I am so thankful that I received a quick, accurate diagnosis. This is not a common condition — things could have turned out very differently for me.
Karin Satrom, 35, felt drunk. Very very drunk. The room was spinning, her vision was blurry and she could barely stand up. But at 23 weeks of pregnancy, she hadn’t had a drop to drink. “Maybe you pushed it too hard today,” her husband, Bert Mains, told her. “Go to bed. You’ll feel better in the morning.” But when morning arrived and the walls were still spiraling around her, she called her obstetrician, Dr. Josine Veca, who told Karin to go to the emergency room immediately. In the NewYork-Presbyterian Brooklyn Methodist Hospital emergency room, the test results were yielding nothing unusual. But knowing something was going on, Dr. Veca called for a neurology consultation, and neurologist Dr. Kristin Babinski, arrived on the scene.
“Dizziness is a very common symptom of a number of different conditions,” says Dr. Babinski. “But because Ms. Satrom’s dizziness came on suddenly and out of nowhere, I suspected we might be dealing with a dissection, or tear, in the artery of her neck.”
An MRI confirmed that Karin did indeed have a tear in the inner lining of her vertebral artery and as a result had experienced a “mini-stoke” known as a transient ischemic attack (TIA). The tear in the inner lining created a sac where blood began to pool and clot, engorging the sac until it blocked all blood flow through the artery.
Although there was no lasting brain damage from the TIA, immediate action was needed to prevent a full-scale stroke with potentially dire consequences — for Karin and her baby. Karin was immediately given a shot of an anti-coagulant, which keeps the blood from clotting.
“Often, a torn vertebral artery is the result of sudden neck trauma,” says Dr. Babinski. “However, a tear can also occur spontaneously, with no obvious cause — and this was the case with Ms. Satrom. After her symptoms subsided, we sent her home with the anti-coagulant and showed her how to inject it. We also gave her strict instructions to avoid activities that required her to turn her neck: no driving, no more swimming until the tear healed.”
A few weeks later, Karin got a starring role in a January 2014 New York Times Personal Health column, in which writer Jane Brody highlighted torn arteries.
“I was glad to be home and have everything under control in terms of my neck, but I was worried about my childbirth,” remembers Karin. “Would the birth cause pressure on my fragile artery? How would my continued course of blood thinners affect things?”
After her case was reviewed, Karin was given the go-ahead for a vaginal birth. “It was such great news,” she remembers. “Dr. Veca told me to stop the blood thinners at the first hint of labor, and by the time I needed to start pushing, they would be out of my system.” When those first hints of labor began, as instructed, she stopped her blood thinners and she headed to the Hospital when her water broke. Donald Robert Mains was born on March 6. Both baby and mother were as healthy as could be.
“I am so thankful that I received a quick, accurate diagnosis. This is not a common condition — things could have turned out very differently for me if it wasn’t for Dr. Veca, Dr. Babinski, and the whole team.”