Issue No. 22
Young and at RiskDate: October 15, 2013
At age 47, Amy McDougall had no reason to think she was having a stroke. But that’s exactly what happened
I’ve always had migraine headaches, but in April 2012 I had this intense pain in the back of my head, along with a bad earache and toothache. And I’d shrugged off some fleeting numbness I’d had a few months earlier.
It was allergy season, so I thought maybe it was just sinus pressure, and when I saw a doctor he put me on antibiotics.
A couple of days later, I started hearing this extremely loud “whoosh” sound in my head. I was hot and flushed and sat down because I couldn’t figure out what I was supposed to be doing with a piece of paper I had in my hand.
My husband and daughter took me to the emergency room. They ran some tests, recommended I see a neurologist in the next two weeks and sent me home.
Later that night, in bed, the “whoosh” sound came back, and I told my husband. That’s the last thing I remember until I woke up in the same hospital. This time the doctor identified a blood clot within my brain and jugular vein, but without a neurologist available he suggested we go to Johns Hopkins.
There, they confirmed a blood clot in a vein on the left side of my brain and down the back of my head. I didn’t have any risk factors for stroke, other than a family history of clotting.
The team at Johns Hopkins put me on blood thinners, which I’ll probably be on for the rest of my life. But I’m doing great now; the pressure in my head is gone, and I’m so grateful I was able to walk out without any lasting problems.
Looking for Signs
Amy McDougall was fortunate to get a quick stroke diagnosis from Rafael Llinás, M.D., a neurologist at Johns Hopkins.
Some of the most common signs of stroke are numbness or weakness, especially on one side of the body; vision changes; a severe headache with no known cause; sudden confusion; and speech problems. McDougall’s only symptoms were a “whoosh” sound in her head—a form of tinnitus caused by a change in blood flow—and a speech abnormality, which might be why her condition went undiagnosed as long as it did.
Another factor in the delayed diagnosis could have been McDougall’s age. At 47, she typified a troubling trend: One in five strokes now occurs in people ages 20 to 55. The increased rate of strokes in younger adults is attributable to risk factors such as high blood pressure, smoking and hormonal birth control, but also greater awareness and better diagnostics.
Llinás is quick to point out that listening to a patient is just as important as looking at symptoms. To him, McDougall’s family history of blood clots was a red flag. “Clots can form in the brain as easily as anywhere else,” Llinás says. “The imaging is great, but it’s all about what the patient tells you about what’s going on. Nothing beats that.”
It’s important to tell your doctor about a personal or family history of conditions, including high blood pressure levels, high cholesterol levels or blood clotting disorders.
Watch a video
To watch a video of Amy McDougall telling her story, visit hopkinsmedicine.org/mystory. For more information, appointments or consultations, call 877-546-1872.