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Hemorrhagic Stroke and Facial Paralysis: Maggie’s Story

A talented actress fights to get her life back after a hemorrhagic stroke and facial paralysis.

Maggie on stage.

A Devastating Stroke and Life-saving Surgery

“B-E…G-R-A-T-E-F-U-L.”

As her sister slowly recited the alphabet, the young woman on the bed squeezed her hand, signaling one letter at a time. This was how Maggie communicated now.

Her family, hastily gathered at her bedside, wondered if this would be Maggie’s last message to them as the neurosurgical team hurried to prepare her for emergency brain surgery.

A week before, in December 2014, Colorado native Maggie Whittum seemed to have it all: health, talent, and a bright future. She had directed and performed in Scotland, South Korea, Taiwan, Hong Kong, China and Canada. She was working toward a master of fine arts degree in acting in Washington, D.C., and was engaged to be married.

But then there was the headache, which two days later brought Maggie staggering into a Washington, D.C. emergency room. Like a building wave, her symptoms became more and more terrifying: double vision, numbness, worsening paralysis. Within 48 hours, Maggie couldn’t breathe on her own and needed a ventilator. She’d had a massive hemorrhagic stroke — at age 33.

The cause was a cavernoma, a bulging berry-like abnormality of blood vessels that can cause bleeding. In Maggie’s case, the location of the cavernoma — in a part of her brainstem called the pons—made it particularly dangerous. She was transferred to The Johns Hopkins Hospital, one of the few neurosurgery centers prepared to address such a serious condition.

“She’s remarkable,” says Judy Huang, the Johns Hopkins neurosurgeon who performed the life-saving procedure on Maggie. “The bleeding was in a very delicate part of the nervous system that controls basic functions such as breathing and consciousness.

“So even though she was paralyzed and had a breathing tube in place, she was fully aware of what was happening to her,” explains Huang.

Maggie has only fragmented memories of the days before her surgery, but recalls meeting Huang as the family gathered around for a meeting. “[Huang] talked to me,” Maggie says. “Sometimes people don’t. They treat you like a piece of furniture. But she spoke directly to me.”

Nine hours of surgery later, Maggie was out of immediate danger.

Huang says, “The whole time I’m in the OR, I’m thinking: ‘Here’s a young, talented woman just a few months from getting married, and here we are working in her brainstem.’ When I knew I was able to get the whole [cavernoma] out, that was reassuring — we knew there was less chance of it bleeding again.”

But Maggie’s challenges were just beginning.

Stroke Recovery and Facial Paralysis

Maggie recalls, “I was young and healthy and didn’t really know much about stroke; I didn’t get the gravity of it or realize what I was up against. When I was being discharged from rehab, I was thinking, ‘I’m not moving like I used to. I thought I’d return to where I was.’

“People were telling me that only 10 percent of stroke survivors make it all the way back. But I was determined to do everything I could to be in that 10 percent.

“After the surgery, Dr. Huang didn’t say I’d ‘never’ do any particular thing. But she was clear that my face might not move anymore. My facial nerve was totally destroyed by the hemorrhage. Half my face looked like it was melting, like wax. I was horrified by the way I looked — I wouldn’t look in the mirror.”

Two months after brain surgery, Huang asked Maggie if she’d thought about consulting the facial plastic surgeon team.

Maggie riding a recumbent tricycle.

Surgery for Facial Reanimation

For an actor, facial paralysis can be a devastating loss. When Maggie met with Patrick Byrne, director of the Facial Plastic and Reconstructive Surgery Center at Johns Hopkins, she found herself struggling to accept her situation.

“[Byrne] was awesome and empathetic, but I was still hoping I’d be better in six months on my own. Dr. Byrne’s office put me in touch with another young woman who had undergone a hypoglossal nerve transfer for facial paralysis. I was so glad to speak with her about the experience.  It really helped me make the very difficult decision to get the surgery.” 

Byrne recalls, “Maggie presented with a challenging facial reanimation case. In many instances of facial paralysis, our team moves a nerve called the fifth cranial nerve to reanimate the side of the face.

“However, Maggie’s fifth cranial nerve was too damaged by the hemorrhage, so we enacted a ‘plan B’ of sorts and instead used the 12th cranial nerve, also known as the hypoglossal nerve. We relocated it to the side of Maggie’s face that was affected by the stroke, and also placed a weight in Maggie’s eyelid so her eye could completely close.

“Maggie’s young age was in her favor, but now, with the newer techniques we have available, we can restore emotion and facial expression even in older people with great results.”

Maggie says, “The facial reanimation surgery went so well and I was so grateful. The care was phenomenal; the people so intelligent.” But she knew the results wouldn’t be immediate, and that restoring her facial balance would take months of therapy and hard work.

Then, another blow: Maggie and her fiancé parted ways. She went home to Colorado. Unable to drive, she wanted to make sure she had access to good public transportation, so she moved to Denver.

On her mind now: resurrecting her career.

Maggie didn’t ask for any of this. But she’s speaking publicly, performing, and helping others with the same problems. She’s coming up with ways to make them laugh, deal with their symptoms. It’s a mission—one with more impact than she imagines.

- Maggie's neurosurgeon Judy Huang

A New Life and Mission

Years before her stroke, Maggie had seen a unique theater group that made its home in Denver: the award-winning Phamaly Theatre Company. The group comprises actors with various physical, cognitive and emotional challenges.

Maggie contacted them, auditioned, and won a part in a musical production. Soon she was on stage at the Denver Center for the Performing Arts, accompanied by a great cast and a full orchestra.

She was back. Or rather, moving forward.

She says, “Having a stroke is disempowering. You feel shame, grief, worthlessness. I was unable to go back to school and be independent. But getting back on stage was great.” She says that she’s already in another production slated for the summer of 2019.

In the meantime, Maggie has added another role to her repertoire: educating the world on what it means to have your physical ability, looks and life plans derailed by a stroke. She visits Johns Hopkins yearly for a presentation to medical students, residents, and surgeons.

Huang notes that during Maggie’s talk, even some of the toughest, most experienced doctors are moved to tears.

Huang marvels: “Maggie didn’t ask for any of this. But she’s speaking publicly, performing, and helping others with the same problems. She’s coming up with ways to make them laugh, deal with their symptoms. It’s a mission—one with more impact than she imagines.”

Meet Maggie's Treatment Team

Photo of Dr. Patrick Joseph Byrne, M.B.A., M.D.

Byrne, Patrick Joseph, M.B.A., M.D.

Expertise, Disease and Conditions: Bell's Palsy, Blepharoplasty, Botulinum Toxin Injections, Brow Lift, Chemical Peels, Cleft Lip, Cleft Palate, Cosmetic Surgery, Cosmetic Surgery of the Face, Craniofacial Injuries, Craniofacial Reconstruction, Craniomaxillofacial Trauma and Reconstruction, Dermabrasion, Dermal Fillers, Eyelid Malposition, Eyelid Reconstruction, Facelift, Facial Aesthetic Surgery, Facial Cosmetic Surgery, Facial Lesions, Facial Nerve Disorders, Facial Paralysis, Facial Plastic Surgery, Facial Reanimation, Facial Reconstruction, Facial Scar Revision, Facial Trauma, Free Muscle Transfer, Gracillis Muscle Transfer, Hypoglossal Nerve Transfer, Microvascular Free Tissue Transfer, Microvascular Reconstruction, Mohs Surgery, Nerve Grafting, Otolaryngology, Reconstruction of Facial Skin Cancers, Revision Rhinoplasty, Rhinoplasty, Synkinesis, Temporalis Muscle Tendon Transfer (T3), Torn Ear Lobe Repair
 
Photo of Dr. Judy Huang, M.D.

Huang, Judy, M.D.

Expertise, Disease and Conditions: Acute Stroke Care, Aneurysm Repair, Aneurysmal Subarachnoid Hemorrhage (ASH), Arteriovenous Malformations (AVM), Brain Cancer, Brain Hemorrhage, Brain Metastases, Brain Tumors, Carotid Artery Disease, Carotid Artery Stenosis, Carotid Endarterectomy, Cavernous Angioma, Cavernous Malformations, Cerebral Aneurysms, Cerebral Revascularization, Cerebral Vascular Malformations, Cerebrovascular Diseases, Cervical Degenerative Disc Disease, Cervical Disc Herniation, Cervical Spine Disease, Chiari Malformations, Complex Skull Reconstruction, Cranioplasty, CyberKnife and stereotactic radiosurgery, Dural Arteriovenous Fistulas, Intracerebral Hemorrhage, Intracranial Aneurysm, Ischemic Heart Disease, Meningiomas, Metastatic Brain Tumors, Microsurgery, Microvascular Surgery, Moyamoya Disease, Neurological Surgery, Neurosurgery, Neurovascular Disease, Primary Brain Tumors, Skull Implants, Skull Lesions, Spinal Dural Fistula, Spinal Vascular Malformations, Spine Surgery, Stereotactic Radiosurgery, Stroke, Stroke Imaging, Stroke Prevention, Stroke Recovery, Stroke Rehabilitation, Subarachnoid Hemorrhage, Syringomyelia, Transient Ischemic Attack
 
Illustrated brain

About Hemorrhagic Stroke and Facial Paralysis

A stroke happens when blood flow to the brain is stopped. Brain cells begin to die after just a few minutes without blood or oxygen. A hemorrhagic stroke occurs when a blood vessel in the brain bursts, spilling blood into nearby tissues. The resulting pressure and blood flow interruption cause damage that may include facial paralysis – inability to move the muscles of the face on one or both sides.

Learn more about stroke.

Learn more about facial paralysis.

Dr. Judy Huang in the operating room with a patient scan.

Stroke Treatment at Johns Hopkins

The Johns Hopkins Cerebrovascular Center is dedicated to providing the best prevention, diagnosis, treatment, care and outcomes for patients with a range of cerebrovascular disorders, including stroke. When developing plans for our patients, we focus on a cooperative approach.

Learn more about the Cerebrovascular Center.

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