Swift action, prehospital communication, and technology helped a young stroke survivor beat the odds

Stroke survivor Eric Jacobowitz with neurointerventional surgeon

Dr. Brijesh P. Mehta

By all accounts, Eric Jacobowitz shouldn’t have had a stroke. The firefighter and paramedic led a healthy life, eating well and keeping fit, and had no known preexisting conditions. At 29, he was also much younger than the average stroke patient. “Based on my previous knowledge of strokes, I was the least likely candidate to have one,” he said.

Jacobowitz, who lives in Broward County, Florida, suffered a stroke while working out at the gym. He had just finished a rope climbing exercise and was about to send a text message when he noticed he wasn’t able to move his left thumb. “That was the first sign,” he recalled, “but I thought, it’s not a big deal. I’m just fatigued from working out.” Soon, though, he was unable to move his left leg and found himself on the floor, drawing the attention of a trainer and then the gym’s owner who called 9-1-1.

EMS transported him to Memorial Hospital West in Pembroke Pines, Florida, a Joint Commission-certified thrombectomy capable stroke center. They alerted the neurointerventional team en route based on the region’s pre-hospital stroke protocol for patients with high RACE scale scores. A non-contrast CT scan was performed as soon as Jacobowitz arrived. Because the site is equipped with the Rapid imaging platform, an automated notification was triggered as soon as the scan results were available. Dr. Brijesh P. Mehta, director of neurointerventional surgery at the Memorial Neuroscience Institute, received the Rapid alert on his smartphone and wasted no time viewing the results. They revealed a hyperdense MCA sign and an ASPECT score of 10, prompting him to fast-track Jacobowitz for mechanical thrombectomy, a clot-retrieval procedure that would remove the blood clot causing the stroke. Thankfully his team was already on standby, having been activated early as part of the hospital’s parallel stroke workflow.

“When I got the push notification from Rapid and saw that there was a hyperdense sign, it allowed us to let the team know it’s definitely a go,” Dr. Mehta said. “As soon as the scan was done, our team was ready to receive him.”

Intravenous tPA bolus was administered in the emergency room to try and break up the clot before Jacobowitz was transported to the cath lab. There, the blocked artery was fully opened with mechanical thrombectomy and blood flow restored in under 60 minutes from his arrival at the hospital.

After the procedure was successfully completed, it was discovered that Jacobowitz had a patent foramen ovale, or PFO, a small hole between the two upper chambers of the heart, along with a genetic mutation that can cause blood clots—both of which contributed to his stroke. He is taking medication to help prevent a future stroke and has returned to work full-time. He said that being a stroke survivor has given him a stronger appreciation for the individuals he responds to in his role as a paramedic with Broward County Sheriff’s Office. He also said his case is an example of how critical illnesses do not discriminate by age.

“It just goes to show you that there’s no specific type of person strokes target, or that any disease targets,” he said.

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