NSLHD News February 11 2022

Stroke patient makes miraculous recovery following game of Oztag

It was during a social game of Oztag that Alessandra Marcelo started feeling pain in her neck, but she didn’t think much of it until a few hours later when she realised the pain was something much more serious. When she got home from the game, 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.”

Royal North Shore Hospital 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 blood supply to her brainstem. “Fortunately the stroke thrombectomy procedure was successful and we were able to reperfuse the brainstem and the visual cortex. “After the procedure I was still uncertain whether she would have sustained a severe brain stem injury from the stroke but to everyone’s great relief she woke up completely neurologically intact.” Alice said Alessandra’s recovery is a result of the teamwork and close collaboration of multiple specialty teams at Royal North Shore Hospital. “The ICU team were 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

Alessandra Marcelo had a stroke following a game of Oztag

her surgery. “I received the best care from all the doctors and nurses who were all so kind and compassionate towards me,” she said. “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 dissection during a game of Oztag is very unusual, and I’ve got an appointment with the genetic clinic to see if I have any predisposing genetic factors.” A keen ballet dancer, Alessandra said she is excited to get back into dancing and, of course, Oztag. “Dr Ma said the vessels are healing up nicely, so hopefully at my next appointment I get the all clear,” she said. removed the clot. “To suffer an artery


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