Advanced Stroke Procedure Saves Patient After Deep Brain Bleed

As she stumbled to the floor of her mother’s kitchen, clutching onto a breakfast plate, Cathy Alexander remembers saying, “Gee, I hope I’m not having a stroke.”

She was, indeed. And it was the most lethal type of stroke, an intracerebral hemorrhage (ICH), which results in a massive clotting of blood deep within the recesses of the brain. According to Mark Bain, M.D., a Cleveland Clinic neurosurgeon who treated Cathy, ICH is typically fatal for about 80 percent of patients and more than half of those who survive are severely disabled.

That’s why Dr. Bain, who happened to bump into Cathy and her husband, Mike, about three months after performing a revolutionary new surgical procedure on her using minimally-invasive technology, was so pleasantly shocked by her appearance.

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“To see somebody you operated on for a brain hemorrhage walking around like that, it’s amazing,” says Dr. Bain. “The stars really aligned for Cathy that day.”

That day was January 12, 2017. When Cathy, then age 59, fell to the floor while visiting her mother in Cleveland, Lorre Anzryszczyk took immediate action, called 911 and told the dispatcher that she believed her daughter was having a stroke.

That prompted the call for Cleveland Clinic’s mobile stroke unit, an ambulance specially equipped with emergency personnel, a CT scanner, point-of-care lab equipment and a telemedicine connection. Soon after arrival, the mobile team performed a CT of Cathy’s brain – and those results were immediately relayed to Dr. Bain and his team.

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“By diagnosing her condition in the field, we could prepare the ICU and the operating room, and plan our procedure – even before Cathy arrived at the hospital,” explains Dr. Bain.

Meanwhile, her husband Mike was preparing to deliver a presentation at his company’s sales meeting in Mobile, Alabama. His sister-in-law called to inform him of Cathy’s situation and that he needed to get to Cleveland … fast.

“My mind was going a million miles an hour,” recalls Mike. “I couldn’t comprehend what was going on.”

With help from his employer, Worthington Industries, Mike used the company plane for the two-hour flight to Cleveland. He had boarded, and was about to take off, when Dr. Bain called to explain the situation – and asked for his permission to try a new procedure.

“I asked him, ‘What are my options?’” says Mike. “He said, ‘You don’t really have any other option.’ So, I approved the procedure, and the plane took off.”

The procedure – being trialed at Cleveland Clinic and two dozen other U.S. hospitals – uses a syringe-like device to access the hemorrhage site by navigating through the natural folds and fibers of the brain. A surgeon makes a dime-sized incision, and slowly “pushes” the device to the problem area – gently moving brain matter to the side, like wind through a wheat field, until it reaches the hemorrhage, where blood is captured and removed.

Mike arrived in Cleveland just before Cathy’s surgery began. Two hours later, she was wheeled out of the operating room, passing by the waiting area where Mike and family members had gathered. “A nurse gave me a thumbs-up,” says Mike. “But we had no idea how she would be.”

Soon after, when she awakened, he got his answer: “I said ‘Hi, Mike,’” says Cathy. Adds Mike, “At least we knew she could talk!”

After 10 days at the Clinic, and a 17-day stay at a rehabilitation hospital near their Columbus residence, Cathy returned home. A year later, she estimates she’s regained 70 percent of “the old Cathy;” her cognitive function is almost completely restored, and she only uses a cane when outside the house.

“I’m not as good as new, but my daily routine is pretty much the same. I can drive, we can travel. I’m independent.”

Dr. Bain says Cleveland Clinic has performed about 80 of these surgeries for patients with ICH, brain tumors and vascular malformations. “Cathy’s was an eye-opening case. It shows that this approach really does help people with very serious brain problems,” he explains. “Our hope is that when the trial is complete, it will completely transform how we treat these patients.”