The Younger Face of Stroke

Linda Thrasybule | August 14, 2012 | Health Care
Although typically associated with the elderly, stroke is increasingly striking the young, with some victims no older than 15

Kathy Doyle, right, a recovering stroke victim, and her family.
Kathy Doyle was sitting in her car with her newborn baby Molly in the back seat, waiting for her husband, Steve, to run into Dunkin Donuts to grab them coffee. She had just left her doctor’s office, going in for a routine checkup two weeks after delivering her third child.

As soon as her husband left the car, Doyle suddenly felt “like someone shot me in the back of the head.”

The pain was so intense, she felt like her whole left side had “melted away.”

At 36 years old, Doyle was experiencing a stroke.

“I couldn’t really talk,” she said. “My husband is a police officer so he was very calm. He took me to the hospital right away.”

More and more young people are experiencing stroke, particularly ischemic stroke, which occurs when an artery to the brain is blocked by a blood clot, reducing blood flow, which can ultimately damage brain cells.

Ischemic strokes represent about 87 percent of all strokes, according to the Centers for Disease Control and Prevention (CDC).

People between the ages of 15 and 44 hospitalized for ischemic stroke increased by 37 percent from 1995 to 2008, reports the CDC.

In fact, nearly 25 percent of all strokes occur in people younger than age 65.

Stroke has specific symptoms such as numbness or weakness on one side of the body, confusion, difficulty speaking, problems seeing in one or both eyes, loss of balance, dizziness, or a sudden severe headache.

The Obesity Factor

Some experts attribute this rise to the burgeoning obesity epidemic. Obesity, along with heart disease, diabetes, poor diet, lack of exercise and high cholesterol are among the risk factors linked with stroke.

“I think that there’s definitely a link that we’re starting to see,” said Dr. Erol Veznedaroglu, also known as Dr. Vez, director of the Capital Institute for Neurosciences and chairman of the Department of Neurosurgery at Capital Health, a state-designated comprehensive stroke center in Trenton.

“Traditionally, people think about stroke as something grandma and grandpa have, but we’re starting to see people in their 20s, 30s, and 40s very consistently now, which is really a new phenomenon.”

Stroke is the fourth leading cause of death in the U.S., reports the American Stroke Association. More than 140,000 people in the U.S. die each year from it.

Vez said that the response to a stroke must be immediate. “When we say immediate, we mean 911,” he said. “It’s a time-sensitive disease, more so than even someone experiencing trauma.”

Capital Health, a state-designated comprehensive stroke center, offers one of only a handful of neurosurgical intensive care units in New Jersey. The center also houses a specialized team trained in complex brain disorders and the most advanced procedures for people with strokes, aneurysms, and brain tumors, among other conditions.

Last year, it became the first hospital in the country to offer a Center for Neurologic Emergency Medicine, a program for patients who need emergency care involving the brain, spine, or central nervous system.

Newer Treatments

By the time Doyle reached the hospital, she was pretty much out of it. Her face was drooping, she couldn’t talk, and she couldn’t move the left side of her body. She was immediately given an IV tPA, a clot-busting drug that helps open up the artery to get the clot moving.

After a CT scan was also performed, the emergency room doctor recommended she be treated at the Stroke and Cerebrovascular Center at Capital Health.

Vez and his team immediately got to work, using a Merci Retriever, a long thin device that is inserted into the blood vessel in the groin and is pushed all the way to the blocked vessel in the brain. The device then captures the clot and removes it.

“We see clinical improvement about 40 percent of the time,” said Vez, “which means someone who can‘t talk, or move the right side of their body, can get some of that function back after the procedure.”

Still, how soon someone can get function back varies from person to person, and recovery from a stroke doesn’t happen overnight. Generally, it takes two years to recover neurologically from a stroke.

“There’s a progression of recovery,” said Vez. “People think after a few months, they’ll recover, but it takes time physically for the brain cells to recover.”

After the procedure, Doyle had to undergo a month of stroke rehabilitation. “I was favoring my right side, so I needed rehab to regain strength on my left side,” she said.

“Even now, I catch myself when I’m walking — it’s not as natural as it used to be.”

Along with the Merci Retriever, the FDA has recently approved a newer device, Solitaire. Solitaire uses stents, which are softer and easier to get into the blood vessel compared with the corkscrew shape of the Merci device.

“The incidence of retrieval is twice than what was seen with the Merci device,” said Vez.

Although Solitaire seems to have shown promising results, stroke specialists still aren’t sure if the device is suitable for everyone.

“The majority of the time we’re successful and we’re able to get the clot out, but we’re still determining the factors that make a patient a good candidate,” said Vez. “So if you’re 80 years old, maybe using the device could be more damaging than helpful.“

Still, the device is another treatment option that could increase the chances of survival.

“With this form of treatment, you’re taking care of the problem immediately,” said Vez.

“With stroke, every minute is a wasted brain cell.”

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