I remember it like it was yesterday. Just before 7 p.m. on August 5, 2018, I was sitting in my living room, watching TV with my wife and son, when the sound of the TV faded away and was replaced by what sounded like the buzz of a thousand bees deep inside my right ear. The buzzing only lasted a few seconds but was followed with all-consuming dizziness and nausea. I was having a cerebellar stroke.
What Is a Cerebellar Stroke?
A cerebellar stroke occurs when there’s a lack of blood flow to the part of the brain (cerebellum) that helps with body movement, eye movement, and balance. They’re most commonly caused by blood clots, like mine was, but can also be caused by trauma.
Cerebellar strokes account for only about 10 percent of all strokes and are not easy to diagnose. They’re often mistaken as migraines, gastritis, meningitis or even inner ear infections. Without a quick and accurate diagnosis, cerebellar strokes can be severely debilitating — even life-threatening.
Luckily for me, Fadi Nahab, MD, stroke quality director for the Emory Healthcare Stroke Program, was able to identify what was happening to me. After looking over my MRI from the night of the stroke, Dr. Nahab told me that I’d actually had two strokes. He saw evidence of not only the cerebellar stroke but also of an earlier episode closer to the front of my brain. At some point, it seems, I’d had some type of minor stroke, probably while sleeping. I have no memory of it, but I learned there’s something called a silent stroke, which often has no symptoms but still causes damage to brain tissue. He was concerned that my heart may have been the cause of the stroke and recommended a small implantable cardiac monitor which soon detected an irregular heart rhythm called atrial fibrillation. As a result, I was able to get on the right treatment for me and have avoided any future strokes.
Life After a Stroke
When I think of how this could’ve turned out, I realize how lucky I am. I’ve made incredible progress with my recovery. There’s some lingering delay in my left hand—my typing isn’t as fast and accurate as it used to be, and playing guitar is harder than it was, but it’s all gotten better with repetition.
Strokes can leave a lasting impact on your life, and often those effects are more than just physical. I sometimes worry about the ‘what-ifs’ — What if I hadn’t made it? What if it happens again? Even though it’s easy to get sucked into the anxiety of worst-case scenarios, I try to quickly shift my focus back to reality. I’m here. I’m physically and cognitively intact. My son Joe, who is severely affected by cerebral palsy, needs me and I’m determined to stay healthy enough to continue caring for him. With the love and support of my wife, Jane, and the expert care of Dr. Nahab, I have confidence that I can look forward to many more years of happy evenings watching TV with my family.
Innovative Stroke Research Conducted by Dr. Fadi Nahab
There are known risk factors for stroke, including high blood pressure, high cholesterol, tobacco use, alcohol and drug abuse, poor diet and a sedentary lifestyle. But sometimes strokes occur in people who don’t have these risk factors. When the cause of a stroke is unknown, it’s called a cryptogenic stroke.
Dr. Nahab has conducted extensive research that concentrates on cryptogenic strokes. He and his colleagues have pinpointed blood biomarkers that identify patients most likely to develop future clotting abnormalities and are national leaders evaluating novel treatments through clinical trials to determine which patients may benefit.
“Studies completed more than a decade ago basically led to cryptogenic stroke patients being placed on an aspirin regimen and wished them good luck,” Dr. Nahab says. “But we’ve known for a while that patients who have had a cryptogenic stroke may have issues that necessitate blood-thinning medicine that is stronger than aspirin.” When it comes to the cause of strokes, Dr. Nahab wants to remove the ‘unknown’ from the equation. “The goal is to get patients the appropriate treatment before they have a recurrent stroke,” he says.
To learn more about the Emory Healthcare Stroke Center, visit our website at emoryhealthcare.org/stroke.