An urgent and complex brain catheterization procedure saved the life of a 16-year-old girl from Jerusalem who suffered a rare stroke during a school day last week.
The girl, who suddenly experienced paralysis on her right side, was rushed to the capital's Shaare Zedek Medical Center, where a team of specialists determined that a tumor on her heart valve had broken apart and blocked one of her arteries.
2 View gallery
The teen's cerebral artery before (right) and after the blockage was cleared
(Photo: Shaare Zedek)
S., 16, was at school when she began to feel numbness, losing movement in her arm and leg, and soon also showed signs of aphasia, experiencing difficulty and confusion in her speech. The school staff responded quickly, calling emergency services, and S. was transported to Shaare Zedek’s pediatric emergency room.
Pediatric neurologist Dr. Dalit Cayam assessed the situation and recognized the signs of a stroke. S. was sent for an urgent MRI scan, during which Dr. Eliel Ben-David, head of the Diagnostic Neuroradiology Unit, discovered a significant blockage in one of the brain’s major arteries.
At the same time, Dr. Michael Teicher, a neurology specialist, was brought in for consultation. Together with Dr. Cayam and Dr. Ben-David, they decided on emergency brain catheterization. S. was quickly transferred to the Interventional Neuroradiology Unit, led by Dr. Yaaqov Amsalem.
Under the guidance of senior neuro-interventionist Dr. Vladimir Boroditsky, the team performed a complex, over-four-hour procedure under general anesthesia. During the procedure, they found the internal carotid artery on the left side was blocked at its origin. The blockage was unusually stubborn and resistant to conventional stroke catheterization techniques. Ultimately, the team decided to implant a stent in the blocked brain artery, allowing them to remove portions of the blood clot and clear the blockage.
The catheterization was successful, and S. showed immediate improvement, regaining movement in her limbs and recovering some speech function right in the operating room. After the procedure, she was transferred to the Pediatric Intensive Care Unit. Further tests were conducted to determine the stroke’s cause, revealing a large tumor on her mitral valve. Due to the tumor’s abnormal size, it had begun to fragment, likely sending particles that blocked the main brain artery. In light of this discovery, she underwent heart surgery at Sheba Medical Center the following day, in collaboration with Shaare Zedek.
“This is an extremely rare case,” Dr. Boroditsky explained, “seeing such a severe stroke in a young, healthy girl. Stroke cases of this kind are more commonly seen in patients aged 60 to 70, but it’s exceedingly rare in a 16-year-old, especially with a heart tumor involved. The brain catheterization was very complex and required a series of intricate and precise steps to open the artery without damaging it. During the catheterization, we consulted with neurology and imaging teams to ensure the best approach for opening the blockage.”
Dr. Vladimir BoroditskyPhoto: Shaare Zedek Medical Center“Given the significant obstruction, we decided to use a stent to open the artery, which allowed us to extract what later turned out to be fragments of the tumor blocking the artery. This case required the seamless collaboration of multiple teams and disciplines during the procedure, which led to a successful outcome and significant improvement in S.’s condition. The tumor was also removed, resolving that issue as well.”
S.’s family described her as a completely healthy child with no prior conditions. “The stroke took us by total surprise,” they said. “We are deeply grateful to Dr. Teicher, Dr. Boroditsky, and all the Shaare Zedek staff for their swift and professional response, which truly saved her life. We never imagined anything like this could happen to her. We were fortunate to have such expertise caring for her, especially in treating complex cases in children.”
“The most important thing is that the girl has returned to herself,” Dr. Boroditsky concluded. “She could have suffered severe disability or even death, but thankfully, her recovery seems complete, and we expect her to return to a full routine over time.”
Get the Ynetnews app on your smartphone: