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Nationally recognized doctors save stroke patient

01/01/2010

For Maine resident Tyra Tarbox, the grass is a little greener, and the strawberries taste a little sweeter than they did a year ago. In September 2009, her family wasn’t sure she’d survive a brain stem stroke and enjoy another summer. Luckily for Tyra and her family, Tufts Medical Center’s nationally recognized specialists were able to help.

It all started on a Friday night when Tyra came home late from work. She was greeting Jim, her husband of 22 years, when she felt a sudden intense pain in back of her neck and the room started spinning.

The major vessel providing flow to the base of her brain had developed a spontaneous tear, launching a blood clot which caused a stroke in Tyra’s brainstem. Her husband called an ambulance and she was rushed to Maine Medical Center in Portland, where she was given an intravenous shot of a “clot buster,” but after several hours there was no improvement.

Not only did she have a clot lodged into her basilar artery – the single central artery that supplies the brainstem with blood – but the tear in her major intracranial vertebral artery that feeds blood to the basilar artery was limiting blood flow. Lack of blood flow to brain tissue can cause paralysis or death and, unless restored in a timely fashion, leads to irreversible damage. A regularly healthy mother of four children, Tyra was in very serious condition.

Jim could see the concern on the faces of the medical staff. The doctors in Portland knew they needed to get Tyra to Tufts Medical Center’s neurosurgery experts immediately. There wasn’t time to send a helicopter from Boston, so a helicopter on its way to an accident in northern Maine was rerouted to take Tyra.

Neurovascular Surgery Chief Adel Malek,MD, PhD met the helicopter on the roof at Tufts Medical Center 28 minutes after it left Maine Medical Center. Tyra was whisked immediately to the state-of-the-art angiography suite where a mechanical thrombectomy was performed to remove the blood clot from her basilar artery.

Once the clot was removed, her blood flow was restored, but was still limited by the tear in her vertebral artery, which needed to be repaired. In tandem back-to-back fashion, Dr.Malek was able to navigate two miniature intracranial stents to reconstruct the normal caliber of the torn vessel, thus restoring normal blood supply to Tyra’s basilar artery and restoring blood flow to her brain stem.

This is a complicated procedure, that until recently would have presented grave danger to the patient. “Thanks to advances in neuroendovascular technology we have been able to offer the latest techniques at Tufts Medical Center while maximizing patient safety,” says Dr.Malek.

The surgery was a success, but the difficult part for Tyra and her family lay ahead. When she first woke up in the critical care unit six days later, Tyra had no body movement and could not move her eyes to the right. She was told that she had survived not only the stroke, but also a series of complications resulting from her brain’s lack of blood. “Every day there was something happening; it wasn’t just stroke I had to deal with,” says Tyra, “but the level of care I received was incredible. I had all the faith in the world in them. It’s nice to know when you’re that dependent and vulnerable, you can trust your caregivers.”

After two weeks at Tufts Medical Center, Tyra was transferred to a rehabilitation center closer to home, where she spent 28 days before returning home on Jim’s birthday.

A year later, she has a few “minor inconveniences” but feels so fortunate to be alive, she doesn’t complain. “I’m so glad I could come back and do what I did before and be involved in my kids’ lives,” Tyra says. She’s still working on regaining all her fine motor skills, but now walks without a cane and is doing exceptionally well. “It sounds crazy to say, but I so appreciate the whole experience and am grateful to have had Tufts Medical Center’s care within my reach.”

Learn about Tufts Medical Center’s Division of Neurosurgery.