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Myrtle Beach Woman Travels to Abington Hospital for Lifesaving Brain Surgery

Abington’s Moyamoya disease task force treats rare disease of blood vessels in brain

Never underestimate the value of a Google search. For Nancy Zovnic, a few keyboard strokes resulted in lifesaving brain surgery performed by the moyamoya disease task force at Abington–Jefferson Health—nearly 600 miles from her home in Myrtle Beach, SC.

The series of events that brought Nancy to Abington Hospital for treatment began in 2013, when at age 31, she experienced a massive stroke that paralyzed the right side of her body and left her unable to speak. The stroke came on the heels of a surgery to correct a hole in Nancy’s heart. Initially, doctors at her South Carolina hospital suspected the surgery caused the stroke—a known risk of the procedure.

Nancy spent the ensuing six months in rehabilitation therapy, relearning how to speak and use the right side of her body. She regained mobility except in her right hand and was able to return to work as a real estate attorney in Myrtle Beach.

Nearly 15 months after the major stroke, Nancy was rushed to the hospital on two separate occasions for symptoms of a ministroke, or transient ischemic attack (TIA). At that point, neurologists diagnosed Nancy with Moyamoya disease—a rare disorder of the blood vessels that feed the brain. The disorder would most likely continue to progress—there was no way to determine how quickly—putting Nancy’s life at risk.

Nancy’s family did that thing nearly everyone does to learn more about anything nowadays – they Googled Moyamoya. They discovered Abington Hospital’s Moyamoya task force and as luck would have it, Nancy’s aunt lives in Delaware County – not far from the hospital. Therefore, it was easy for Nancy to coordinate the logistics of a consultation with the Abington specialists, as well as subsequent surgery and recovery away from home.

Abington neurosurgeons perform intricate procedure to support the brain’s own healing power

Qaisar A. Shah, MD, director of Neurointerventional and Neurocritical Care Services, is a member of the Abington task force team dedicated to the early diagnosis and treatment of moyamoya disease. Comprised of specialists in neurology, neurovascular surgery, psychology, and radiology, the team meets on a case-by-case basis to evaluate each individual diagnosed with moyamoya disease. Together, they determine the best treatment option for each patient.

In people with Moyamoya disease, blood vessels at the base of the brain narrow, restricting blood flow. As the artery narrowing progresses, the body compensates for the reduced blood flow by creating a network of blood vessels that detour the blockage. First identified in Japan, the disorder was named moyamoya because the network of vessels resembles a “puff of smoke” on X-ray (cerebral angiogram). When the narrowing becomes severe, symptoms occur—as was the case for Nancy – and may include stroke, ministroke, headaches, and seizures.

“Our goal with treatment is to increase the blood flow of the deprived brain,” said Dr. Shah. Treatment may include medical therapy with blood-thinning medications, as well as measures to control risk factors and maintain adequate hydration. For some people like Nancy, who experience recurrent episodes, surgery may be an option.

In Nancy’s case, the recommended treatment was a surgical procedure to bypass the area of blockage to restore blood flow to the brain. “I was completely confident in the Abington team,” said Nancy. “They explained every detail to me in a way I could understand and I knew I was in good hands.”

Steven J. Barrer, M.D., director of the Vickie and Jack Farber Institute for Neuroscience at Abington, performed the surgery. During the delicate procedure, Dr. Barrer used a branch of the temporal artery (that runs along the temple) from Nancy’s scalp and stitched it to the membrane that covers the brain. “Laying against the brain, this portion of the artery will sprout new blood vessels that grow into the brain over time, compensating for the blood supply that was lost due to the blockage. In essence, we bypassed the blockage,” explained Dr. Barrer. In most patients, the natural growth of new blood vessels occurs over a six-month period.

Traveling afar, but not for surgery

In the 2 ½ years since her brain surgery, Nancy maintains an active lifestyle in Myrtle Beach. Passionate about travel, she has begun planning a trip to visit family in Australia – her first international trip since the start of her serious health issues in 2013. “Unfortunately, with my stroke, heart surgery, brain surgery, and being out of work for so long while I recovered, I haven't been able to travel abroad since 2013,” said Nancy, “But I plan on it very soon.”

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