Neuroscience Institute

How to Survive a Stroke: Precision Medicine and a Family’s Love

“That’s me, hooked up to everything.” Annie Barron is holding a heavy photo album, the cover showing her in a Critical Care Unit bed, barely visible among the tubes and blinking machines. In September 2017, 28-year-old Annie, was running errands with a friend when she suddenly got a headache, escalating to the worst pain of her life in about one minute. “They call those a thunderclap headache,” says Annie.

The thunderclap was blood building up in Annie’s brain from a ruptured arteriovenous malformation (AVM). A brain AVM is a tangle of abnormal blood vessels connecting arteries and veins. The faulty connections can increase pressure on the walls of the affected vessels, causing them to dilate and weaken over time. In Annie’s case the escaping blood into the surrounding brain triggered a catastrophic stroke.

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Thinking she was having a migraine, Annie made it home that day with her friend’s help. Like most people with the rare condition, Annie was unaware of the potential time bomb in her head, likely present since birth. She has no memory of telling her friend to go home, or that she’d sleep the migraine off. Later, a roommate found Annie having a seizure.

“Annie’s AVM was large enough that she quickly got very sick from it,” says neurosurgeon Robert Ryan, MD, who saw Annie the night of her seizure. “We had performed a cerebral angiogram and embolization of the AVM on her arrival, and had planned to remove it with an operation the next day. The way her condition progressed we had to do surgery overnight, not wait until the next day.”

Annie’s surgery became a race against time when the Critical Care team spotted an ominous sign: One of her pupils was starting to dilate, indicating potentially deadly pressure in her brain.

Dr. Ryan performed an emergency craniotomy, removing a section of Annie’s skull to find the safest path through the brain to eliminate the damaging blood. With the pressure decreased, the next goal was removing the AVM itself.

“We’re fortunate to have a multidisciplinary team providing the best environment for the brain and body to heal.”

“I remember waking up and there was a team around me, telling me what happened,” says Annie, who was unconscious for about three weeks following her stroke. “I don’t remember anything before I woke up, but I know I was never alone.”

Annie’s parents were at her bedside throughout the ordeal, her mom keeping a detailed journal that would later become the treasured photo book. It is now a way for Annie to reflect on those surreal weeks recovering in the hospital, completely dependent on family, friends and a hospital team to help rebuild her life.

“We’re fortunate to have a multidisciplinary team providing the best environment for the brain and body to heal,” says Dr. Ryan. “But many things contribute to healing well. All the supportive people in Annie’s life were a factor in her recovery, and she worked hard with rehabilitation. I was always impressed at our visits by the progress she’d made.”

After leaving the hospital, Annie lived with her parents for several months in Eugene, Ore., recovering well enough to return to her apartment near Seattle and her job as a dietary technician. While Annie has no permanent deficits following the massive stroke, she’s had to slow her pace. If she tries to do too much, exhaustion takes hold and she’ll forget things, but people around her understand. Annie can definitely live with that.

“So much good has come from this that even if I could go back, I wouldn’t change it,” says Annie. “I’ve never felt closer or more supported by my family and friends.”

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