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Timing, Technique –
and One Tot’s Warning

Early Intervention and Advanced Care Stop Woman’s Stroke in Its Tracks

She’s only two and a half, but Charley Newdeck is the kind of pint-sized protector everyone should have. Her grandparents, Nancy and Jack Maccord, watch Charley two days a week while her mom is working. Apparently, Charley keeps a pretty close eye on her grandparents, too.

Nancy MaccordOne day in September, Nancy, 53, was playing with Charley while her husband was in his office, talking on the phone. The Blue Bell woman remembers telling Charley it was time to get ready to go home. Charley popped off the couch, but when Nancy rose, she immediately fell. “I told myself to get up. But as soon as I stood again, I fell flat on my face,” she says.

Since she landed on the carpet, Jack didn’t hear a thing. While Nancy floundered, numb on one side, Charley ran to her pop-pop’s office to tell him her mom-mom had fallen. Jack immediately called 9-1-1 and the paramedics rushed Nancy to Abington Memorial Hospital.

“I’m so lucky to have been taken to Abington,” Nancy says. “I remember parts of what was happening but I didn’t know why.”

The Emergency Trauma Center team was already waiting, with Neurologist David C. Weisman, MD and other specialists diagnosing an ischemic stroke and administering the clot-busting drug, rT-PA, intravenously to help break up the clot. According to Qaisar Shah, MD, director, Neurointerventional and Neurocritical Care in the Neurosciences Institute, the drug takes some time to move through the system. “In Nancy’s case, scans showed the clot in her brain was not dissolving quickly enough. Since she arrived and was treated so quickly in our ETC, we could quickly move her to the Neurovascular Laboratory.”

AMH is one of the first community hospitals to provide around-the-clock availability of interventional neurologists to diagnose and treat urgent intracranial and vascular problems using neuroendovascular therapies. For patients like Nancy, timing and technique mean everything.

Dr. Shah explains, “We made a small incision in her groin and threaded a micro-catheter through an artery, guided by magnified fluoroscopic images. Once we reached the clot in her brain, we injected it with rT-PA. The blockage was eliminated and normal blood flow resumed.

Nancy says, “As I became more aware, I asked Dr. Shah how long this was going to take. I said I was bored, not realizing they were guiding medicine through my brain at that very moment.”

Today, Nancy has no complications from the stroke. “It almost seems like it never happened.”

Because of the coordination of clinical forces that brought Nancy from her home to the ETC for treatment so rapidly, we were able to advance her to the neurovascular laboratory for intra-arterial treatment and enroll her in a clinical trial. Dr. Shah is principal investigator of the trial, known as IMS-III (Interventional Management of Stroke Study III). The study will follow early intervention stroke patients from across the country to determine if combining intravenous and intra-arterial rT-PA produces better outcomes for patients with ischemic strokes.

Abington is involved in numerous clinical trials in virtually every area of care, something that was once only available through academic medical centers. In essence, hospitals like Abington that offer these leading-edge research studies combine the latest in medical science and technology in a nearby location.

“Thanks to the amazing treatment of Abington’s staff, I have so much to look forward to – including my daughter’s wedding in early 2012.”

Of course, Charley – Nancy’s own early warning system – will be there, too. “She’s my little hero.”

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