EvEry MinutE counts

Essentia Health Stroke Program Provides Fast, State-of-the-Art Care

// By connie wirta

Edina Kulaglic knew something was going terribly wrong in her body, and she knew she needed to find her husband. As she struggled to find the words to alert him, she collapsed in their condo.

“I tried to call my husband but I couldn’t speak,” Kulaglic recalls. Her husband, Shaid, heard her fall and quickly called an ambulance. That’s when things began going right for Kulaglic, who had just suffered a severe stroke.

Paramedics recognized Kulaglic’s symptoms and called in a stroke alert to the Emergency Department at nearby Essentia Health-Fargo. A specially trained team was waiting for her, ready to expedite the imaging and lab tests needed to confirm the diagnosis.

Dr. Ziad Darkhabani, an interventional neurologist, found the 53-year-old Fargo woman had a large blood clot in a major artery on the left side of her brain. It threatened an area that controls language as well as sensation and movement in the right arm and leg.

“Edina had a very severe stroke,’’ recalls Dr. Darkhabani. “It’s the worst side. Your language can be completely gone, so it can be devastating.”

Within 60 minutes of her arrival, Kulaglic began receiving a powerful clot-busting drug called tPA. It must be administered within 4 1/2 hours of the onset of symptoms, so prompt action by Shaid and the medical team began paying off.

Dr. Darkhabani used a special test and high-resolution imaging to determine nearby brain tissue had not yet suffered permanent damage. Because the clot was in a large vessel, there was a high possibility that tPA alone would not completely open it. So the interventional neurologist took the next step. Using a tiny catheter, Dr. Darkhabani guided a special stent to the blood clot. First he opened the artery to allow blood flow and then he carefully pulled out the clot now lodged in the stent.

“We were able to completely open the clot within 90 minutes of Edina’s arrival and that played the most important factor in her recovery,’’ says Dr. Darkhabani. “She’s made an amazing recovery.”

“I was so very lucky, so fortunate,” says Kulaglic, who has made a full recovery from her stroke. She also considers herself fortunate to have benefited from the expertise of Dr. Darkhabani, who had joined Essentia Health-Fargo shortly before she suffered her stroke last August.

Dr. Darkhabani and Dr. Michael Hill, an endovascular neurosurgeon, offer a new level of stroke care in the Fargo area. In the past, stroke patients like Kulaglic needed to be transported to specialists in the Twin Cities, which delayed care in situations where even minutes count.

Essentia Health’s Stroke and Neurovascular Center features a $3.2 million state-of-the-art diagnostic and surgical suite. This new hybrid suite offers the stroke team the most advanced equipment available to both diagnose and treat strokes, aneurysms and other complex neurologic conditions. Highdefinition, 3-D images help the physicians see a blood clot or hemorrhage in the brain and then navigate tiny catheters to the site for treatment.

“I was amazed at what Dr. Darkhabani could do and how much medicine had improved,” says Kulaglic, who had worked as a nurse practitioner back in Bosnia. “But I was just a patient, not that different than anyone else. I was scared. I listened to what the doctors said and I did what they said.”

After a hospital stay, Kulaglic spent time in a rehabilitation unit. Her right hand and leg wouldn’t go where she wanted, but she was determined to make them work. In speech therapy, she discovered she had reverted to her native tongue, Bosnian. Soon her hard-won English returned.

The stroke led doctors to discover that Kulaglic suffered from congestive heart failure. Her weakened heart produced the clot that caused her stroke.

Dr. Saeed Ally, an Essentia Health cardiothoracic surgeon, determined only 15 percent of Edina’s heart was working. He recommended four bypasses, which required open-heart surgery last December.

After surgery and cardiac rehabilitation, Kulaglic has made a great recovery. She’s proud to be back at work in the mailroom at the Fargo Forum.

“I’m fortunate that God gave us such men,’’ Edina says of her doctors. “They saved my life.”

To learn more about strokes and Essentia Health-Fargo’s Stroke and Neurovascular Center, call the stroke program coordinator at 701.364.4398.

Stroke symptoms

The American Stroke Association offers FAST as an easy way to remember the sudden signs of a stroke. If you spot these signs, call 911. The sooner a stroke victim gets to the hospital, the sooner treatment can begin and that can make a difference in recovery.

1. Face drooping: Does one side of the face droop or is it numb? Ask the person to smile.

2. Arm weakness: Is one arm weak or numb? Ask the person to raise both arms and watch if one arm drifts downward.

3. Speech difficulty: Is speech slurred? Is she unable to speak or hard to understand? Can he correctly repeat a simple sentence?

Time to call 911: Call even if the symptoms go away and get to a hospital immediately.

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