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UT-Houston Medicine Magazine

UT Physicians

Stroke patient thankful for fast-acting physicians

By Darla Brown

"They told me I'd never speak or walk again."

This, Tyrone Brown says matter of factly and clearly, recalling the days in late November 2006, following his recovery from an acute stroke.

Brown was sitting on his front porch when "my brain started locking up," as he describes it. "My right side locked up, and I couldn't talk. When I woke up, I had tubes in my nose and mouth, and a team of doctors over me with tears in their eyes," he continues, himself wiping away tears.

Those people were UT Physicians on staff at Memorial Hermann Hospital, including Hashem Shaltoni, M.D., a vascular neurologist and interventional neuroradiology fellow, and Edwin Cacayorin, M.D., professor and chief of interventional neuroradiology.

"Mr. Brown is a young man in his 40s who came in with a dramatic stroke with severe deficit. We were able to retrieve the clot from his brain in a timely fashion to open the vessel," Dr. Shaltoni explains. "He had a miraculous recovery."

For such an outcome, the interventional neuroradiologists, Drs. Shaltoni and Cacayorin, used the Lilliputian corkscrew-like device known as the Merci Retrieval System, which engages with the clot via a catheter in the artery and under the skillful guidance of the physician's hands. With twists and pulls and vigorous aspirations, the clot is retrieved and blood and oxygen is released back to the blocked side of the brain.

"The clot was on the left side of his brain, and it was out in one attempt," Dr. Shaltoni says, adding that this device has been approved since 2004.

Timing is everything when it comes to a stroke – and the minutes were counting down in Brown's case.

"At 8:30 a.m. he complained of weakness, at 9:39 he was at Memorial Hermann, at 11:08 he was given TPA (clot-dissolving drug) and he was intubated for the procedure. He walked the next day," Dr. Shaltoni recalls.

"I didn't know I wasn't supposed to be walking," Brown says. "The doctor told me that most people with my stroke don't walk – my leg still hurts because of neuropathy from diabetes, but I'm so thankful."

"It's a blessing to still be alive and walk."
- Tyrone Brown

It is the fast action by multiple teams that allows for such swift care and optimal outcomes. When a stroke victim is identified by EMS crews in the Houston area, members of the UT stroke team's pagers are alerted as is the emergency room and 24-hour interventional neuroradiology service team at Memorial Hermann Hospital. The anesthesia team and neurosurgery and cardiology are available as needed. There is a highly integrated team of experts to treat a victim of acute stroke at Memorial Hermann Hospital.

"Memorial Hermann Hospital is one of the few places in the country that has an MRI facility in the emergency room that is available 24 hours a day. That is very important for stroke patients," Dr. Shaltoni explains.

The hospital also has new high-speed MRI for fast and accurate diagnosis of stroke while the patient is receiving initial treatment, Dr. Cacayorin adds. "We use the latest in brain imaging technology for accurate detection of acute stroke and estimation of cerebral circulatory impairment," he says.

Dr. Shaltoni did some detective work to contact his miracle patient three months later – getting the phone records of Brown during his stay in the hospital.

"The only number I could remember when I was here was my sister's – and when my sister kept calling me, telling me a doctor was calling, I thought it was a joke," he says.

But Dr. Shaltoni wanted to get in touch with Brown to follow up with his care, and to let him know what an incredible recovery he had experienced.

Tyrone Brown

"When it dawned on me that I could have died, I started crying and praying - I'm a firm believer in God. I thank God for him (Dr. Shaltoni) and whatever doctors worked on me.

"It's a blessing to still be alive and walk. I can't walk fast or run, and sometimes stumble, but God picked me up," Brown says.

For more information, or to refer a patient,
call 1.877.4UT.DOCS (1.877.488.3627)

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