No Time to Lose

When a pleasant breakfast with her 2-year-old son was interrupted by a loud buzzing in her head, it didn’t occur to 43-year-old Anise Pettersen that she was having a life-threatening stroke.

A young mother has a stroke while eating breakfast with her 2-year-old son. Here’s how WMCHealth’s Comprehensive Stroke Center saved her life and kept a family together.

As seen in the December 2020 Issue of Advancing Care.

When Anise Pettersen realized the loud buzzing she was hearing was not an emergency alert coming from her phone, her heart sank.

“I covered my ears and realized this was coming from inside my head. I thought, This can’t be right. I tried to open my phone, and I couldn’t use my fingers… I tried, really, really hard. I thought, Am I having vertigo? Am I dehydrated?’’

It did not even occur to the 43-year-old Kingston mother that she was having a stroke. What started as a fun breakfast at a local bagel shop with her 2-year-old son unfolded into a race-the-clock care scenario spanning two Westchester Medical Center Health Network (WMCHealth) hospitals recognized for stroke-care excellence.

Operating Within a Short Window

Another customer at the bagel shop called 911, and Pettersen was quickly brought to nearby HealthAlliance Hospital, a member of WMCHealth whose experts work in close partnership with experts at WMCHealth’s Comprehensive Stroke Center at Westchester Medical Center.

At HealthAlliance Hospital, which recently won awards for stroke care from the American Heart Association (see sidebar), Pettersen was evaluated by a neurologist via a telemedicine consult.
According to Fawaz Al-Mufti, MD, a neuroendovascular surgeon at Westchester Medical Center, the flagship of WMCHealth, Anise was diagnosed at HealthAlliance Hospital with a blockage in a major artery that was restricting blood flow to her brain. She was given a powerful clot-busting agent — tissue plasminogen activator, or t-PA — and then airlifted to Westchester Medical Center for more advanced care. There, she was met in the Emergency Department by several members of the Comprehensive Stroke Center care team, who acted quickly and efficiently.

FAST

According to Dr. Al-Mufti, while having a stroke at age 43 is not common, they do occur. According to the Centers for Disease Control and Prevention, there are 800,000 cases of stroke each year. An easy way to remember the signs of a stroke is…

F – Face Drooping
A – Arm Weakness
S – Speech Difficulty
T – Time to call 911

“The most important factor in the effective treatment of a stroke is time,” says Dr. Al-Mufti. “The longer blood flow to the brain is restricted, the greater the chances of permanent damage, which can result in paralysis and other long-term disabilities.

“Receiving Comprehensive Stroke Center accreditation is difficult because facilities must guarantee that not more than 35 minutes will elapse from the time the patient arrives at the hospital to the time when the blockage is removed. We must do this as an orchestrated team, with no variations whether the patient comes in at 10 a.m. or at one in the morning.”

A Complex Procedure Yields Great Results

In Pettersen’s case, the risk of coma or brain death was very high, Dr. Al-Mufti said, because her basilar artery was completely blocked.

“She had a blockage of this very important artery,’’ says Dr. Al-Mufti. “But while symptoms were starting to improve very modestly, the vessel showed complete blockage of the artery. She was going to get worse very quickly if we did not act.’’

Dr. Al-Mufti chose to perform a trans-radial access procedure, in which a catheter is threaded through an artery in the wrist to the blockage. This is a complex, yet safe, procedure in which few physicians specialize and is rarely used in this type of case. It was conducted under moderate sedation, so she could remain awake. “We were operating in such close proximity to the area of the brain responsible for consciousness, so communicating with her during the intervention was key to determining how her brain was being affected,” Dr. Al-Mufti says.

Thanks to the speedy actions of the staffs at HealthAlliance Hospital and Westchester Medical Center — as well as follow-up care in Westchester Medical Center’s Neurocritical Intensive Care Unit — Pettersen’s long-term prognosis is very good, according to Dr. Al-Mufti, with no perceptible brain damage nor expectation of disability.

Petterson, who is looking forward to future breakfasts out with her son and husband, says she is extremely grateful to WMCHealth and the entire team at the Westchester Medical Center’s Comprehensive Stroke Center. “It was a tough time, but I got through it. I’m very proud of myself and grateful to everyone who made my recovery possible.’’

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WMCHealth Brings Home the Gold

Westchester Medical Center and HealthAlliance Hospital, along with WMCHealth’s Good Samaritan Hospital and MidHudson Regional Hospital, recently earned the American Heart Association/American Stroke Association’s Get with the Guidelines® – Stroke Gold Plus Quality Achievement Award. The award recognizes each hospital for its commitment to, and success in, ensuring stroke patients receive excellent care based on the latest evidence-based scientific guidelines.

Additionally, Westchester Medical Center and HealthAlliance Hospital received the American Heart Association’s Target: StrokeSM Honor Roll Elite award. To qualify for this recognition, Westchester Medical Center and HealthAlliance Hospital met the American Heart Association’s quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with tissue plasminogen activator, or r-tPA, which the American Heart Association considers “the gold standard” for treating ischemic strokes, which are caused by blood clots.

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Call 911 immediately at the first signs of a stroke. To make a non-emergent appointment call 914.493.2363 (Valhalla), 845.368.5936 (Suffern), 845.331.3131 (Kingston), 845.483.5951 (Poughkeepsie) or 845.586.2631 (Margaretville).