December 6 – 2:00 PM
Renato Iozzo is finishing his Christmas shopping just blocks away from Thomas Jefferson University, where he has long served as the Gonzalo E. Aponte Endowed Chair Professor of Pathology, Anatomy, and Cell Biology. As the pathologist continues to shop, he begins to feel funny.
He wakes up just a minute later to find himself lying on the floor, unable to move the right side of his body. Knowing something was seriously wrong, store cashiers quickly dial 9-1-1.
December 6 – 2:20 PM 20 minutes
EMS personnel have arrived at Thomas Jefferson University Hospital’s emergency department (ED), a key part of the hospital’s Joint Commission-accredited comprehensive stroke center. Just minutes after arrival, emergency personnel activate a hospital stroke alert.
Dr. Fred Rincon, Comprehensive Stroke Program Director at the Vickie and Jack Farber Institute for Neuroscience, explained what happens during a stroke alert. “A group of experts and stroke specialists meet the patient at the ED’s launching pad where they measure the blood pressure, blood sugar, and stroke severity. At the same time, technicians in the radiology department reserve direct access so that patients can obtain an emergent CT-scan of the brain and paramedics prepare further transport to rush the patient to the Interventional Neuro-Radiology (INR) Suite.”
December 6 – 2:30 PM 30 minutes
Matthew Bokhari, MD, a neurologist undergoing advanced training in stroke, arrives to Dr. Iozzo’s bedside. Dr. Iozzo is now being transported to a CT scan machine to see what kind of stroke Dr. Iozzo was having.
Dr. Iozzo’s CT scan showed he was having the most common kind of stroke, called an ischemic stroke. This is when a clot prevents blood from getting to the brain. Further imaging, done right after his CT scan, showed that the clot blocked his left middle cerebral artery, or MCA. This was preventing blood flow to key structures in the brain, including his brain’s centers for speech, language comprehension and movement for many of the body’s limbs.
December 6 – 3:00 PM 1 hour
tPA, a powerful clot busting drug, is given to Dr. Iozzo. But given the severity of his stroke, he also requires a minimally-invasive procedure to actually remove the clot from his brain. He is quickly moved to Jefferson Hospital for Neuroscience INR Suite, our area’s only hospital dedicated to the treatment of neurological disorders.
December 6 – 3:45 PM
Once at Jefferson Hospital for Neuroscience (JHN), Dr. Stavropoula Tjoumakaris, Associate Professor of Neurological Surgery, begins the procedure that will remove Dr. Iozzo’s clot. Using real-time x-ray guidance, Dr. Tjoumakaris advances a thin catheter through his body’s vessels. Once she arrives at the clot, she essentially “grabs” the clot and removes it from the artery.
“This procedure, namely mechanical thrombectomy, allows oxygenated blood to flow back to the brain as soon as the clot that caused the stroke is removed,” explains Dr. Tjoumakaris. “This reduces the risk of further damage to the brain and even reverses transient neurological deficits. Just fifteen years ago, Mr. Iozzo’s stroke could have left him with severe, permanent disability.”
December 6 – 5:00 PM
The procedure is now over and Dr. Iozzo is recovering in JHN’s Neuroscience Intensive Care Unit. When he arrives, he cannot form meaningful words. “I found myself surrounded by friends and family,” Dr. Iozzo recalls. “Their faces told me how serious they thought the situation was, and believed that the damage was irreparable and irreversible. You can imagine the inner fear, the panic, the frustration, the pain and sense of hopelessness [of being unable to speak.]”
December 6 – 7:00 PM
Thankfully, family members’ concern of permanent damage is proving to be false. As blood flow returns to Dr. Iozzo’s brain, his function begins to improve. By 7:00 PM, just five hours after he was found on the floor of a nearby store, Dr. Iozzo is now able to speak to his nurse, Ryan Hopkins, BSN, RN.
December 8 – 7:00 AM
After just one day of monitoring, Dr. Iozzo is preparing to go home. He can now walk, understand everyone and speak without defect. Nabeel Herial, MD, Clinical Assistant Professor of Neurology and Neurological Surgery, first places a heart monitoring device that will determine if Dr. Iozzo has a heart rhythm that will require further treatment to reduce risk of stroke.
“I am so grateful to have another chance in life,” Dr. Iozzo reflects. “I am truly blessed for having so many wonderful friends and colleagues. This experience renewed my zest for life in all that I do, and with this new viewpoint I eagerly look forward to many happy and healthy years filled with family, friends and, of course, fruitful research endeavors.”