This morning I awakened to the news that a US Senator from New Mexico, Ben Ray Lujan, had sustained a stroke in his cerebellum last week, diagnosed after he presented to the University of New Mexico Hospital with dizziness. Of course, the media was making it into a political Senate 50/50 split issue (and in a divided nation, this certainly seems to get the ratings these days), but I was thinking – I wonder if he is relatively young, as so many of my cerebellar stroke patients have been. And he is – 49 years old.
Which had me wondering if he could have had a vertebral artery dissection. Or was prone to forming blood clots because of an underlying condition. Or has a patent foramen ovale (a PFO – a tunnel between the right and left atria of the heart that is thought to permit blood clots to more easily reach the brain, rather than being filtered out by the lungs). I really don’t know what caused his stroke at this point, as I only know as much as is being released to the media, but I am concerned for him.
Reports are stating that he underwent “decompressive surgery” as part of his treatment. This means he developed enough severe swelling in the cerebellum that his doctors were concerned that the swelling could compress his brain stem and create a life-threatening situation. A decompressive suboccipital craniectomy involves surgically removing part of the skull on the back of the head to allow the cerebellum to swell outward, rather than pushing on the brain stem in such a tight, confined space. I won’t post an image here in case it causes anyone discomfort, but if you click here you can watch a video at the Neurosurgical Atlas website to see a demonstration.
Typically, patients who are diagnosed and treated early with cerebellar strokes do “well.” But what does “well” mean? In the world of stroke survivors, doing well usually means living independently, walking, talking, and eating. Many of my patients have told me that while they are back to independent living, they have not made a “full recovery.” They feel off-balance, particularly if they turn too quickly. Or they struggle with fatigue. Or headaches. Or double vision. Or some combination of the above. Sometimes cerebellar stroke patients can even have difficulty speaking because of language impairment, a condition known as aphasia. When I saw the statement from Senator Lujan’s office about him being expected to make a “full recovery,” I had my doubts, but I sincerely do hope that he has a very robust recovery and can celebrate the milestones along the way.
With a cerebellar stroke that is large enough to require a decompressive suboccipital craniectomy, the situation can become rapidly fatal without recognition and treatment. I am glad that he sought treatment and was appropriately diagnosed and treated. May his stroke also serve as an example to others about the importance of good, early stroke care.
4 comments
Nana Rose says:
Feb 2, 2022
My stroke came when I awoke hearing my hubby come home from our grand daughter’;s volley ball game. I could not see correctly. I could not sit. 911 put me in a office chair on wheels and pushed me to the ambulaNCE. I was out. They had me so doped up. Husband got to hospital to be informed Life Lite was on their way to the bigger hospital. Worst place to be. I woke after 5 days and had lost 11lbs. Kicked out after 5 days until Hubby yelled for help. I had also fallen. No one told hubby until we read the report later. Hubby was not going to take me home. He called a neighbor for a phone number to a nice rehab place. That lady came over quickly to see me and I went there for 6 weeks. It was heaven. Yes, it was a Vertrebal. cerebellar stroke on the right side and the left side was affected. It has been 4 years and my left balance is off and I sleep at all odd hours. I am in bed by 7:00PM every night and up around 3:30AM. Often I take a nap around noonish. I truly do not think it will get any better. I am glad I am doing as well as I am. On Eliquis. Crestor also. Hubby will not let me drive the car. But so what. I use a walker with the seat and a cane. I thank God every day.
Pat says:
Feb 2, 2022
My son suffered a stroke in his cerebellum/ arterial dissection at the young age of 36. He had been seeing a chiropractor and had many, many cervical 1 and 2 manipulations by his so called chiropractic friend/doctor. My son had a high pressure, demanding job and was prone to headaches. Even after suffering a thunderclap type of migraine, the chiropractor “treated” my son with a C1 manipulation…only making all previous damage from the cervical manipulations and develop8ng arterial dissection that much worse. My son “recovered” but to this day, almost 20 years later still suffers from the many symptoms described by Dr, Gehring. My son has never been able to fully work again at the profession of his post graduate education. I can only wonder if this young senator was being treated by a chiropractor. It is worth looking into. It is time for the medical profession to warn the public that high velocity low amplitude manipulation of the neck can cause life altering consequences if not death! Thank you Dr Gehring. for your post.
Pat Chevrier says:
Feb 2, 2022
I wonder if this young senator was being treated by a chiropractor and being subjected to the very dangerous high velocity low amplitude neck manipulation – one of the main treatments techniques of the chiropractic profession.
Elizabeth S Morgan says:
Feb 20, 2022
As an MD, mom, and athlete, who had a massive cerebellar hemorrhage—treated by a large 5 cm occipital craniectomy, I can say every day is both a challenge and a gift. We need to advocate for more research about the role of the “multiprocessor” cerebellum.