University of Missouri

In the Nick of Time

Stroke patient’s journey proves that every second counts
In the Nick of Time

The Missouri Stroke Program team includes, from left, Ashish Nanda, MD, co-director and neurointerventionalist, William Humphries III, MD, cerebral vascular neurosurgeon, Niranjan Singh, MD, co-director and neurologist, Vikas Gupta, MD, neurological interventionalist, Brandi French, MD, neurologist and director of the inpatient neurosciences program, Tami Harris, RN, program coordinator, and Debbie Self, office support staff member.

On most afternoons, Latisia Wiggins’ pet Chihuahua keeps her company while her daughter, Lorinda Webb, is at work. So, it was a strange coincidence that on the afternoon of Jan. 29, 2015, her daughter happened to be at their home in Brookfield, Missouri.

“One minute I had fixed her a grilled cheese and she was sitting down to eat it and the next I hear her moaning from the living room,” Lorinda said.

What Lorinda thought was the sound of her mom’s moaning was actually Latisia trying to talk to her. But the left side of her face had become paralyzed. Latisia was having a stroke, and, in addition to the sharp pain she felt on the right side of her head, she was panicking because she could not move her arms or legs.

“I told her that God intended for her to be there because had she not been there, I would have died,” Latisia said.

Latisa Wiggins

Latisia Wiggins, shown with her dog, Darla, at home in Brookfield, Missouri, is thankful for the emergency care she received at University Hospital following a stroke.

Minutes later, the ambulance crew arrived and the decision was made to transport Latisia via helicopter from Pershing Memorial Hospital in Brookfield, Missouri to Columbia. Lorinda requested that her mother be taken to the University of Missouri.

The next thing Latisia remembers, she was being awakened after surgery by a nurse in University Hospital’s Neurological Intensive Care Unit.

Fifteen minutes before Latisia’s helicopter touched down, the stroke team at University Hospital in Columbia was activated and waiting for her. By the time daughter Lorinda completed the 1.5-hour drive from Brookfield to University Hospital, Latisia was already in recovery. The stroke team updated her along the way.

Twelve miles outside of Moberly, Missouri, Lorinda received several phone calls within five minutes. First, a pharmacist called to let her know about the medication being administered to her mother, then a nurse called to let her know Latisia would receive medication to break up the clot. Vikas Gupta, MD, neurological interventionalist, then called to let Lorinda know they were taking her mother in to surgery.

Making every second count

The longer a stroke goes untreated, the greater the potential for brain damage and disability. In 2014, the stroke team at MU Health Care treated approximately 61 percent of eligible stroke patients with the clot-busting drug tPA in less than 45 minutes after they arrived at University Hospital’s emergency room. Nationally, only 24 percent of eligible patients are treated in less than 45 minutes.

Certified Excellence

MU’s stroke team includes experts in neurology, neurosurgery, physical therapy, cardiology and emergency services, among other specialties. MU’s stroke program includes:

  • three board-certified vascular stroke neurologists
  • three neuro-interventionalists
  • the only neurosurgery cerebral vascular physician in central Missouri
  • a dedicated stroke clinic
  • a leading-edge diagnostic and treatment facility for patients with complex neurological disorders
  • a neuroscience intensive care unit dedicated to patients who require critical care and evaluation

University Hospital has been designated one of the state’s first Level I Missouri State Time Critical Diagnosis Stroke Centers, the highest recognition a hospital can receive for its stroke program. University Hospital’s stroke program is also certified as an advanced primary stroke center by the Joint Commission.

The program is a member of the American Heart Association’s Target: Stroke Honor Roll-Elite Plus and has received the Stroke Gold Plus Performance Achievement Award.

Latisia Wiggins received tPA within 32 minutes of her arrival. After receiving tPA, Latisia underwent surgery. Ashish Nanda, MD, co-director of the Missouri Stroke Program, removed a 5 cm clot from Latisia’s right middle cerebral artery, which supplies blood in the brain. It was four to five times larger than what is considered to be a normal-sized clot, Nanda said.

“When Latisia arrived at University hospital, we classified the severity of her stroke on the NIH stroke assessment scale with a score of 12,” Nanda said. “Anything above a 10 on that scale we consider to be a severe stroke with the likelihood of a worse outcome for the patient. What’s remarkable about Latisia’s case is that less than 24 hours after she arrived in our care, she had just trace weakness on her left side. Her symptoms were pretty much completely resolved.”

If Latisia’s stroke wasn’t treated at the right time by a specially trained team, she might have been permanently disabled. “There are three key factors in this case that likely contributed to Latisia’s outcome,” Nanda said. “First, she was transferred rapidly. Secondly, the team at MU Health Care was able to complete all of the imaging needed and administer the tPA medication quickly. Third, we were able to get her to the catheterization laboratory very quickly after that.”

Both Latisia and her daughter agree that while they didn’t like the reason they were there, the care they received at University Hospital was phenomenal.

“I’ve never seen a doctor care for a patient in the way that they do,” Latisia said. “You have some of the best nurses and doctors ever, and I would recommend them to anyone who needs neurological care.”

“The timing of this case really exemplifies our streamlined approach to stroke care of all of our patients that arrive in the emergency room and it is just getting better,” said Pradheep Sahota, MD, professor and chair of the Department of Neurology.

“The stroke team was wonderful,” Lorinda said. “They told me when she arrived at University Hospital that she had a 50 percent chance she wouldn’t be able to use the left side of her body again, but she can.” Latisia and her daughter have been impressed by the level of follow-up care. Gupta calls weekly to check on Latisia’s condition.

Do you know the signs of a stroke? Learn about the symptoms at www.muhealth.org/stroke.