A Dramatic Reversal
Neurointerventionalists save Hatfield man from profound stroke results
March 13, 2011. A major storm was brewing inside Muhammad Rahman’s head. As the 53-year-old Hatfield man went about his regular weekend chores, he expressed feeling fatigued. According to his son, Jamil Haidar, his father decided to lie down for a bit.
While Muhammad slept, lightning struck – vague symptoms that had likely begun that morning grew into a massive stroke. When he still hadn’t awakened by early evening, his wife and family checked on him.
“He wasn’t able to talk,” Jamil remembers. “We called 9-1-1 right away and he was taken to Grand View Hospital. By the time he arrived at the hospital, my father was outside the ‘window’ for treating the blood clot.”
Fortunately, Grand View’s ETC physicians contacted Larami MacKenzie, M.D., and Osman S. Kozak, M.D., of Abington Memorial Hospital’s Neurosciences Institute. Muhammad was quickly transferred to Abington’s Emergency Trauma Center.
On the National Institutes of Health Stroke Scale, with “0” being normal, anything over 20 is considered to have an extremely poor prognosis. Doctors gave Muhammad an NIHSS rating of 24.
Because of the availability of AMH’s neurointerventional team, the “average” window of three to four hours after onset of symptoms for treating ischemic stroke with a “clot-busting” medication can be expanded to almost eight hours through intra-arterial intervention. Instead of infusing the drug into his arm, Dr. Kozak sat with the family and discussed administering rt-PA directly into the artery leading into the brain and then removing the blood clot. It was Muhammad’s only hope of coming back from such a major brain attack.
In AMH’s highly advanced neurovascular laboratory, Dr. Kozak threaded a catheter from Muhammad’s groin, delicately guiding it all the way up his left side. The neurointerventionalist inserted a mesh stent to allow blood to flow again around the blockage. Above the carotid was a large clot. Dr. Kozak then performed a technique using a catheter to break up the clot while removing it at the same time via suction, thus opening up the artery for oxygen-rich blood to flow to the brain.
The left side of the brain, which controls the right side of the body, is where major speech and comprehension lie. Without the intra-arterial intervention, Muhammad would have been unable to talk and would have suffered permanent right-sided paralysis.
About 24 hours after the procedure, Muhammad had regained complete movement in his arms and legs, and within two days, he was trying to speak. “He was already remembering,” Jamil says. “I was supposed to attend a conference in Chicago and he wanted to know why I hadn’t gone. He asked for a newspaper in our native Bengali language to read.”
Qaisar A. Shah, M.D., director, Neurointerventional and Neurocritical Care Services, adds, “Muhammad’s situation is a perfect example of what it means to have expanded neurointerventional capabilities here at AMH. He had missed the regular stroke treatment window before he arrived at the first hospital. Because of the rapid availability of AMH’s interventional team, he’s already back to walking and talking. He’ll be able to return to work.”
Jamil says it best. “My whole family is so grateful. Quite simply, my father is lucky to be alive.”
Abington Memorial Hospital is among very few hospitals in Pennsylvania offering rapid availability of advanced neurointerventional services to help stroke patients who couldn’t benefit from treatment if they arrived at the ER more than three or four hours after onset of stroke. We believe that Abington Memorial Hospital has treated one of the largest numbers of patients in the state with clot-busting medication.
For more information about neurointerventional services at our Neurosciences Institute, call 215-481-MEDI (6334).