The stroke that hit Courtney Cruze as she drove to pick up her daughter from dance practice July 2 was “like a trust fall.”

Courtney Cruze and Tennille Creekmore in front of Emergency Department.
Stroke survivor Courtney Cruze pictured with Parkwest Stroke Coordinator Tennille Creekmore, RN.

But this was no make-believe exercise – it was a frighteningly real massive stroke that landed her in the waiting arms of the Parkwest Medical Center stroke team. “About five minutes down the road I knew I was swerving  a  little  bit,   but it didn’t seem real, like I was kind of confused,” the 38-year-old mother of two recalled. Almost as quickly, she  suddenly  was  unable to speak,  steer,  accelerate or brake as her SUV rolled backwards down a steep hill and toward heavy cross traffic on Westland Drive.

“Internally,  I was freaking  out because  I knew something bad was happening, but I didn’t know what,” she said. “I had this overwhelming feeling that my parents, both of whom are deceased, were there with me. I didn’t hear or see didn’t hear or see anything, but I just got this sense that ‘It’s ok. It’s like a trust fall. You’re going to be fine.’”

CT scan of Cruze.
Cruze’s CT scan showed that the blood flow to almost the entire left side of her brain (shown in red) had stopped.

The CT scans at Parkwest Medical Center, however, suggested otherwise. In fact, the images
showed the blood flow to almost the entire left side of Cruze’s brain had stopped. The cause? A spontaneous dissection of her left carotid artery, perhaps occurring as much as 10 days earlier, had led to a blood clot that caused a 100 percent blockage to the left side of her brain.

“To anyone who knows what they are looking at, the scan would more than likely represent devastation for a patient,” said registered nurse Tennille Creekmore, stroke team coordinator at Parkwest, a Covenant Health facility which is certified as an Advanced Primary Stroke Center. It also serves as a vital link in the health system’s stroke network with its Comprehensive Stroke Center at Fort Sanders Regional Medical Center.

Of course, with strokes, time is everything. Thanks to a good Samaritan who came to Cruze’s rescue after her vehicle slammed into a guard rail, an ambulance arrived quickly and rushed her to Parkwest’s waiting stroke team.

PAtrick Flynn head shot
Patrick Flynn, physician assistant

“Some strokes you know right off hand if this going to be an interventional candidate, meaning is she going to need tPA? Is she going to need an embolectomy?’” said Patrick Flynn, a physician assistant to Parkwest’s neurohospitalists Robert Malka MD, and Sergio Loaiza, MD. “Immediately off the bat, we knew she would need one or both of those because she couldn’t talk, she couldn’t move the right side of her body, she was completely paralyzed on the right side of her body.”

“As soon as the EMTs brought me in, there was a team of people all around me and they all seemed to know exactly what to do. They were awesome!” recalled Cruze. “They were so nice. Although I couldn’t understand what was going on I could see there was a lot of compassion with the people here. You could see they were in ‘work mode’ like, ‘We’ve got to help this woman!’ But you could also see the compassion in their faces. They were genuinely concerned and wanting to help.”

The Parkwest stroke team diagnosed her stroke as “severe” with a National
Institutes of Health stroke rating of 27 out of 42 – an attack capable of permanent disability or even death. Within 47 minutes, they stabilized her blood pressure, performed a CT brain scan without contrast, a CT angiogram and a CT perfusion, determined the source of the clot, notified her husband, administered the clot-busting drug tPA and had Cruze back in an ambulance on her
way to Fort Sanders Regional Medical Center for an embolectomy.

As she arrived at Fort Sanders Regional, Cruze found herself surrounded by
another team of professionals, including neuro-interventional radiologist Keith Woodward, MD, and neurohospitalist Arthur Moore, MD.

“I did not know what was going on,” she said. “I just knew something big was wrong with me. I had no choice honestly. At that point I just felt like I was in God’s hands, and I knew they were working on me and helping me as best they could, and doing everything they can for me.”

Within 15 minutes, Dr. Woodward had guided a tiny device through a catheter inserted through her groin up to her brain, plucking out the cot. Almost immediately, Cruze began to recover.

“After they were done, Dr. Moore came over to me, and was asking, ‘What’s your name?’” Cruze said. “I couldn’t say it at first. The he says, ‘C’mon, what’s your name?’ Finally, I was able to murmur ‘Courtney’ and he got this big smile on his face and he shouts, ‘She’s OK!’ And I’m like, ‘I’m ok! I’m ok! I didn’t know what had happened to me but I was able to speak finally.”

Not only could she speak, but she soon emerged from the ordeal with zero deficits and was discharged from Fort Sanders Regional the next day as if the stroke had never happened. “I think that’s incredible and amazing that they can do something like that,” Cruze said. “It definitely
saved my life and my quality of life. I had such an amazing recovery because everything happened so quickly.”

Cruze said even her husband, a nurse practitioner at another hospital, was impressed by Parkwest’s rapid response. “My husband told me over and over, ‘That Parkwest team was really on it. They did everything!’” said Cruze. “He was so impressed because he used to work in ERs, too. Timing is everything with a stroke. Every minute counts.”

Meanwhile, Parkwest’s stroke team is also beaming. “Courtney is a special lady,” said Creekmore. “She will always be remembered in this ER because her story is so special and such a huge

Physician assistant Flynn was proud to be a part of that success, too. “The team did great!” he said. “We got everything we needed right away, got the tPA in and got her to Fort Sanders Regional really fast. She left the hospital the next day at Fort Sanders Regional. It doesn’t get much better than that for a 38-year-old female who wasn’t walking and talking hours before. Those are the cases that stick with you.”

Stroke network map.

“It was definitely a team effort,” he added. “It took the whole system …it’s really a great highlight for the Covenant Health system, especially with Parkwest and Fort Sanders because we really work closely with those guys. This one was as close to a 10 as you can get.”

Cruze still can’t believe she came out of it all without any disability. She also can’t believe she
had a stroke at 38. “It’s not something you think about having. A stroke at 38?!” she exclaimed. “And all my numbers were good. My cholesterol was great. I was on zero medication. I was healthy. It really puts things in perspective because anything can happen at any moment.
We never know.”