain out (was damaged)," Anna explains.
Treatment again
Once her providers knew the source of Anna’s decline, she met with Rush neurosurgeon Lorenzo Muñoz, MD. He recommended treating the hydrocephalus with a shunt placement, a surgery to place a tube in the brain to drain the fluid buildup.
At the end of January 2025, Anna underwent a successful shunt surgery and was able to go home from the hospital the very next day.
"It was amazing, they cut my brain open, put in the shunt and sent me home the next day," she remembers.
The shunt surgery was a game changer.
"The day after the surgery, I was able to walk with a walker again," she says. "Soon, I started walking with a cane, and the next thing you know, I was walking with no assistance. It was a truly amazing recovery."
Over the next month and a half, Anna continued outpatient rehab and grew stronger and sharper every day. Eventually, she was cleared for daily activities with no restrictions and was back at work by April.
"Without the amazing neuro ICU and neurosurgery teams at Rush, I could have had so many worse consequences and deficits from this," Anna says. "All my providers knew how to both save my life and give me back my quality of life."
Moving forward
Today, Anna continues her important work as the Sexual Assault Nurse Examiner (SANE) program coordinator at Rush, where she trains other nurses to care for people who have experienced sexual assault.
"I’m incredibly lucky to be here right now talking to you and getting to do the work that I love by helping survivors of sexual assault," Anna says.
"After this experience, the way I look at my life is that there's a reason why I'm here to do this very important work. And it is truly a testament to our brilliant providers in the neuro ICU and the neurosurgery department here at Rush."
