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Young Stroke Patient Now Enjoying College

Last May, Sarah Mordis, 18, of Palos Park, Ill., stayed the night at a friend’s house after a graduation party. She was a healthy teenager, excited about starting college in the fall. That night while she slept, a blood clot lodged in her brain, and she suffered a brain attack, otherwise known as a stroke. She woke up disoriented and unable to move her left arm and leg. When she arrived at a nearby hospital, it was too late to administer an emergency clot-busting medication to reduce brain damage. Her stroke had happened many hours before, and the damage was already done. The goal at that point was to help her recover, find out what caused the brain attack and prevent another one.

Ms. Mordis was transferred to the inter-nationally recognized Stroke Center at Loyola University Health System (LUHS). The center has four neurologists who are board certified in vascular neurology – more than any other stroke center in the region. This certification acknowledges those American Board of Psychiatry and Neurology certified neurologists and child neurologists who have developed expertise in the field of vascular neurology.

Ms. Mordis’ neurologist, José Biller, MD, worked with a team of other specialists to uncover the cause of her stroke. Multiple diagnostic tests were performed to examine her brain, blood and heart for underlying abnormalities.

Stroke occurs when blood flow to the brain is disrupted by a blood clot (ischemic stroke) or when a blood vessel in the brain bursts (hemorrhagic stroke). Brain cells start to die in only a few minutes without blood. Some strokes are preceded by a mini-stroke called a transient ischemic attack (TIA), which can cause mild stroke symptoms or symptoms that last briefly. About 750,000 strokes occur each year in the United States in people of any age. Less than 5 percent are in people under age 45.

A heart abnormality, called a patent foramen ovale (PFO) was identified as the cause of Ms. Mordis’ stroke. It is a small hole in the wall that separates the right and left upper chambers of the heart (atria). The opening is normal in developing fetuses but usually closes after birth. As many as 20 percent to 25 percent of people have a PFO and never suffer any ill effects. In rare cases, the PFO allows a piece of clotted blood to travel from the right to left atrium and then to the brain where it causes a stroke.

Coincidentally, Israeli Prime Minister Ariel Sharon was found to have a PFO after his initial stroke in late 2005. Physicians can not know for sure if the PFO caused Prime Minister Sharon’s stroke. “In many cases, the PFO could be an innocent bystander,” said Dr. Biller, who is chairman of the Department of Neurology at LUHS. “In a young woman like Ms. Mordis, who has no other risk factors for stroke, a PFO is not likely to be an innocent bystander.”

Six out of 100 people with PFO who have suffered a stroke may have a second stroke or TIA within the following two years. Dr. Biller and his colleagues are investigating the best treatment for stroke patients with PFO through a clinical trial called Closure I. Ms. Mordis was eligible and chose to participate in the study, which will analyze the effectiveness – in terms of preventing stroke or TIA recurrence – of conventional blood thinning medications versus permanent closure of the PFO with a special implant. She was randomly assigned to receive the implant which was placed by Fred Leya, MD, an interventional cardiologist at LUHS.

“Sarah has made a remarkable recovery,” Dr. Biller said. The stroke initially caused total paralysis on her left side. She spent eights days in the Loyola University Hospital, 16 more inpatient days at a rehabilitation hospital learning how to walk again and regaining her strength, and many more days of outpatient speech and physical therapy.

She has some residual weakness in her left arm and tires more easily than in the past, but her classmates at Indiana University in Bloomington can barely detect the signs of stroke in Ms. Mordis, who is now in her freshman year studying business marketing and rushing for a sorority. “I was very excited to go to college. I was very determined. My friends and family were a huge part of my recovery. They helped keep me motivated,” she said. “I took it as a bump in the road – a big bump that’s for sure.”

For more information, visit www.luhs.org or call (888) LUHS-888 for an appointment. To find a facility in your area or a specialist, visit the Locations & Maps or Choose a Doctor areas of our web site.