A stroke occurs when a blood clot — and less commonly a ruptured artery or blood vessel — interrupts blood flow to the brain. Stroke is the third leading cause of death in the U.S. and is a leading cause of long-term disability. When stroke symptoms occur, time is of the essence to dissolve the blood clot and get blood flowing to the brain.
A Team Effort
Joe was rushed to Jersey Shore University Medical Center. When he arrived at the emergency department (ED), he was paralyzed on the right side and couldn't speak. The Stroke Rescue Team stepped into high gear.Within an hour of when his symptoms began, Joe had been examined in the ED by Alan Colicchio, M.D., chief of neurology, and an emergency team of nurses and physicians.
"The first key to Joe's recovery was his colleague recognizing the signs and symptoms of stroke and getting him to the ED and a comprehensive stroke center," Dr. Colicchio explains. "Then our phenomenal nurse got the wheels in motion and escorted Joe for an emergency CT scan."
Dr. Colicchio also commends the critical roles Gregg Mojares, D.O.; Stephen Martino, M.D.; David Wells- Roth, M.D.; Robert Sweeney, D.O.; and Jackie Dwyer, R.N., played in Joe's quick diagnosis and treatment.
Joe was given the clot-busting drug tissue plasminogen activator (tPA) intravenously within 58 minutes of arrival in the ED. It must be given within three hours of the onset of stroke symptoms to be effective — one reason it's so important to get treatment immediately.
An Advanced Treatment Option
Sometimes intravenous tPA alone is not enough. Joe's blockage was large, so he required additional treatment. Joe was fortunate to be at Jersey Shore, which has a state-of-the-art hybrid operating room. This means there is an operating table for traditional surgery and a special table for endovascular procedures, like intra-arterial tPA.
Dr. Wells-Roth, an endovascular neurosurgeon, was called in to perform the procedure. During it, the doctor inserts a thin, flexible catheter into a groin artery and weaves it through the patient's body into the blood clot. The catheter delivers tPA directly into the clot.
"Intra-arterial tPA delivers a lower dose of the drug with less risk for intracranial bleeding," says Dr. Wells-Roth. "It can be a very useful tool for some stroke patients."
Candidates for the procedure include those with a large blood vessel blockage, like Joe's; those who have had recent surgery; and those on blood thinners. It can be used within six hours of when symptoms begin.
By the time Joe was moved to intensive care that evening, he had started moving his arm and leg and was speaking again. "When I saw him the next day, he was practically symptom-free," says Dr. Colicchio. "A good outcome is some return of movement and some return of speech. To have no neurological deficit is a better-than-average outcome."
Following the procedure, Joe spent two weeks in inpatient rehabilitation. He worked on motor tasks and speech therapy to regain his independence. Each day he regained more function. "They are the best, the nicest people," he says.
He has full use of his arm and leg, has regained his ability to speak, and is spending time with his wife, children, and four granddaughters. He's even looking forward to returning to work.
"I consider what happened to me a stroke of luck," he says. "The medical staff calls me the miracle man."
About the Doctors
- Alan R. Colicchio, M.D.
Board certified in Neurology
Neptune, NJ | 732-774-8282
- David Wells-Roth, M.D.
Board certified in Neurosurgery
Neptune, NJ | 732-455-8225
