US Senator Mark Kirk Recovering From Ischemic Stroke

Nancy A. Melville

January 23, 2012

January 23, 2012 — US Senator Mark Kirk (R-Ill.) is recovering from decompressive surgery after undergoing an ischemic stroke on Monday, his office has confirmed. He is being treated at Northwestern Memorial Hospital in Chicago.

Kirk, who is 52 years old, reportedly checked himself into Lake Forest Hospital, near his residence in Highland Park, Illinois, on Saturday after suffering dizziness and headache.

Doctors there discovered a carotid artery dissection on the right side, and the senator was transferred to Northwestern Memorial, where tests showed he had suffered an ischemic stroke, his office said in a statement.

When Kirk started to "deteriorate neurologically," surgeons made the decision to perform a craniectomy, removing a 4-inch by 8-inch section of Kirk's skull to allow the brain to swell without being compressed, the Chicago Tribune reports.

The statement from the senator’s office reported that the surgery was successful and that Senator Kirk was recovering in Northwestern Memorial's intensive care unit on Monday.

Neurosurgeon Richard Fessler, MD, who was among the doctors treating Kirk, said the stroke involved the right side of the brain.

"What that means is it will affect his ability to move his left arm and possibly his left leg," and there is a possibility of some facial paralysis, Dr. Fessler told the newspaper.

Dr. Fessler said he could not say how long Kirk's recovery would take, but that his age and health worked in his favor.

"Senator Kirk is young, he was very healthy and in good shape, and he's very strong," Dr. Fessler said. "Senator Kirk's job is cerebral, and I believe the functions required to do his job are going to be fine."

When it comes to stroke in someone as young as Kirk, the culprit of an artery dissection is not surprising, said Joseph Broderick, MD, the chair of neurology at the University of Cincinnati Neuroscience Institute.

"Under the age of 50, a dissection of the artery is 1 of the top 3 causes of strokes," said Dr. Broderick, who is a fellow of the American Academy of Neurology.

"In older people, the atherosclerotic disease in blood vessels and heart problems become so dominant that artery dissection is no longer the most common cause," he said. "But as physicians, when we see a young person with stroke we look for clues in the history that could be representative of dissection."

Patrick D. Lyden, MD, chair of the Department of Neurology at Cedars-Sinai Hospital in Los Angeles, California, says that not only are such strokes more common among young people, but they appear to be rising at an alarming rate.

"It's almost an epidemic at American stroke centers at this stage," he asserted. "These 50- and 60-year-old patients are tearing their arteries in increasingly frequent numbers and it's becoming at least as common as a typical atherosclerotic stroke in an 82-year-old."

Dr. Lyden speculated that the trend seems to ironically be related to the one thing that should be keeping older people healthier — activity.

"We don't know the exact cause of the trend, but my own theory, based on what I see in my practice, is that people are becoming more and more active in their 50s and 60s, whereas once upon a time people didn't work out."

"I've seen a number of cases that were surfing- or skiing-related carotid dissections, so my unproven speculation is that this is due to people keeping very active and having sports-related accidents."

Not all dissections are serious, but Dr. Lyden noted that when a craniectomy is performed, as in Kirk's case, it suggests that the stroke was indeed large.

"The vast majority of dissection-related strokes never even need a surgery of any kind," he said. "The need for a craniectomy suggests that there was a lot of brain swelling related to the stroke."

Dr. Broderick added that with a stroke with swelling serious enough to require a craniectomy, recovery will be a challenge.

"It would be safe to say 100% recovery of all motor function and sensory and vision as well as cognition is probably not going to happen with that size of stroke."

"Cognitively you could do pretty well, but with an injury to the right side of the brain, one of the biggest issues will be how much motor function will be affected and whether there will be a loss of vision on that side."

Kirk was elected to the Senate in 2010, taking the seat formerly held by President Barack Obama.

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