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When Minutes Count: Patient Saved by State-of-the-Art Comprehensive Stroke Center


By Michelle Brubaker   |   January 08, 2015

The day began like any other for hair salon owner Stefan Reisch. He was driving to work, listening to the radio, when he began rubbing his neck. It felt like he had a bruise. Suddenly, it seemed like he was on the verge of passing out. The left side of his body became numb. He found himself driving into the center divider.

“I felt like I was in a dream state. Cars were honking at me. I finally ran off the freeway and my car stalled. I kept trying to push the clutch, but my leg wasn’t moving,” Reisch, a father in his forties, recalled.

A motorist behind Reisch’s car called 911, thinking he was a drunk driver. But when first responders arrived, they discovered Reisch was in the midst of a stroke.

He was rushed by ambulance to UC San Diego Medical Center in Hillcrest – a designated comprehensive stroke center. The certification recognizes the significant resources in infrastructure, staff and training necessary to provide state-of-the-art complex stroke care. UC San Diego Medical Center was one of the first five certified comprehensive stroke centers in the nation.

“When a stroke happens, every minute counts. The faster you are diagnosed with a stroke and treated, the better the chances of recovery, which is why it’s critical patients having a stroke come to a comprehensive stroke center,” said Alexander Khalessi, MD, director of endovascular neurosurgery and surgical director of neurocritical care in the Division of Neurosurgery at UC San Diego Health. “As a leader in stroke care, we offer training to experts around the world on the most advanced technology and best practices.”

As soon as Reisch came through the emergency room doors, he was immediately evaluated by one of UC San Diego’s vascular neurologists. His medical care team said Reisch’s initial physical exam was highly concerning.

“We are given pre-notification of a stroke patient en route to our hospital,” said Royya Modir, MD, vascular neurologist at UC San Diego Health. “Because of this, we were waiting for Stefan in the emergency room upon his arrival. The left side of his face, arm and leg were paralyzed, and he was unable to see or perceive anything on his left side. It was obvious he was having a stroke.”

After a head computed tomography (CT) scan ruled out hemorrhage, Reisch was given tissue plasminogen activator (t-PA) , which dissolves clots and restores blood flow. More intervention was needed after the t-PA was administered, so the decision was made for Reisch to undergo an embolectomy – an emergency surgical removal of blood clots.

“Using state-of-the-art devices, we were able to go through the groin area and remove the blood clot that was on the right side of Reisch’s brain within 15 minutes,” said Khalessi, who is currently working with health care leaders and San Diego County officials to redefine stroke guidelines and improve patient care on a local and national level. “Our team saw almost immediately recovery as he started to move the left side of his body.”


After recovery, Stefan Reisch (far right) with his family.

Reisch vividly remembers the moment: “I was awake during the procedure and heard the surgical team yell, ‘We’ve got movement.’ It was such a relief. I could feel my strength coming back while still lying on the operating table.”

Khalessi and Modir say the most likely cause of Reisch’s stroke was a carotid dissection, a small tear in the artery that may have occurred while surfing. He was also found to have a genetic mutation, which may increase his risk of forming blood clots.

Reisch said he continues to recover every day. He is back at work and driving, but still notices some slight issues with his left arm.

“I received outstanding care by a multidisciplinary team at the UC San Diego comprehensive stroke center. The decision first responders made to take me to UC San Diego saved my life,” said Reisch, who has dramatically changed his diet to lower his cholesterol in an effort to prevent another stroke.

Experts strongly encourage anyone experiencing stroke symptoms, such as a facial droop, numbness, weakness, blurry vision or speech difficulty, to call 911 immediately.

“Even if what you are experiencing is not a stroke, it’s better to be safe than sorry,” said Modir. “Many times loved ones won’t call because the patient does not want them to, but patients having a stroke often do not have insight into their symptoms due to the brain damage occurring. Time is brain, call 911.”

The rapid stroke evaluation performed by the UC San Diego stroke team in this case is no longer limited to patients in San Diego County. With the launch of Telestroke, clinicians can extend their expertise to patients throughout the state, nation, even internationally, to provide acute stroke management guidance when and where it is needed.

"Our stroke telemedicine program has been active for more than 10 years. With this technology, we can bring instant expertise to the patient without geographic limitations or boundaries,” said Brett C. Meyer, MD, co-director of the comprehensive stroke center and medical director of telemedicine specialties at UC San Diego Health. "We have provided immediate treatment decisions regarding the use of thrombolytic therapy or other interventional techniques to several hundred patients who would likely have otherwise gone without this instant expertise.”

Care at UC San Diego Health

Neurological Institute

Stroke Center