Julie Milanese Jensen
As Julie Milanese Jensen was shooting off her last email before going home from work at the end of a typical day, she looked down at her left arm and didn't recognize it as her own.
"It was around Halloween," she remembers, "and I thought my co-workers were playing a trick on me and had put a fake rubber arm next to mine."
But it was no joke: Milanese Jensen, then 26 years old, was experiencing dissociation - a rare symptom of stroke in which a person experiences a sudden mental detachment from him- or herself. Although unaware of it, she was also slurring her words. Her co-workers immediately called 911.
Numbness in one arm or leg, as well as speech or vision problems, may signal a stroke. These symptoms occur because the blood supply to the brain is temporarily reduced, resulting in an ischemic stroke. Strokes are not uncommon in people 15 to 45 years of age, and are also the second leading cause of death among women worldwide.
"At UCSF's Stroke Center, we have 24/7 neurologist coverage, newer imaging technology and trained doctors who use cutting-edge therapy for the treatment of stroke," says Vineeta Singh, MD, a critical care neurologist who treated Milanese Jensen. "The key step in successfully treating acute stroke is rapid diagnosis. Not all hospitals have full-time staff who are trained in recognizing the various stroke signs and symptoms."
Within 15 minutes at UCSF, Milanese Jensen was diagnosed with a severe embolic stroke caused by a blood clot, or embolism, which was blocking the blood supply to her brain. This prevents oxygen and nutrients from reaching brain cells, sometimes causing permanent brain damage or even death.
"Getting treatment fast is an essential part of improving chances for recovery in acute stroke," Singh says. "Had Julie not received treatment right away, her odds of having severe neurological disability or death would have been higher."
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Upon arrival at the hospital, Milanese Jensen agreed to receive a thrombolytic drug that she was told might help dissolve the blood clot lodged in her brain. To be effective, the drug must be given within three hours of the onset of symptoms.
The treatment saved her life, but now doctors were trying to determine what had caused a healthy, athletic 26-year-old to have a stroke.
Among other diagnostic tests, Milanese Jensen had an echocardiogram, which uses sound waves to produce detailed, moving images of the heart. Doctors discovered that Milanese Jensen had a condition called a patent foramen ovale (PFO), which is a small hole located between the upper two chambers (atria) of the heart. Normally, this hole closes after birth, but in 25 percent of people, it remains open.
Although most people with a PFO never experience any problems, it is the greatest risk factor for strokes in adults. If an adult with a PFO has a blood clot in a vein in his or her leg, the clot can travel through the PFO from the right side to the left side of the heart and into the brain, where it can become stuck, thus blocking normal blood flow to the brain and causing a stroke.
Her doctors told Milanese Jensen that they would have to repair the hole. In the past, her condition would have required open heart surgery and a long recovery time. However, now heart specialists successfully close PFOs with a nonsurgical procedure that involves cardiac catheterization and a special device that acts as a patch to cover the hole between the right and the left atrium.
Milanese Jensen's PFO closure was conducted in the UCSF Cardiac Catheterization Laboratory, where experts perform more than 425 catheterization procedures each year for heart defects. Two days later, she was released from the hospital.
"There was no physical recovery time, and I felt completely like myself afterwards," says Milanese Jensen. "I feel very lucky that everything turned out so well. I had many angels on my side the day of my stroke, and I keep in touch with all of them: my doctors, paramedics and co-workers."
Within three months after her stroke and PFO procedure, Milanese Jensen was back at work and planning her wedding. Now 28 years old, Milanese Jensen is married and the director of custom solutions for Fox Interactive Media. She says she is back to being herself - though with a few major improvements.
"My experience has totally changed my outlook on life," says Milanese Jensen. "I think of it as a wake-up call. Now I try to be more balanced and realize that life is very precious. I spend a lot more time with family and friends, rather than in the office."
For more information about the Stroke Center or to make an appointment, please call the 415/353-1489.
Source: Abby Sinnott
Photo by Christine Jegan
Links:
UCSF Medical Center
