When Latoya Roberts had a stroke in April, she knew exactly what was going on. Roberts had suffered a mini-stroke the previous June. She is 26, previously healthy and didn’t have any of the typical stroke risk factors.
“Fortunately I knew what was going on because I work for a hospice company so I deal with a lot of nurses, doctors and patients,” Roberts said.
She was in the middle of doing her hair before work when her hands went numb. She sat down and when she tried to get up, she fell to her knees. When she tried to get up again, she fell to the floor. Her sister found her, called 911, and Roberts was rushed to Memorial Hospital West in Pembroke Pines, where she was treated at its Comprehensive Stroke Center.
Doctors determined the stroke occurred because of a pseudo aneurysm in Roberts’ left internal carotid artery in her neck, causing clots to break off and impede blood flow to the brain. The hospital’s neurointerventional team restored blood flow to her brain, started her on blood thinners and planned to treat the aneurysm.
Two days later, while she was being monitored in the ICU, she started showing stroke-like symptoms again. This stroke was much more serious, paralyzing Roberts’ right side and causing speech difficulty. The surgeon removed a large clot from the left carotid artery, and Roberts immediately began talking and moving her right arm while on the table. The surgeon then closed off the neck of the aneurysm with a stent, preventing further clots.
“Every minute, approximately 1.9 million neurons die, which increases the risk for irreversible injury,” said Dr. Brijesh Mehta, medical director of Stroke and Neurocritical Care at Memorial Healthcare System, who treated Roberts. “This type of outcome is a big success story, but it doesn’t happen all the time, unfortunately.”
Heart disease and stroke share many of the same risk factors — smoking, poor diet, obesity, high blood pressure. Some risk factors like oral contraceptives, pregnancy and post-menopausal hormone therapy leave women especially vulnerable to stroke and heart disease. African-American and Hispanic women are also at higher risk.
Stroke is the third-leading cause of death for women, and according to the American Stroke Association, women suffer more strokes than men. Heart disease, according to the American Heart Association, is the No. 1 killer of women. At about one death per minute in 2011, heart disease kills at a rate similar to all cases of cancer, respiratory disease and diabetes combined. Together, heart disease and stroke dwarf the numbers for any other health risk in women.
There are new developments in treating stroke and heart disease that improve survival rates, but doctors still say awareness is vital in seeking treatment quickly.
New treatments like stentrievers — catheter-like devices used to open up arteries — allow for more effective opening of arteries. Older drugs like IV tPA, which Mehta administered to Roberts, are effective in breaking the blood clots in ischemic strokes. However, IV tPA is only effective if administered within 3 to 4 1/2 hours from the beginning of the stroke, so an understanding of symptoms is crucial.
Memorial, because of its ability to administer IV tPA to stroke patients within the first 60 minutes of their arrival to the hospital, was designated as an “Elite Plus” program by the American Heart Association and American Stroke Association. More than 50 percent of Memorial’s stroke patients received the drug within 45 minutes of arriving.
“It was a huge milestone,” Mehta said. “But there are many times that people don’t call 911 for more than an hour after experiencing a stroke because they think it’s a headache or they’re tired or they’ll sleep it off. Data shows that greater than 60 percent of patients wait more than an hour before calling 911.”
Dr. Robert Hendel is the chief of the cardiovascular division for UHealth and director of the cardiac care unit at University of Miami Hospital.
“Cardiologists and neurologists have actually now started doing research specific to women. For many decades, even at the National Institutes of Health, and at the federal funding level, women were underrepresented in a lot of the clinical trials,” Hendel said.
Meanwhile, Roberts continues to work as a patient care secretary with VITAS Hospice.
“Dr. Mehta told me that I was lucky I was in the hospital for the second one because it was so much worse. Had it been any longer then maybe I wouldn't have gotten my speech back,’’ Roberts said. “I learned that time is important.’’