Portrait: Sarah

My name is Sarah LacertosaI am currently Mrs. Monmouth County International 2025I have an experience to share with you in the hope that it will bring awareness around the often overlooked Vertebral Artery Dissection (VAD), a common cause of strokes in patients under the age of 45.

A little bit about Sarah 

On October 31, 2016, at 32 years old, I suffered a strokeI was at work at a local restaurant when I began feeling dizzyI didn’t think much of it and neither did anyone elseMy manager suggested I may have vertigo and I should follow up with a doctor. It was a surreal feeling of nausea, disorientation, inability to swallow and loss of bladder function. I was sent home into the care of my family members who had no idea of the severity of my physical and mental stateI wasn’t aware of what was happening to me.  

A surprising diagnosis 

The next morning, I called my primary physician to explain the symptoms and was advised to go directly to the emergency roomIt was there that I was questioned about previously being involved in an accident, seeing a chiropractor or attending a yoga class. None of this had occurred, but I did consider that I often “cracked” my neck in an attempt to relieve cervical discomfort. This prompted a series of tests ordered by a neurologist including MRI and MRA. My symptoms kept me overnight and the next morning, the MRA showed a tear in my vertebral artery which led to two strokes that happened at the same time. I was kept in the hospital for eight days on blood thinners and observation.   

More about VAD 

The signs and symptoms of VAD can be vague, and diagnosis can be difficult. Spontaneous dissections have been reported. However, incidental minor trauma often precipitates this potentially dangerous condition. Often some neck distortion such as chiropractic manipulation, bending of the neck, or blunt trauma causes the dissection. The dissection of the artery may ultimately lead to a stroke which often can be delayed for days following the acute dissection. 

My journey through two strokes 

Experiencing two strokes in one day can be a life-altering event, both physically and psychologically. Each stroke affects different parts of the brain, leading to a unique set of challenges and symptoms. My journey through a medullary stroke and a cerebellar stroke has given me a profound understanding of the complexities of brain health, the importance of timely medical intervention, and the resilience of the human spirit. 

Medullary stroke symptoms and impacts 

The first stroke I experienced was a medullary stroke, which occurs in the medulla oblongata, a critical part of the brainstem responsible for regulating vital functions such as breathing, heart rate, and blood pressure. The onset of this stroke was sudden and dramatic. Initially, I experienced vague symptoms like dizziness and a severe headache that seemed to worsen with movement, such as bending or coughing. The headaches became so intense that they felt unbearable. 

As the situation progressed, I faced a cascade of alarming symptoms: double vision, numbness on one side of my body, and significant weakness in my limbs. I experienced bouts of dizziness that challenged my ability to walk and maintain balance, leading to a frightening loss of coordination. The persistent hiccups felt like a quirky inconvenience at first, but over time, they became a reminder of the fragility of my condition. The most alarming moment came when I lost consciousness, making it clear that I was grappling with a serious medical emergency. 

The consequences of this medullary stroke were profound. I learned firsthand how the medulla is not just a passageway for sensory and motor signals but also a control center for essential reflexes. This realization deepened my appreciation for the resilience of the human body and the critical nature of swift medical responses to stroke symptoms. 

Cerebellar stroke symptoms and impacts 

The second stroke I encountered affected the cerebellum, the area of the brain responsible for motor coordination, balance, and even some cognitive functions. The symptoms I faced this time were markedly different, yet equally debilitating. Ataxia, or decreased coordination of muscle movements, became a central challenge. I found myself struggling with simple tasks that once felt automatic, such as walking steadily or reaching for objects without overshooting. 

Hypermetria, the tendency to overshoot a target when reaching for it, made everyday actions feel like an exercise in frustration. I experienced dyssynergia, where my movements felt disjointed and jerky, impacting not only my physical activities but also my ability to communicate effectively. Dysarthria, characterized by weakness in the muscles used for speaking, made conversations difficult, often leaving me feeling isolated in social situations. 

The cerebellum's role in maintaining balance and posture became painfully evident as I grappled with severe instability. The awareness of my body’s inability to coordinate movements and maintain equilibrium affected my confidence and independence. Additionally, I faced challenges in swallowing, which not only impacted my nutrition but also made me acutely aware of the complexities of seemingly simple actions that I had previously taken for granted. 

What I’ve learned in recovery 

Recovering from both strokes has been a journey filled with physical therapy, emotional ups and downs, and a newfound understanding of the brain's intricate functions. I learned the importance of rehabilitation therapies, which have been pivotal in regaining my motor skills, balance, and cognitive functions. The road has been long and, at times, discouraging, but the support of healthcare professionals, family, and friends has played a crucial role in my recovery. 

Moreover, my experiences have fostered a profound appreciation for the interconnectedness of the body’s systems. While the medulla governs vital functions, the cerebellum fine-tunes our movements and balance, illustrating the complexity of brain health. This journey has also highlighted the importance of awareness surrounding stroke symptoms. Recognizing the signs early on can make a significant difference in outcomes, emphasizing the need for education and resources in communities. 

As I continue to recover, I aim to share my story to raise awareness about stroke symptoms and the importance of timely medical care. Ultimately, this journey has not only tested my strength but has also deepened my appreciation for life’s simple joys and the remarkable capacity for recovery. 

Dedicated to raising awareness 

Without the proper attention, I would not be here today to share the importance of VAD awarenessThere was an overwhelming possibility, because of my age and overall good health, I would have never been aware I suffered a stroke due to lack of understanding around a cervical spine injury. I am forever grateful to the medical professionals that ordered the necessary testing to diagnose the injury which led to a potential life-threatening strokeI was completely unaware of the damage I had causedI consider myself blessed to be here and share my storyAlthough there are symptoms I will never recover from, I walk my path stronger and wiserMy goal is to raise awareness around the signs and symptoms of a stroke. This is not exclusive to the elderly. 

Please, pay attention to your body’s physical signs as well as your intuitionAdvocate for your health and take nothing for granted.

Make a Difference: Your contribution can change lives. Donate today to support stroke survivors like Sarah by helping us with brain injury research. Together, we can build a brighter future. 

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