Minimally invasive treatment for Mollie's stroke

In December 2012, Mollie McDonnell, then 36, was at work when she began to feel not quite herself. She decided to leave the office early and began her 40-minute commute from Wilmington to her West Chester home.

As McDonnell drove, she noted that she couldn’t use her left hand to turn on the radio. But she didn’t think much of it. In fact, she didn’t take much notice when she hit another car, then pulled right onto her lawn instead of the driveway. Thankfully, a neighbor was outside and ran over.

The neighbor helped McDonnell walk inside since she wasn’t capable of using her left leg. But McDonnell insisted she just needed a nap. Not convinced, the neighbor called McDonnell’s sister, Kate, who was at a meeting nearby. When Kate arrived, she called an ambulance.

“I remember the paramedics asking me to smile and raise my arm. I didn’t know why,” says McDonnell, who was paralyzed on her left side. “I had no idea I was having a stroke.”

When you're having a stroke, every minute matters

The paramedics rushed McDonnell to Paoli Hospital, where she was given an IV drug called tPA that’s used to stop stroke. However, imaging tests showed that McDonnell’s blockage was in a large vessel in her brain, which typically doesn’t respond to medication. The emergency staff transferred her immediately to Bryn Mawr Hospital, part of Main Line Health Neurosurgery, a member of Jefferson Neuroscience Network, for specialized care. 

Grahame Gould, MD, a neurointerventionalist for Main Line Health, met McDonnell at Bryn Mawr’s neurological interventional lab. This state-of-the-art lab allows physicians to use specialized imaging and equipment to remove blood clots from the brain with minimally invasive procedures. Dr. Gould is an expert in this type of advanced brain surgery.

“When a person is having a stroke, it’s important to get blood flow back to the brain as soon as possible. Without treatment, Mollie would live with permanent disability,” explains Dr. Gould. “Interventional procedures enable us to treat stroke victims when medication doesn’t work.”

Minimally invasive treatment for stroke

Dr. Gould performed what’s called a mechanical thrombectomy — the manual removal of a clot from the brain. Using advanced imaging guidance, he directed a catheter through McDonnell’s arteries and blood vessels to the brain from a small incision in her leg. Then, using a specialized stent retriever device, Dr. Gould removed the blockage.

“Similar to how stents are used to treat a heart blockage, we opened the blood vessel in Mollie’s brain at the point of the blockage,” explains Dr. Gould. “We then removed the stent, pulling the blockage with it.”

Minimally invasive mechanical thrombectomy is reserved for situations in which tPA can’t be used or isn’t effective. This includes patients with blockages in larger blood vessels, as well as those who have bleeding issues or trauma. It may also be used in people who did not seek treatment early enough for tPA to be administered.

“Unfortunately, the vast majority of people are not candidates for tPA,” says Dr. Gould. “This treatment provides another option. We work with all four Main Line Health hospitals to offer this treatment.”

Getting back to a normal life after stroke

McDonnell serves as an example that stroke can happen to anyone. She’s young and had no risk factors. But she hasn’t let her experiences hold her back. Completely recovered, McDonnell continues to work in marketing, travels, practices yoga, and has taken up new hobbies like sewing and cooking.

When McDonnell woke up in Bryn Mawr Hospital’s intensive care unit, she learned she’d had a stroke.

“I was shocked. It was a miracle that things happened as they did. My life could have been very different,” says McDonnell, who stayed in the hospital for nine days. “My care was phenomenal, and Dr. Gould spent time with me every day I was in the hospital. He put me and my family at ease.”

“It took me longer to get over the stroke emotionally than physically,” says McDonnell. “But I’ve learned a lot. It taught me that it’s okay to accept help from others and to count my blessings daily. I’m trying new things whenever I can and feel so fortunate for the care I received.”