In the Lucky Thirty Percent

Today I was searching on the Internet for information about recovering from my stroke. My referral to a neurologist still hasn’t gone through. I’m doing very well indeed, but I have one disturbing symptom that’s keeping me from getting back to work: When I stand for more than about a minute, I feel woozy — not exactly dizzy, but headachy, faint, sick, and wanting to lie down. It’s not real severe, and comes on gradually, and generally feels better after a nap. But it is there, and I’m wondering if that’s my remaining effect of the stroke.

So, I Googled “Cerebellar Infarction” (the type of stroke I had). And then I got really distracted. Because I found out how lucky I was.

This article: Pitfalls in the Diagnosis of Cerebellar Infarction reported a study of people with Cerebellar Infarctions (like me), whose diagnosis was missed when they initially went to the Emergency Room (like me).

I got to that article from this one: The Clinical Differentiation of Cerebellar Infarction from Common Vertigo Syndromes. The article outlines the different common Vertigo syndromes and how Cerebellar Infarction is different. It said that only 0.7-3% of patients presenting with vertigo actually have a Cerebellar Infarction, but of those 35% get misdiagnosed.

I was sent home from the Emergency Department that Monday night with a diagnosis of vertigo, probably stemming from my migraines. They had done a CT scan, so I thought they were right, and I must be fine. I went back on Thursday morning (to a different Emergency Department) with additional symptoms (mainly a wicked headache and feeling faint plus right side tingling), and they did an MRI and learned I’d had a cerebellar infarction from vertebral artery dissection.

From reading the article, I can see how they missed the diagnosis. Once they found out I had a history of migraines (though never ever with vertigo), that presented an easy thing to blame. I did not realize that CT scans only catch 26% of cerebellar infarctions.

The article says that one tip-off of cerebellar infarction is being unable to walk without support. Well, I did walk from the Information desk at the library to the sofa in the back room. But I doubt I made it clear to the doctor that there was no way I could have done that without the help of my coworker. And I leaned on every desk or wall that I passed along the way, and was not able to walk straight. (By the time the doctor saw me, probably 45 minutes after the initial attack, the vertigo had just ended. So I was able to walk by the time they were done with me.)

Anyway, the really sobering part of the article was this: In the study of misdiagnosed cerebellar strokes, 40% of the patients died! Out of the remaining 60%, half of those had “disabling deficits.” So as it looks like I will get through this without disabling deficits (assuming the wooziness clears up), it looks like I am in the “Lucky” 30%.

Now, the study was based on a small sample. But the fact remains: I am glad I asked for prayer after I went home from the Emergency Room! And I am all the more thankful to be alive and thinking and functioning!

So I am going to have to stop thinking about this, though. After researching it and reading the articles this morning, I really didn’t feel good and slept all afternoon! But let me go on record as being thankful to God that my life was spared!

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