On January 7, 2016, Naperville resident Toni Tompkins, 41, woke up with a bad headache, tried to get up, and fell. Alarmed at her slurred speech and the lack of movement on her left side, her husband Charles helped her up and asked their 19-year-old son Christopher to call 9-1-1.
She was brought to the Edward Hospital Emergency Department where she was evaluated by Mohammad Sajed, MD, neurologist and Medical Director of Neurocritical Care. Images of Tompkins’ brain showed she had suffered an ischemic stroke. The cause: two large blood clots blocking the blood supply in her right middle cerebral artery, which carries blood to the brain.
With strokes, quick treatment is key to minimizing loss of functions controlled by the affected part of the brain. Tompkins received an infusion of tPA (tissue plasminogen activator), a clot-busting enzyme that should be given within 4.5 hours of the onset of symptoms to be most effective. Thanks to the quick response of her family and Naperville first responders, Tompkins was well within this window.
But 45 minutes into the infusion, Dr. Sajed determined the tPA wasn't sufficiently reducing the clots. Tompkins was transferred to Edward’s neurointerventional suite where Sameer Ansari, MD would perform a thrombectomy, a procedure to remove the clots. Both he and Dr. Sajed are with the Edward Neurosciences Institute and members of the hospital's 24/7 on-call Stroke Team.
For Tompkins' thrombectomy, Dr. Ansari, a neurointerventionalist, threaded a catheter from a small incision in the patient's groin to the brain, where the two clots – each two centimeters in length – were retrieved using suction. Dr. Ansari used a new, improved type of aspiration (suction) catheter, called the Penumbra ACE 64/3Max.
“The system's larger catheter allows for better aspiration, and its flexibility and (tapered) design make extraction of the clot easier," according to Dr. Ansari. "Doing the tPA and the thrombectomy saved Toni Tompkins from a major stroke with serious consequences, such as paralysis and loss of function."
During Tompkins' four-day hospital stay, Li Zhang, MD, a neurologist with the Edward Neurosciences Institute, ordered tests to examine possible causes of Tompkins' stroke. While the cause couldn't be pinpointed, tests did rule out a hole in the heart or a heart rhythm problem.
A week after her procedure, Tompkins was able to return to normal activities. She no longer has the symptoms that brought her to the ER.
"Sometimes repetitive motion may start to bother me,” she says. “Then I think about how blessed I am. There are a lot of people who went through what I did but things didn't turn out so well."
She continues to monitor her blood sugar and cholesterol counts – both stroke risk factors if the numbers are high. She also watches what she eats and exercises regularly. Her efforts have paid off. Her A1C numbers (a blood test to monitor diabetes) are now normal and she no longer needs medication for type 2 diabetes.
A couple of times a year she'll check in with Yonghua Michael Zhang, MD, a neurologist with the Edward Neurosciences Institute, who says "Toni is doing great and, provided she continues to manage risk factors, her prognosis is very good."
For more information, visit www.EEHealth.org/services/neuro
. To learn if you’re at risk for stroke, take the free, five-minute StrokeAware assessment at www.EEHealth.org/StrokeAware