糖心传媒

On the night of April 23, 2017, Cindi, a 46-year old graphic designer who lives in Salinas,听California, went to bed around 10:30pm,听anticipating a 5:00am wake-up from her听husband, as she was scheduled for outpatient听surgery at Stanford. She did arrive at Stanford the next morning鈥攏ot as an outpatient, but as the victim of a massive ischemic stroke.

鈥淢y husband woke me up at 5 o鈥檆lock as planned, and when I started to speak to him, I couldn鈥檛 talk. I knew what I was trying to say in my mind, but it had nothing to do with the sounds that were coming out of my mouth,鈥� Cindi said.

Her left side was also paralyzed. Her husband called 911. An ambulance rushed Cindi to Salinas Valley听Memorial Hospital. But because she鈥檇听had the stroke while asleep, the 鈥渃lock鈥澨� determining whether she could be administered a clot-busting medication or undergo a clot-removing surgery had already started ticking. For stroke patients, the clock starts at the last time they are seen well, and for Cindi, that was 10:30 the previous night. It was already too late for either听of these treatments, the attending physicians explained.

But an emergency room doctor told her husband about an ongoing study at Stanford, and coordinated her听transfer. Within 30 to 45 minutes, a helicopter operated by Stanford Health听Care was on the scene to whisk Cindi to Stanford Hospital. By the time Cindi鈥檚 husband and son arrived, she听was already out of surgery. Seven days later she was discharged.

Brain-Imaging Clinical Trial

Cindi was treated at Stanford as part of a 38-center clinical trial sponsored by the National Institutes of Health, and led by 糖心传媒ers at the Stanford University School of Medicine. Brain-imaging software developed at Stanford identified that she could benefit from a surgical procedure called a thrombectomy to remove the clot in her brain, despite the number of hours that had elapsed since she suffered the stroke. The Stanford stroke study has shown that far more people than previously thought can benefit from an emergency procedure for acute ischemic stroke.

鈥淣early half of all patients treated between six and 16 hours after the onset of their symptoms were largely spared from the consequences of their stroke,鈥� said the trial鈥檚 principal听 investigator, Gregory Albers, MD, the听Coyote Foundation Endowed Professor of Neurology and Neurological Science听and the director of the Stanford Stroke Center. The number of stroke patients who died or were confined to nursing homes was nearly cut in half, the biggest improvement seen in any stroke-related听trial to date.

Key to the study鈥檚 findings is a growing understanding that strokes spread听through individual brain tissue at different rates, Albers said. It is not听so much the amount of time elapsed听since a stroke began as the amount of remaining at-risk, but salvageable brain tissue that determines who will benefit from stroke therapy, he said.

At a follow-up appointment at Stanford听Health Care, Cindi鈥檚 doctors showed her听鈥榖efore and after鈥� images of her brain.听鈥淏efore the thrombectomy, it looked like half of my brain was gone. There was no blood supply whatsoever,鈥� she said. 鈥淎fter, it looked like a tree of life. My brain lit up with veins and arteries.听I wouldn鈥檛 have survived without the treatment.鈥�

Ischemic strokes account for about 85 percent of the roughly 750,000 strokes suffered annually in the United States. They occur when blood supply to part of the brain is cut off by a clot in a blood听vessel in the brain. The resulting lack of oxygen and glucose quickly kills brain tissue in the immediate vicinity, and the affected area continues to expand until blood supply is restored.

Recovery through Rehabilitation

While Cindi immediately regained some听use of her arms, hands and feet after her thrombectomy, her recovery did not happen overnight. After a week in the听hospital, Cindi was moved to an inpatient听rehab facility in Santa Clara. She arrived in a wheelchair, unable to do anything听for herself. 鈥淚t was a huge frustration,鈥� said Cindi, who was determined to walk听again. Four weeks later, she was able to go home. This time, on her own two feet. But her work was not done. She continued daily occupational, physical and speech therapy.听

鈥淚 have been working on my recovery every day since I had my stroke,鈥漵aid Cindi. After more than a year听of intensive rehabilitation, she has听returned to work part time, and is听talking, walking and driving as before. Her weekends are spent hiking in Big Sur with her husband, and she has started to swim and ride a bicycle again.

鈥淏y the grace of God I was chosen for the Stanford study,鈥� said Cindi. 鈥淚 am literally standing on this Earth as a wife听and a mother because of that procedure. It saved my life.鈥�