Police officer makes surprising recovery after stroke surgery

UC Irvine Health neurovascular specialist removes blood clots in four-hour procedure

May 19, 2015
David Castenada and his wife, Denise, talk about his stroke recovery at UC Irvine Medical.

David Castañeda had grown used to the idea of dodging bullets in his 19 years as a policeman. But the disaster he dodged when he suffered a stroke in 2013 has even his stroke specialists at UC Irvine Health marveling at his recovery.

“Hearing that makes me feel really lucky,” Castañeda says.

The 44-year-old Riverside police officer had just finished serving a warrant with his department’s SWAT team when he suddenly collapsed. He was taken by ambulance to Riverside Community Hospital, where doctors administered clot-busting drugs and transferred him by helicopter to UC Irvine Medical Center.

After touching down at the medical center, Castañeda was rushed into surgery, where Dr. Shuichi Suzuki spent almost four hours removing two clots that had lodged in the right side of his brain. The neurovascular specialist with the UC Irvine Health Comprehensive Stroke and Cerebrovascular Center feared that Castañeda might lose all movement on his left side. But when Suzuki checked his patient a few hours later, Castañeda was awake — and moving his left thumb.

“They pretty much have said that for David to even make it through the night was a miracle,” says Castañeda’s wife, Denise.

Exceeding expectations

Castañeda’s recovery was just beginning. Told he might need to spend six months in a rehabilitation center, he stunned everyone by walking the next day. Soon nurses and staff members from all over the hospital were coming to see his progress. He was discharged less than a week after his surgery.

“He’s young, but I was still surprised by how quickly his symptoms resolved,” says Suzuki, noting that most stroke patients are older and need more recovery time.

Although Castañeda suffered no long-term effects to his cognitive or motor skills, he lives with constant headaches and fatigue, and he must take blood thinners and cholesterol medication to prevent further clotting problems. Foods he used to love no longer taste good. But he’s been able to make those adjustments with help from his UC Irvine Health team.

“Everyone’s been incredible,” Denise says. “I didn’t know what to expect, even when we came home. But the number they gave me went right to the nurse in the ICU. We have the best of the best doctors. He got the best care.”

First signs of trouble 

Castañeda’s doctors believe he made a small tear in his right carotid artery (known as a dissected artery) while lifting weights two days before his stroke. That would account for the nausea, headaches and fatigue he experienced before he collapsed. 

“If I had to do it over again, I’d have gone straight to the doctor on that first day,” he says.  

Being aware of stroke symptoms and acting on them quickly is vital, says Dr. Lama Al-Khoury, Castañeda’s neurologist at the stroke center. Even relatively routine stoke treatments like clot-busting drugs are more effective the sooner they’re given. During a stroke, a patient can lose about 2 million brain cells every minute, so every second truly counts.

“The most important thing is alerting the patients and the community to call 911 right away if any sudden acute neurologic symptoms occur,” Al-Khoury says. “We have treatments of choice that work only early on. There is a window there, but it doesn’t mean you have a lot of time.”

Contributing factors 

Castañeda’s case is unusual, not only because it involved a dissected artery (the cause of about 2 percent of ischemic strokes), but also because he was younger than most stroke patients and didn’t have any of the common factors that contribute to stroke — obesity, smoking and heavy alcohol consumption. Al-Khoury worries that she’s seeing strokes more frequently in younger people because they’re not controlling those risk factors.

“People don’t take good care of themselves,” she says.

Castañeda has retired from police work. Since his stroke, he has enough energy for about two hours of physical activity each day, so he makes them count. He spends time with his family and watches his three children play sports. It’s a different life, but one he credits to the care he received at UC Irvine Health.

“We were told that this is the place to go for stroke, and I’d say it lives up to that.”

— Justin Petruccelli, UC Irvine Health Marketing & Communications 

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