Surviving a Stroke at 16
At 16 years old, Christopher Moldanado Ortiz is already a seasoned athlete. A sophomore at William Tennent High School in Warminster, he has excelled in a number of sports, including wrestling and football.
He knows that no matter what the sport, success depends on teamwork, physical conditioning, and a good bit of luck. In Christopher’s case, all three factors came into play when he faced a physical challenge that few his age ever encounter: A stroke.
An Unseen Injury
During his third match at a wrestling tournament in January 2014, Chris’ opponent delivered a sharp hit to the back of his neck. Unbeknownst to him, that move resulted in a vertebral artery dissection (VAD), one of the leading causes of stroke in young people. A VAD is a tear in one of the inner layers of the vertebral arteries in the neck that supply blood to the brain.
Chris’ initial symptoms, which included dizziness and short-term memory loss, weren’t severe enough to cause significant concern. It was only hours later that alarm bells started to ring – almost literally.
“Later that evening, I was standing at the side of a football field, watching a few friends throw a ball around, when I heard a loud ringing,” Chris says. “I immediately grabbed my ears – and fell flat on my face. Then I realized that my left side had gone numb.”
Determining the Damage
Paramedics brought him to Abington Memorial Hospital, where he was first seen by emergency physician Chad Garson, MD. By this time, he was unresponsive and paralyzed on his right side and a machine was helping him breathe.
When the initial CT did not show traumatic bleeding in the head, James Yuschak, MD, director of the Trauma Program, ordered a CT angiogram; this study uses a contrast dye to illuminate blood vessels. The test revealed the tear in Chris’ right vertebral artery and showed that it had resulted in an even more serious issue. A blood clot had formed, which had blocked blood flow in the vertebral artery and had also migrated to and lodged in the critical basilar artery, which supplies the crucial brain stem and other important areas of the brain.
Shortly after the CT angiogram was read, Hana Choe, MD, assistant director of Neurointerventional Care at the Neurosciences Institute at Abington Health, was on her way to the hospital. “At that point, I didn’t know much about Chris beyond the fact that he was a 16 year old with a blocked basilar artery, which was serious enough,” she says.
Deploying the “Stentriever”
In the Neurovascular Lab, Dr. Choe carefully threaded a catheter from the femoral artery in Chris’ groin up to his brain.
“We had to access the blood clot in the basilar artery through his left vertebral artery, because by this time, his right vertebral artery was completely blocked,” she says. She then deployed a “stentriever,” a thin, expandable mesh stent, to capture and remove the clot, restoring blood flow to the basilar artery.
Even though they had pulled him out of immediate danger, Dr. Choe and the rest of Chris’ doctors still expected some level of brain injury. But he surprised everyone. “By the time we took him to the Neuro ICU, any signs of stroke had resolved, and he was moving his arms and legs normally and gesturing for the breathing tube to be removed,” Dr. Choe says.
Reality Sets In
Chris himself was astonished when he learned how close he’d come to death or disability. “When I was told that I’d had a stroke, I thought, how can that be?” he says. “I’m only 16.”
A day later, Dr. Choe performed another procedure to place a permanent stent in Chris’ right vertebral artery to help heal the torn lining and keep the vessel open. Chris was awake during the procedure and was able to follow Dr. Choe’s instructions to stay perfectly still throughout so she could visualize and precisely maneuver catheters and wires through his blood vessels under X-ray guidance. Chris also had to remain still for four hours afterwards to avoid bleeding from the tiny incision in his leg through which the catheters were inserted.
He believes his athletic training may have helped him through the ordeal. As he lay on the operating table, he realized that lying perfectly still was just another way to practice the physical discipline that playing sports had instilled in him.
“The doctors seemed surprised that I stayed awake and that they didn’t have to strap me down,” he says. “But I just willed myself not to move.”
Finding a New Path
Dr. Choe agrees that Chris’ youth and health played a key part in his recovery, noting that the vast majority of patients would not be able to bounce back nearly as quickly, if at all. “If Chris had gone to sleep that night instead of being out with his friends, he probably wouldn’t have woken up,” she says. “I told him that he was extremely lucky, and that I believe that he was destined to do great things.”
One of Chris’ main priorities is finding outlets for his athletic talent. Because doctors still don’t know if Chris might have an underlying condition that makes his blood vessels more susceptible to injury, certain contact sports could be off limits for at least the near future. In the meantime, he is entering his junior year and keeps busy working part-time at a local restaurant.