Duke neurologist diagnoses tricky underlying cause of stroke in a young patient

Duke neurologist diagnoses tricky underlying cause of stroke in a young patient


My girlfriend woke up and saw my arm was
twitching and I said, I can’t feel my arm.>>I received a phone call that
I thought I would never ever. It’s like a parent’s nightmare but I
received that call at 1:30 in the morning, but I immediately just said 911,
call, hurry. They immediately took me to intensive
care, but then they wanted to get the CT scan done, the MRI done, and it quickly
showed that I had a hemorrhagic stroke. They told me it was unknown ideology,
so we got a referral while I was in the hospital
from a neurologist I knew, Dr. Dodds.>>When I first met Brett,
he could not move his left arm. It was in a sling, it was completely limp. He couldn’t move his fingers. He had difficulty walking. He was able to walk with
a four-pronged cane. And when I looked at his MRI of his brain, what I noticed is that he had the
hemorrhage there that I expected to see, but he also had a separate area that
looked like an ischemic stroke. So that amazed and perplexed me because
it greatly limited what this could be. So at that point, we spent a lot of
time just talking about his history, his symptoms, did he have any fevers. And then suddenly he said,
yes, I did have a fever for several weeks before the stroke, and
then I asked him if he had a rash and he started telling me about this rash that he
had in his thoracic region on his trunk. And that sounded a lot like a shingles
rash and I looked at Brett, and his mom, and his girlfriend and said, I can’t tell
you with definitive certainty what this is right in this moment,
I need to go home and sleep on it. Dr. Dodds, I remember sitting down and her
asking about the weeks leading up to it. I knew that if anyone was gonna find out,
it was gonna be her.>>I woke up at about 4
o’clock the next morning and just thought it’s just got to be
Varicella-Zoster vasculopathy. So I went to the medical literature
at 4 o’clock that morning and found case reports with very
similar MRIs to Brett’s. I called him the next day,
told them what my theory was, we had to get the lumbar puncture set
up in his town because at that point, it was a very big deal for him to
have to travel up to Durham for care. As soon as his final
fluid came back positive, we begun antiviral therapy for him. That was when he really started
to do this amazing turnaround from a symptom standpoint. His arm started getting so
much better, his walking got better. Symptomatically, he is getting so
close to normal at this point. He’s just continuing to do very,
very well.>>It’s been eight months since my stroke
happened in the beginning of August. Was just a couple days ago, I ran two and
a half miles with my girlfriend.>>We thought we were gonna have
to accept the unknown ideology and just go through life not knowing.>>Had Brett not been diagnosed
with a Varicella-Zoster virus infection as the underlying
cause of his brain hemorrhage and his stroke, there is a possibility that he
could have had another brain hemorrhage. He could have another ischemic stroke. He could have had both. Stroke can happen to anyone at any age,
you’re never too young to have a stroke. There really needs to be more
awareness about how common this is and what a huge problem it is.

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