2022 - Year in Review

Alessandra Marcelo

Pain in neck turns out to be stroke

It was during a social game of Oztag that Alessandra Marcelo felt pain in her neck, but didn’t think much of it until a few hours later when she realised the pain was something much more serious. Upon returning home, the 28-year-old physiotherapist said the room started spinning. “I had to lie down and I was vomiting,” Alessandra said. “As a physio, I started thinking this could actually be a torn artery in my neck, or a vertebral artery dissection, which is classified as a medical emergency. “I told my partner to call an ambulance straight away and I was taken to Blacktown Hospital to be assessed and a CT scan showed the dissection.” A vertebral artery dissection is considered a medical emergency due to the risk of a blood clot and the risk of the clot dislodging and going up to the brain, like it did for Alessandra. “As a result of the dissection, I had a basilar ischemic stroke where a blood clot blocked off my basilar artery which provides oxygen-rich blood to the brain,” she said. “Thankfully I was already in hospital when I had the stroke, and at that point the doctors knew I had the dissection so were already consulting with my specialist

at Royal North Shore Hospital and discussing my treatment and planning my transfer from Blacktown.” RNSH Interventional Neurologist Dr Alice Ma said Alessandra was lucky to survive the catastrophic stroke. “What was initially a small injury to the vertebral artery developed into a severe stroke” Alice said. “Alessandra’s case was particularly complicated as she had bilateral vertebral artery dissections further compounding the effects of the clot blocking her brainstem. “Fortunately the stroke thrombectomy procedure was successful and we were able to reperfuse the brainstem and the visual cortex. I was still worried she would have a severe brain stem injury or a visual impairment but almost miraculously she woke up completely neurologically intact.” Alice said Alessandra’s recovery was a result of the teamwork and close collaboration of multiple specialty teams at RNSH. “The ICU team was particularly crucial in her post-operative care, optimising her hemodynamic management to allow time for her blood vessels

to start healing,” she said. Alessandra spent nearly two weeks in the ICU following her surgery. “The surgery itself was

incredible, it just blows my mind to think that Dr Ma went through my leg all the way up to my brain and removed the clot,” she said.

NSLHD 2022 Year in Review 13

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