Watch: Opening skull to let brain heal from stroke.

The brain surgery on Feb. 11 at Scripps Green Hospital in La Jolla marked a major milestone in one stroke victim’s journey of recovery.

That journey began when the patient, a 40-year-old woman, was rushed to the hospital after suffering the most common type of stroke — one caused by a blood clot in the brain.

Typically, physicians would put a catheter into a person’s femoral artery in the leg and snake it all the way to the brain so the clot can be removed. But the technique wasn’t feasible for this patient because of damaged tissue in a key area.

Staff members at Scripps Green had to make a quick decision because the patient’s brain was swelling. Left untreated, the enlarged brain would shift because of tremendous pressure within the skull.

“We got a call … right before midnight. We sent in an emergency surgical team. Her brain swelling was worsening, the brain was starting to shift and it became a life-threatening situation,” said Dr. Rene Sanchez-Mejia.

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After talking with the patient’s family, Sanchez-Mejia and the Scripps surgical team opted for a hemicraniectomy.
This surgery involved opening the patient’s skull and removing part of a cranial bone flap so her brain would have room to swell. The flap was stored in a special freezer for eventual reattachment.

The patient was quite sick for several weeks after the hemicraniectomy, Sanchez-Mejia said. She was eventually able to walk again and recovered some of her language and comprehension skills.

“She went from almost dying and essentially being in a comatose state to regaining some functional independence,” Sanchez-Mejia said.

After the swelling went down, he and the Scripps surgical team reattached the bone flap — securing it in position with titanium clips.

Sanchez-Mejia said this type of decompression surgery for stroke victims is underused even though some studies have shown positive results for most stroke patients who undergo the procedure.

Several weeks after her brain surgery, the patient is continuing her physical therapy, regaining her motor skills and recovering her linguistic abilities in both English and her native Russian, according to Scripps.

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