D.L. thought she was just having bad headaches. She was a self-proclaimed "work-a-holic" and had been putting in long days at her job as a set designer. This might just be the result of too much stress and too much work, so she decided to get a cervical spine manipulation done by her chiropractor.

While driving in her car on 12-7-06, D.L. experienced left sided weakness and was at the point where she felt that she could no longer handle her car. She pulled over and tried to get out of her car. She fell to the ground and was laying in a gutter when the emergency personnel reached her. She was taken to the emergency room with left-sided hemiparesis (worse in her left upper extremity than in her lower extremity), severe headache, left-sided neglect, and left facial droop.

Brain imaging revealed abnormalities in the basal ganglia, internal and external capsules, and reduced blood flow in the right corona radiata. Through this imaging, D.L. was diagnosed with a right internal carotid artery stroke. Tissue plasminogen activator (tPA), a protein involved in the breakdown of blood clots, was considered in the treatment of D.L.'s stroke. However, this treatment is only effective if administered within the first 3 hours of the onset of symptoms and D.L.'s symptom onset had occurred more than 3 hours ago, making her ineligible for tPA.

D.L.'s stroke left her with many deficits, including a left visual field cut, left sided neglect, decreased judgment and safety awareness, impaired processing skills, decreased attention to detail, and decreased cognitive endurance. Physically, D.L. was dependent upon a wheelchair for mobility and had an upper extremity sling to support her left side.

After approximately one month in the acute hospital rehabilitation setting, D.L. transitioned to Centre for Neuro Skills ® modified inpatient program, in Encino, CA. In this program, D.L. engaged in occupational, physical education therapies, as well as cognitive rehabilitation in the clinic and at night and on the weekends, neurorehabilitation specialists assisted D.L. in her home with activities of daily living, such as cleaning, cooking, organizing her home, etc. Whereas the goals of acute rehabilitation are to medically stabilize the patient, post-acute rehabilitation involves getting the patient as independent as possible and integrating him or her back into the community. After 9 months of intense rehabilitation in all therapeutic disciplines at CNS, D.L. was transitioned to the supported living program at CNS. This program involved occupational and physical therapies as well as outpatient counseling. During this time period, D.L. was able to engage in work trials in which she did set designing with the help of a personal assistant.

After another 9 months of being involved in the supported living program at CNS, D.L. decided to stop her treatment due to funding issues. D.L. had made remarkable progress in her programs at CNS. She is currently able to drive with modifications, ambulates with an AFO (ankle foot orthotic) for stabilization, volunteers at a local church and is completing 8 hours a day or work trials with a personal assistant.

If you are interested in receiving more information about CNS’s clinical, behavioral, and/or assisted living programs please call 800-922-4994.