The odds of a stroke increase with age, but patients can be old or young.
One was just days from her 40th birthday when she came to Fountain Valley Regional Hospital and Medical Center, weak and barely able to speak. The hospital has a specialized team of physicians who treat strokes, but they were unsure of this woman’s prognosis.
Dr. Tim Korber, who saw the mother of two in the emergency room, said her left side was “not working at all.”
The jammed vessel behind her right eye was tiny. The veteran doctor braced himself for a loss.
Strokes are potentially devastating, frequently fatal and commonly occurring “brain attacks,” typically caused when a blood clot forms anywhere in the body, breaks free and travels to the brain, where it becomes lodged.
Without blood flow, the brain becomes starved of oxygen. Survivors often lose limb function and have permanent speech impediments. The most severe side effect is being “locked in,” remaining conscious and cognitively unimpaired but mute and fully paralyzed except for eye movement.
Korber thought the woman before him could die. Instead, just a few weeks later, she was one of the nine stroke survivors who returned to the hospital to accept a rose symbolizing and celebrating endurance and joy.
Doctors like Korber triage patients, aware that time is of the essence when treating stroke, and colleagues like Dr. Hamed Farid do the delicate, cutting-edge work to restore blood flow.
Farid is Fountain Valley Regional’s medical director of neurointerventional radiology.
“It’s just a fancy word for brain plumber,” he said. “I go in the brain and suck a clot out, or if there’s an aneurysm rupture, plug up the hole.”
A stroke happens in the U.S. every 40 seconds. About 13% are hemorrhagic, the result of bleeding. Aneurysms, when a weakened vessel balloons and breaks, are hemorrhagic.
The vast majority are ischemic strokes, where the blood clots become wedged in brain vessels. Ischemic strokes are the No. 1 cause of adult disability, the second-leading cause of death worldwide and the fifth-leading cause of death in the United States, according to the American Stroke Assn.
A stroke in the basilar artery of the brainstem is the most likely to cause death or major disability, but all are serious. Every minute without oxygen kills 2 million neurons, or brain cells.
Farid said every hour without treatment takes 3.6 years off a patient’s life, with the average stroke cutting out 36 years of life — meaning the typical stroke goes 10 hours before treatment.
People of all ages have strokes. The youngest Farid has treated was 6.
His plan of counter-attack is a minimally invasive procedure where he feeds a wire and catheter into the patient’s brain via an incision in a groin artery. Tracking his progress through X-rays, he maneuvers the retrieval device into the choked-off vessel in the brain and places a stent. The stent opens and grabs the clot, which he pulls out, restoring blood flow. The process takes about 15 to 20 minutes.
Blood vessels in the brain are tiny and fragile, about 2 to 3 millimeters in diameter and of thinner composition than other vessels, with less lining.
But with modern technology, patients are more likely to survive without the obvious “neurological deficits,” Farid said.
Delia Estrada is one of them.
She spent April 25 doing errands. While at a Kinko’s copy shop, she developed blurred vision and felt drunk.
She returned to her Santa Ana home and lay on the couch. She was aware of her risk factors for stroke. Estrada has a blood clotting disorder and has survived two pulmonary embolisms. She takes blood thinners but those didn’t stop this stroke or a “mini-stroke” she suffered a few months prior.
She stubbornly told her husband that she was fine. Then she stood up and crashed into a table.
She took a Lyft to Fountain Valley Regional.
“Do not let me be a vegetable,” she told Oscar, her husband of 22 years.
Another member of the stroke team, Dr. Aaron Bress, removed the clot. A little more than a month later, Estrada accepted her survivor’s rose.
Korber, the E.R. doctor, told the people gathered for the May 31 ceremony how he thought Estrada might not make it.
She said her left hand doesn’t feel pain. It feels like it’s asleep. This is the only lingering effect she reported.
“I’m grateful,” she said, “for every day that I breathe.”