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Overcoming the odds
REMARKABLE RECOVERY: From left, Richard and Barbara Collard, Rost and Rabinov
EVEN UNDER the most challenging odds, patients can make remarkable, unexpected recoveries. Barbara Collard is one such patient. In July 2008, she suffered a serious brain-stem stroke, a deadly condition affecting the blood supply to areas of the brain vital to basic life support functions. Despite a poor prognosis, Collard has made a complete recovery thanks to her perseverance, the support of family and the care she received.
Collard was rushed to the MGH after collapsing at work. An acute neurologic examination showed she was unresponsive to a variety of stimuli, and a CT angiogram revealed both a blockage of the left vertebral artery in her neck and a clot that had moved into the basilar artery, which supplies the brain stem.
"Embolic strokes in the posterior circulation are a life-threatening situation," says James Rabinov, MD, an interventional neuroradiologist in the MGH Vascular Center. "We talked with Barbara's husband and children about the range of possible outcomes. We were not sure if she would have much quality of life, but her situation was not hopeless so they chose to give her every chance possible."
Rabinov performed an endovascular procedure targeting the blood clot. He navigated a catheter through her blood vessels to the site of the clot and used a variety of techniques to restore blood flow. Natalia Rost, MD, a neurologist with the MGH Stroke Service, helped make treatment decisions, monitored indicators of Collard's future neurological health and kept the family updated about the team's progress.
After the procedure, Collard spent seven days in the Neurological Intensive Care Unit and 16 total days at the MGH. She was then transferred to a rehabilitation hospital where she continued her remarkable recovery.
"My whole right side was gone," Collard says. "I couldn't walk, talk or eat, but the next week I was on my feet moving around. I worked hard because I wanted to talk again. I have too many grandchildren to enjoy, and I'm too young to be stuck in a wheelchair."
Collard was at the rehabilitation hospital for two weeks before returning home to New Bedford. Within a year, she was walking without a cane and had no trouble with her speech.
"I didn't recognize her the first time she came to my clinic for a follow-up appointment," says Rost. "I was in the waiting room expecting someone in a wheelchair, and she was just standing there smiling at me. Moreover, she has continued to improve every time I have seen her since."
To help raise awareness of stroke, Collard was one of 75 survivors to gather at the Massachusetts State House May 11 to mark American Stroke Month. The Massachusetts Department of Public Health reports that stroke is the third leading cause of death in the state.
"I'm amazed at how I came through it all, just amazed," says Collard. "I hope I can offer some hope that it is possible to survive a brain-stem stroke. It can be done."
Collard's case will be published in the Journal of Neurointerventional Surgery.