It was a normal weekday morning for Pam Simon, 45, of Hockessin, Del. She’d gone to the kitchen to get breakfast started. She noticed she was having trouble peeling a banana.
“I dropped the banana twice and spilled over some milk,’’ she recalls of that morning last October. “I thought I was really tired, and I sat down at the kitchen table and laid my head down.’’
That’s how her son, Jake, 16, found her a few minutes later.
“I asked her if everything was OK,’’ he said. “She couldn’t respond.’’
Jake, a sophomore at Tower Hill School, called out to his father, who dialed 911. Paramedics arrived within minutes and, recognizing the signs of stroke, rushed Simon to Christiana Care, where Barbara J. Albani, M.D., director of neurointerventional surgery at Christiana Care, found an injured artery that cut the flow of oxygen-rich blood to the left side of Simon’s brain. If this stroke had gone untreated, her chance of survival was very low, and if she had survived, her chance of meaningful recovery was even lower.
Surgery to insert a stent into her left carotid artery and removal of clot from the brain arteries restored the flow to the brain tissue. It all happened very quickly. When a stroke strikes, time is critical, said Dr. Albani
“You lose millions of neurons in a minute, so literally every second counts,’’ Albani said. “The moment a stroke patient arrives, we’re running.”
Patients have an advantage at Christiana Care because stroke care here is comprehensive and state-of-the-science, Dr. Albani said. Christiana Care has a 24-bed stroke unit, highly specialized staff, and the most advanced medicines and medical devices to treat all types of neurovascular emergencies at any time of day or night. Christiana Hospital, which sees the second-highest number of inpatient stroke admissions in the country, “offers everything—the latest in technology, three full-time neurointerventionalists, a dedicated neuro ICU, neurology, neurosurgery and rehabilitation,’’ Dr. Albani said. “These technological advances have expanded our ability to successfully treat some of the worst strokes and preserve life and normal functioning. This type of advanced stroke care is available in only a few centers across the country, primarily in large tertiary-care and academic institutions. Christiana Care is the only hospital in Delaware that offers this level of neurovascular care.”
That all came together for Simon. Today she walks, drives Jake to school and shows no signs of having had a massive stroke, except for her speech, which is halting but easily understandable, and is improving.
“It’s miraculous,’’ said Jake.
Stroke once was considered a kind of fait accompli—when it occurred, there wasn’t much that could be done. In the mid-1990s, a powerful blood thinner, tissue plasminogen activator, or tPA, was approved to treat heart attacks, then strokes, and that “changed the paradigm in stroke treatment,’’ Dr. Albani said. Before that, “strokes were not considered an emergency,’’ she said. “Prior to tPA, stroke had been approached as a chronic disease, something that you diagnosed, but could do little about acutely. You just helped direct the patient to rehabilitation and hoped for the best. Today, that paradigm is so different.’’