The New Face of Stroke

Featured Article, Healthy Heart, Stroke
on January 28, 2011

Last December, Lucy Louison got out of bed in the middle of the night to use the bathroom and glanced in the mirror. “I realized that my body was leaning toward the right,” she says. Her head felt strange and her right side achy, but she dismissed any worry: “I just thought I’d slept too long on my side.”

But when she woke again at 5:30 a.m., she knew better. “I couldn’t get up, and my vision was jumping. It was like my world was rocky.” She called her sister, and two hours later she was at Montefiore Medical Center in the Bronx. By this time, Louison was vomiting, and the ambulance workers looked like they were upside down. Louison was having a stroke. She was age 36 at the time.

Strokes in young people like Louison are becoming more and more common. According to a 2010 study, the number of people younger than 45 having strokes rose from 4.5 percent in 1993 to 7.3 percent in 2005.

The numbers have increased as stroke risk factors such as high blood pressure, diabetes, high cholesterol and obesity are occurring at younger and younger ages. And Louison carried some of those risks: excess weight, no exercise and stress from her social work job. Her riskiest habit, though, was smoking, says her doctor, Dr. Daniel Labovitz, attending neurologist at Montefiore.

Unfortunately, the three-hour window had passed for Louison when a blood clot-related stroke—the most common—can be treated with the clot-busting drug tPA. “We had almost nothing we could do to affect the course of her stroke,” Labovitz says. “We could only make sure to minimize the risk of another one.” To do that, Labovitz prescribed one baby aspirin a day and a preventive course of cholesterol-lowering medication. (Louison doesn’t have high cholesterol.)

Although tPA is still the gold standard treatment, researchers are developing more sophisticated ways of removing clots with catheters. “That’s the future of treatment,” says neurologist Dr. Brett M. Kissela, of the University of Cincinnati College of Medicine.

Another relatively unexplored area is in helping people recover. “The brain has a capacity to reorganize itself and find alternate ways to get the same job done,” Labovitz says. “That reorganization is part of the reason people improve.”

When Louison, now 37, was released from the hospital, she moved to the Montefiore Rehabilitation Center where she learned to stand and walk again.

“It took about three months for me to stop walking with a cane,” she says. As important, she’s shaped up her health habits: She quit smoking and started walking for exercise. She still experiences numbness on her left side and bouts of vertigo. “But I am optimistic,” says Louison, who is pregnant and due to deliver in March. “I am determined to become a healthy person.”