Monthly archive December, 2014

“Miracle Minstrels” choir demonstrates the wonder of singing after stroke

In honor of the holiday season, I wanted to share this article, profiling the Miracle Minstrels, a choral group in the Sacramento area comprised largely of stroke survivors with aphasia.

In the majority of people, language function is largely housed in the left hemisphere of the brain. A stroke or brain injury involving injury to these centers or pathways on the left side can result in language impairment. This is known as aphasia. Sometimes symptoms may be consistent with motor aphasia, also known as Broca’s aphasia, in which expressed language impairment exists while potentially sparing interpreted language (understanding what others are saying or retaining the ability to read written language). Sensory aphasia, also known as Wernicke’s aphasia, occurs when interpreted language is impaired, although the person may still speak fluently. However, the speech may not make sense to others. More commonly, there is at least some component of both aphasia types present, even if one aphasia type is more noticeable than the other.

miracle minstrels

The Miracle Minstrels, a singing group comprised mostly of stroke survivors with aphasia, performs at a holiday luncheon. Photo by Brian Baer, featured in The Sacramento Bee

A speech therapist in California, Renee Garner, and a stroke survivor, Barbara LaPlaca, started a choral group of aphasic brain injury survivors as a way to provide social engagement and to continue rehabilitation beyond speech therapy sessions. The brain’s musicality section, where musical familiarity, recognition, and production is generated, is housed in the right side of the brain. These creative individuals utilize music as a way of bypassing language impairment to allow patients to share their voices.

Among the countless ways the brain has amazed me during my time as a neurologist is witnessing the musicality that may be present in patients who are otherwise unable to speak. During my residency training, a hospitalized woman who remained completely silent for a week after a large left-brain stroke suddenly sprung to verbal life as a small group of us entered her room one morning, singing “Happy Birthday to You.” Overwhelmed by the familiarity of this tune (Do any of us actually remember the first time we heard this song?), she joined us for the fourth and final line. We then continued to sing the song a second time, not wanting the experience to cease, and she was able to vocalize some of the words as long as they were part of a song.

There is a memorable scene in Corrie ten Boom’s memoir, The Hiding Place, in which her mother, left severely aphasic after a stroke, suddenly starts to sing her favorite hymn when it is played at a wedding. Corrie sees this event as miraculous. Regardless of an individual’s religious beliefs, it is difficult not to experience awe and to marvel at the organization and processing capabilities within the human brain. It is fascinating.

My figurative hat is off to the Miracle Minstrels, for stepping outside of a comfort zone to perform in front of audiences after brain injuries have left them struggling with language, as well as to the founders for their clever idea and motivation to start such a group.


Sports columnist Tom Sorensen returns after intracerebral hemorrhage

Tom Sorensen, a Charlotte-based sports columnist known for infusing wit into his writings on sports in the Carolinas, has returned to print after sustaining an intracerebral hemorrhage. He emerged back into print in The Charlotte Observer this week, opening up about his journey since tripping on a curb in September of this year.

His story is another example of why medical attention should be sought when something just does not seem right neurologically. It also may provide hope to those out there struggling to recover from a brain injury. Life can be good again.


Read Tom’s story by clicking here.

Mistakes young stroke patients make

I will keep today’s post brief, but wanted to relay mistakes that young stroke patients frequently make in hopes that they will not perpetuate. Yesterday I saw a young stroke patient who decided to rest when symptoms began, so it is worth reiterating errors made and why these actions should be avoided.

  • Taking a nap/lying down when stroke symptoms begin. Remember, an ischemic stroke patient is only eligible for IV t-PA (the “clot busing” medicine) for 3-4.5 hours after a stroke begins, and with each passing minute that the brain does not receive blood flow, approximately two million cells will perish. When a stroke patient awakens from a nap, it is often too late to intervene. Call 911.
  • Driving himself/herself to the hospital. This is a terrible mistake for many reasons. A stroke patient is more likely to be involved in a motor vehicle collision if trying to drive while the brain is not receiving adequate blood flow/oxygen. Vision and cognition may be impaired. There could be delays in care with traffic on the road. Instead of being brought directly back to be evaluated by the emergency medicine physician, a patient may incorrectly be asked to wait in the triage area if not arriving by ambulance, which creates further delays. Do not drive to the hospital if you may be having a stroke.
  • Taking aspirin at home. Remember that 20% of all stroke are hemorrhagic, or “bleeding strokes.” Aspirin may worsen bleeding, and no one will know whether a stroke is ischemic (due to a blood clot blocking blood flow to the brain) or hemorrhagic until a head CT scan or MRI can be performed to visualize the brain.

I had the privilege of providing a basic overview about stroke on May 1, 2014 on a local news show in Charlotte, NC to start Stroke Awareness Month this year. If you are interested in viewing this, click here. Remember the FAST mnemonic for identifying stroke early so we can work to prevent disability from stroke.

  • Face – Is a facial droop present on one side?
  • Arm – If both arms are extended, and one drifts down due to weakness, this could be a stroke until proven otherwise
  • Speech – Is there slurred speech? Is there difficulty finding the words with which to communicate?
  • Time – Time is critical, as stated in the above points. Call 911.