Neurology and Neurosurgery

Woman avoids a stroke by getting quick treatment for a carotid dissection

 Nuvance Health employee Eileen Miller on a hike with her husband Rob Sweet and Goldendoodle George. Eileen had a carotid dissection that could have caused a stroke without emergency care.


A longtime Nuvance Health employee trusted her instincts and sought emergency medical care after an extraordinary headache would not go away


Eileen Miller, 48, had no reason to think a headache was going to turn into a life-threatening experience. She is active and healthy, except for a long history of migraines. Even though Eileen was used to managing debilitating migraines, she knew something was not normal when she had a bad headache on a Thursday afternoon.


A carotid dissection can cause stroke-like symptoms

“I was wrapping up a meeting when all of a sudden I felt intense pressure and pain in my head; it felt like someone hit me in the back of my skull,” Eileen said. “Then I heard a swooshing sound near my right ear.”


Eileen took her migraine medication and continued her workday. She has worked for Nuvance Health and its former health system for 21 years. She is currently the assistant vice president of human resources for the western region.


“I’ve always been able to manage my migraines with medication,” Eileen said, which is why she continued her workday and even went to work the next day.


“On Friday, I went to work in a baseball cap, sweatshirt and leggings because I felt terrible,” Eileen said.


That evening, Eileen had double vision and nausea. The pressure, pain and swooshing continued. Eileen had not been sleeping because of the pain; she was exhausted and worried about what might be wrong because the migraine medication was not working. 


Getting emergency medical care for carotid dissection to prevent a stroke

On Saturday, Eileen started calling colleagues at Nuvance Health for guidance. She ended up speaking with Dr. Andrew Wilson, vice president of medical affairs at Northern Dutchess Hospital and an emergency medicine physician. Based on her symptoms, he said she should go to the emergency department quickly. 


Eileen’s husband Rob Sweet drove Eileen to the Northern Dutchess Hospital Emergency Department, which is near their home in Hyde Park, New York. She could not sit up in the car because the pain was so intense. 



Eileen had a computerized tomography angiography (CTA) that showed a carotid dissection. A carotid dissection occurs when layers of an artery separate. This can stop blood flow to certain areas of the brain and cause a stroke. A stroke is a life-threatening medical emergency that can lead to permanent disability or death if it is not treated quickly.



“I heard the message, but I felt numb at first,” Eileen said. “Then I saw the look on Rob’s face and realized it was serious.”



Eileen’s emergency medicine doctor at Northern Dutchess Hospital said she needed a higher level of care and that an ambulance was going to take her to Vassar Brothers Medical Center (VBMC).VBMC is a Level II trauma center.



Eileen went directly to the intensive care unit (ICU) where a team was ready for her. She was treated with a blood thinning medication, and doctors and nurses immediately started monitoring her closely for stroke symptoms. She had neuro checks every hour; staff asked if she knew her name and where she was, asked her to smile, open and close her eyes, and move her arms and legs.


B.E.F.A.S.T when it comes to stroke. Learn more in this short video.


Her team included neurologist and stroke specialist Dr. Paul Wright, endovascular neurosurgeon Dr. Jonathon Lebovitz, vascular surgeons Dr. Mohamed Elsagga and Dr. Andreas Spirig, and a team of neurology residents and nurses.


“The pressure in my head got worse before it got better,” said Eileen.


After four days in the ICU, Eileen was finally able to eat and started feeling better. After seven days, she was able to go home.



Recovery after a carotid dissection

At home, Eileen had to take it easy and avoid strenuous activities.


“My Goldendoodle George was my companion on the couch while I recovered,” Eileen said. George is a therapy dog.


Eileen and Rob love to travel and spend time outside including biking, hiking and kayaking. Eileen’s activities were limited to mild walking. But her doctor recently gave her a green light to ride her bike outside — just in time for summer.


Many times a carotid dissection happens from an accident or injury. After extensive testing and imaging of her head and neck, Eileen’s care team determined she had a spontaneous carotid dissection. Meaning, they could not pinpoint an exact cause.


However, people with migraines can be more susceptible to carotid dissections because migraines change the blood vessels in the brain.


Book now with a neurologist who can help you manage headaches and migraines.


A vascular specialist will continue to monitor Eileen and she will stay on a blood thinning medication for the time being.



Eileen is sharing her story to help others know how important it is to listen to your body and get medical help quickly if something feels wrong.


“No one knows your body better than you. If I had kept treating my symptoms as a migraine, I would have had a very different outcome,” said Eileen. “But I knew something felt different and I called my trusted colleagues for help.”


“Even after working here for more than two decades, I have a new appreciation for what our patients go through. Whether it’s an emergency or planned hospital visit, it can be really scary to be vulnerable, put yourself in other people’s hands and rely on them to make appropriate decisions,” Eileen said. 


“But as scary as it was, everyone at Northern Dutchess Hospital and Vassar Brothers Medical Center put me at ease. They focused on me and made me feel comfortable,” Eileen said. “I am so appreciative of the care I received and grateful for the team I had.”


“Please understand how valuable your life and health are, and try not to sweat the small stuff. Life can change in an instant,” Eileen said. “I could dwell on my health scare, or look forward and live my best life, which I am doing by staying positive and with help from my husband and great support team,” Eileen said.


Disclaimer: Outcomes from carotid dissection vary from person to person. No individual results should be seen as typical.