Plano, TX

When it comes to treating strokes, urgency is the rule. The sooner a patient is treated, the better. And if the onset of symptoms can be pinpointed to a specific time, even better still.
So when a 52-year-old woman was brought to The Medical Center of Plano with loss of speech and right-sided paralysis, she was unable to communicate when her symptoms had started.

However, her fiancée was able to show doctors a video he’d taken with his smartphone earlier in the day at the time the symptoms began. Due to his thoughtful actions, the video helped determine the course of action that was used to successfully treat her.

“A stroke is like a heart attack for the brain, where there is decreased blood flow,” says Dr. Vallabh Janardhan, an interventional neurologist at TMCP. “The challenges are having to identify that someone is having a stroke, when it started, and to do that in a time-sensitive way before there is too much damage to the brain.”

If caught early, within three hours from when the person was last seen as normal, the stroke can be treated with medication. If more time has elapsed, more intensive measures are used to remove blood clots that have formed in the brain, including the Solitaire FR, a new medical device recently approved by the FDA that is inserted via catheter, literally snags the clot and is then removed. That was used on this patient, because the treating physicians knew that she was outside the window for drug treatment, but well within the time frame for a stent-retrieval device, thanks to the recording.

“She was sitting with her fiancé on the porch, and her speech was becoming affected,” Dr. Janardhan says. “He had the presence of mind to take the video, because at first she would not come to the hospital. By the time they came, she was paralyzed on her right side and could not speak. Had he not been here with that recording, we would not have known when her symptoms started, and so would have taken longer to determine which therapy would be most effective for her. She could not tell me what was going on, but the video could.”

Within a couple of weeks, the patient had made an almost full recovery. Her mobility and speech were back to normal, and during her hospitalization it also had been discovered that she had an irregular heartbeat. That may have led to the stroke, so it’s now being treated and monitored. Her happy outcome gives Dr. Janardhan and other neurologists hope that a smartphone may be a new and unexpected ally in early stroke detection.

“More than 795, 000 people have a stroke every year, and only 3 percent to 4 percent make it to the hospital in time to get IV-drug treatment,” he says. “ We now have catheter-based therapies that can treat stroke patients up to eight hours and in some instances even beyond, but people are not connecting the dots at home and realizing that it’s a stroke. Mobile technology is one way to bridge that divide between the patient and the hospital.”