NCH surgery cures Naples woman of condition causing regular strokes

Writer: Joey Pellegrino

Having just one stroke is terrible and potentially life-changing; imagine having them regularly. A Naples woman lived with a rare condition that causes strokes monthly, weekly, or even daily until an NCH brain surgeon offered her a life-changing procedure.

The past four years have been a long, arduous journey for Liliam Vazquez. In 2018, she felt a sudden weakness and tingling sensation in her hands. She called 911, and paramedics took her to the hospital.

“And they say I had migraine and stress, so I went back home,” Vazquez said. “Then I was home eight days later, and I have same symptom.”

It happened time and time again for years. What Vazquez didn’t know was that she actually suffered a series of strokes because of a rare condition called moyamoya disease.

“Moyamoya is a condition or disease of the brain where the blood vessel has started narrowing inside of a brain, so the lumen of a blood vessel gets smaller and smaller and smaller until people start having strokes.,” said NCH neurosurgeon Dr. Edison Valle.

Most doctors never see the disease, making it difficult to diagnose. All the while, Vazquez was living a nightmare.

“I have pains in my, my neck, my arms everything,” Vazquez said. “I cant move my arm.”

It took a big stroke before she ended up at NCH and was seen by Valle, who has treated moyamoya disease before. Using advanced CT imagery, he clearly saw what was happening inside Vazquez’s head.

“It was lacking all the blood flow here, ” Valle said. “Every time that she was standing up, she was having stroke-like symptoms.”

The longer moyamoya disease persists, the more dangerous it becomes, as the lack of blood flow to the brain can result in death or permanent disability.

“When you have a narrowing of the blood vessel, what happens is that the brain is lacking brain perfusion,” Valle said. “And you cannot put a stent on it to open the blood vessel because it’s the whole blood vessel that is diseased. So, what we do is, basically, brain bypasses; like they did cardiac bypass, we do a brain bypass. We basically take arteries that go on the scalp, we basically dissect those arteries, then make a window on the head, and then we suture those arteries to the closing arteries inside of a brain.”

With no other options, Vazquez underwent brain surgery. It required high-technology tools and microscopes along with the hands of a practiced surgeon.

“This probably the most complex surgery,” Valle said. “These are paper-thin arteries that are smaller than a millimeter most of the times. And sutures, also, that are basically not even able to be seen by the naked eye.”

Over the course of hours on the operating table, Valle took arteries from Vazquez’s scalp and used them as a bypass for the narrowed blood vessel, restoring order in her brain.

“In the hospital, we’ve also got this imaging that allows us to see how much the brain flow has changed from how she was before surgery to how she’s post-surgery,” Valle said.

Vazquez’s family noticed the difference while she was still in recovery.

“Seeing her then, and then after the surgery, it is… I feel like I have my aunt back,” said Pan Padilla, Vazquez’s niece.

“I’m so happy,” Vazquez said. “So happy and glad.”

After a result that was nothing short of miraculous, Vazquez is back at work as a hairstylist, catching up with her life.

This surgery was a first for NCH; it is primarily performed in academic centers.

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