Who would have thought that Jerome Hiers, a 64-year-old Stony Brook University Hospital lab technician, whose team had collaborated with David Fiorella, MD, PhD, on the development of a new procedure to treat an often-misdiagnosed condition, would end up having his own life saved by the very same procedure developed at Stony Brook!

On Friday morning, March 25, 2022, Jerome, who’d recently experienced a lot of fatigue and bad headaches, was feeling a bit off as he walked into work. The next thing he knew, he collapsed, and was rushed over to the hospital’s Emergency Department.

Dr. Fiorella, the Principal Investigator (PI) of the clinical trial for this groundbreaking new procedure, took a look at Jerome’s CT scan and immediately realized that Jerome had what’s called a chronic subdural hematoma (cSDH). Blood that escaped from a blood vessel in Jerome’s brain had led to the formation of a blood clot in the space between his skull and brain. It was placing pressure there, causing Jerome’s symptoms and contributing to the risk for further damage. This condition often afflicts older people and is sometimes mistaken for dementia. Over time, and given its chronic nature, it can gradually impair a person’s quality of life.

In the past, the only treatment available for cSDH was a craniotomy (holes drilled into the skull and skull parts removed to alleviate pressure on the brain). However, the risk for reoccurrence using that method of treatment is often high. The minimally invasive new procedure pioneered by Dr. Fiorella, and known as a middle meningeal artery embolization (MMAE), treats the clot without drilling into the skull. Instead, it uses a specialized fluid that’s injected into the targeted arteries through a micro catheter (a small, thin tube used to pass medical devices and medicines).

Within just a few weeks of his minimally invasive MMAE procedure, all of Jerome’s neurological symptoms vanished. He completed his one-year clinical trial follow up in March 2023, and for two years now, he’s been walking, doing yard work… you name it!

In Jerome’s professional life, there have been many times when his work ethic has been as a lifesaver to his research team colleagues. But the way Jerome sees it, there’s only one person who truly merits the distinction of lifesaver. And that’s Dr. Fiorella.

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Gabrielle Neubert, RN, February 2024

29-year-old stroke survivor/mechanical thrombectomy performed by Dr. Reza Dashti

Meet with a florist for the wedding. Check. Get a good night’s sleep. Check. Rise and shine. Check. Let the dog out. Check. What happened next to 29-year-old Gabrielle Neubert, RN, of Ronkonkoma, on the morning of Thursday, February 8, 2024, was certainly not on her check list… or even on her radar.

In a split-second, Gabrielle’s facial expression went from smiley to droopy. Thankfully her fiancé, Stephen was there and immediately recognized that Gabrielle was having a stroke. He called 9-1-1 and described Gabrielle’s symptoms to the dispatcher. As a registered nurse (RN) studying to become a nurse practitioner (NP), Gabrielle couldn’t believe this was happening to her.

Within minutes, local EMS providers along with Stony Brook mobile stroke unit specialists arrived at Gabrielle and Stephen’s home. Gabrielle’s condition was assessed onboard the mobile stroke unit via telemedicine by a Stony Brook stroke neurologist back at the main hospital. Then, upon consultation with neurosurgeon Reza Dashti, MD Associate Director of Stony Brook Cerebrovascular Center, Gabrielle was whisked off to Stony Brook University Hospital. Just one hour later, Dr. Dashti performed a mechanical thrombectomy that removed the large vessel occlusion (blood clot), saving Gabrielle’s life and future.

While stroke seems unlikely for a 29-year-old, it happens more frequently than you’d think. At the time of her stroke, Gabrielle had an often-undiagnosed congenital condition (meaning one that she was born with). It’s called PFO, or patent foramen ovale (a hole in the heart) and is thought to have triggered Gabrielle’s stroke. According to the American Heart Association, young people with congenital heart disease have a risk of stroke that’s 11 times higher than the general population. On the heels of her life-saving mechanical thrombectomy, Gabrielle also had her PFO successfully treated at Stony Brook.

Now anytime someone expresses surprise that a stroke could happen to someone so young, the nurse in Gabrielle reminds them how important it is to go for annual check-ups. You just never know.

When Gabrielle gets married in September 2025, she’ll have the man of her dreams at her side. An NP to add to the RN after her name. And gratitude in her heart for the 9-1-1 dispatcher, EMS providers, mobile stroke unit specialists, and Dr. Dashti and his team at Stony Brook who helped make it all possible.

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Logan Baar celebrates a three-year milestone, January 2024

Just two days into 2021, Logan Baar was a 9-year-old, freshly-minted, junior black belt in karate. And he was stuck at home with the rest of his family — who were all COVID-positive — making the most of his quarantine. Suddenly, his mom heard a blood-curdling scream come from Logan’s room. She found him laying there, with the right side of his face paralyzed. He said his head hurt and as he went in and out of consciousness in his father’s arms, a call was made to 9-1-1 to describe Logan’s stroke-like symptoms.

Within minutes, a Stony Brook mobile stroke unit appeared, and Logan was rushed to Stony Brook Children’s Hospital Emergency Department (ED), where he arrived in a comatose state.

The cause of Logan’s bleeding was a ruptured brain arteriovenous malformation (AVM). It was located too deep within the left frontal lobe (the brain’s speech center) to remove surgically. Any additional injury to this side of the brain would leave Logan completely paralyzed on the right side and unable to talk or understand speech for the rest of his life.

Dr. David Fiorella, was brought in to perform a minimally invasive surgery, called an embolization, to cure the AVM. As one of the most experienced interventionalists in the country, Dr. Fiorella cured Logan’s AVM completely. During the month that followed in the pediatric intensive care unit, Logan continued to move forward in true Black Belt character, with tremendous strength throughout his recovery. Logan’s a lefty instead of a righty now when he writes, plays video games and does karate sparring, but he’s still the same funny, sarcastic, passionate and driven boy he was before the AVM. Life is good.

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Ben Graham approaching an important one-year milestone, January 2024

AVM survivor, treated with neurosurgical/neurovascular intervention by Dr. David Chesler and Dr. David Fiorella

They say that kids are resilient, and eight-year-old Ben Graham is living proof. Out of the blue, on February 17, 2023, Ben suddenly complained that his eye hurt. When things got worse from there, his parents, Kate and Bill, called 9-1-1 and Ben was rushed to Stony Brook Children’s Hospital. Upon examination, Dr. David Chesler, Director of Pediatric Neurosurgery, diagnosed Ben with a ruptured arteriovenous malformation (AVM). An AVM is an abnormal tangle of blood vessels, usually in the spine or brain, that disrupts the normal flow of blood. Ruptured AVMs are highly fatal and early detection in children is especially rare. The one Ben experienced had resulted in what’s known as a significant intracranial/intraventricular hemorrhage. This means that Ben’s brain bleed had caused blood to pool between his brain and skull and that the bleeding had spread into the fluid-filled areas (ventricles) inside his brain. In other words, it was life-threatening. Time was of the essence. Ben was successfully treated via neurosurgical and neurovascular intervention by Dr. Chesler and neurointerventionalist, David Fiorella, who heads the Cerebrovascular Center at Stony Brook. The treatment and care that Ben received at Stony Brook made a lasting impression on the entire Graham family. Today, Ben wakes up happy every day. He’s back to playing sports and doing everything he’s always loved doing with family and friends.

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Jeanne Shore, October 2023

Stroke survivor / mechanical thrombectomy performed by Dr. David Fiorella 

Who would think that a nurse leading a healthy life, could have a stroke? It happens. Just ask 68-year-old Jeanne Shore, RN. On Sunday morning, October 29, 2023, while getting ready to go to 9 am mass, Jeanne breezed through her usual routine. She washed up, did her makeup and her hair. Then, just as she went to make her bed, her partner Bill noticed something wasn’t right. When Jeanne couldn’t respond to Bill’s questions (even though in her head, she knew the words she wanted to speak), Bill called an ambulance. EMS arrived quickly.

After checking Jeanne’s vitals and recognizing that she was unable to produce words/speak, EMS asked where they wanted to go. (There are two primary stroke centers right near Jeanne’s home.) Without missing a beat, Bill said, “She’s going to Stony Brook!” And that was that. Bill knew about Stony Brook University Hospital’s excellent reputation for stroke care and wanted her to go directly there. And it’s a good thing she did. Because the two primary stroke centers closer to her home would not have been able to treat her severe kind of stroke. They would’ve had to transfer her to a comprehensive stroke center — which can sometimes take up to three hours or more.

Upon arriving at Stony Brook, Jeanne was diagnosed with a large vessel occlusion (blockage) of her middle cerebral artery (the area of the brain that controls one’s ability to produce speech). Neurointerventionalist Dr. David Fiorella was called in to remove the blockage and restore (reperfuse) the blood flow to Jeanne’s brain by performing a mechanical thrombectomy – an advanced procedure that is only performed at a comprehensive stroke center. This image-guided, minimally invasive procedure includes the use of microcatheters to remove the occlusion. 

Jeanne was one of the first patients in the U.S. to be treated using brand new microcatheter technology available only at Stony Brook in our region. She was discharged within four days, and her speech returned to normal soon after. A week later, Jeanne celebrated her birthday surrounded by Bill, her children and grandchildren. Jeanne has so much to be grateful for. And she is no longer at a loss for words. In fact, she’s now on a mission to tell anyone who will listen, about the importance of going directly to Stony Brook, a comprehensive stroke center, when a severe stroke is suspected. As she put it, “Why waste time? Go where you gotta go. I did!”

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Ralph Sabatino,   April 2023

Stroke survivor / mechanical thrombectomy performed by Dr. David Fiorella

At 67, Ralph Sabatino thought of himself as typical for his age. His heart doesn’t work perfectly. He has high blood pressure. And his wife says he snores. The day Ralph’s stroke happened was typical, too…until it wasn’t. It was April 23, 2023. Ralph was working on his laptop in his bedroom. As he rose from the chair, he collapsed and fell to the floor. At first, he thought he’d simply slipped out of the chair. But he couldn’t get up. Thank goodness his sister, who had been visiting, happened to enter the room a minute later and called his wife Claire to the room. Claire, an RN, noticed Ralph’s left side was paralyzed and his speech garbled and slurred. She immediately called 9-1-1 and told the dispatcher she thought her husband was having a stroke. Within minutes, a Stony Brook mobile stroke unit was there at their house. From the CT scan taken onboard the mobile stroke unit, doctors at Stony Brook confirmed Ralph had indeed suffered a stroke. He wasn’t bleeding but they saw he had a blood clot in his brain. “In the five minutes it took to get to the hospital,” said Ralph, “the Stony Brook team had everything ready and a plan in place for Dr. Fiorella to perform a procedure to remove the blockage.” Ninety minutes later, Ralph was in the recovery room. From Ralph’s perspective, “It was as if nothing happened. I felt exactly the same – great—as before the stroke. I resumed activities immediately. Dr. Fiorella, his team and the mobile stroke unit saved my life.” Ralph's story was also covered on News 12, as part of a segment on Stony Brook Mobile Stroke Unit Program's five-year anniversary in May 2024. 

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Peter Giordano,   December 2022

Stroke survivor / mechanical thrombectomy performed by Dr. David Fiorella

On December 29, 2022, Pete Giordano was as happy as could be. The day before, he had submitted all his paperwork for his February 2023 retirement from his job with the Town of Hempstead. And minutes earlier, he’d left his favorite Japanese restaurant in Hauppauge in great spirits, joking as usual, with his wife and two cousins. No one expected what happened next. Pete’s speech began to slur, his face shifted, and then he suddenly passed out in his wife’s arms in the restaurant parking lot. Within minutes of calling 9-1-1, the police, along with a Stony Brook Mobile Stroke Unit (MSU) arrived. While onboard the MSU, Pete was examined via telemedicine by neurointensivist, Dr. Neil Nadkarni, and neurology fellow, Dr. Nick Koroneos. He also received a clot buster medication while in transit to Stony Brook University Hospital. Pete’s CT scan and CT angiogram that were taken while onboard the MSU were reviewed by neurointerventionalist, Dr. David Fiorella back at the hospital. Pete was diagnosed with a major stroke and a large vessel occlusion – which occurs when there is sudden blockage of a major artery supplying the brain. When Pete arrived at Stony Brook University Hospital, Dr. Fiorella and his team were already waiting and performed a mechanical thrombectomy to immediately restore blood flow to Pete’s brain to prevent ongoing irreversible brain damage. By New Year’s Eve, Pete was back home watching the ball drop in Times Square. He went back to work the following Monday, and is now enjoying a fully active life in retirement with his wife Helen.

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Shashi Talwar,   July 2022

Stroke survivor / mechanical thrombectomy performed by Dr. David Fiorella

Back home resting, after a routine visit to the hair salon, Shashi Talwar was chatting with her daughter, Richa Kalra, who is a trained nurse. The next thing Richa knew, her mom’s speech suddenly went haywire and her bottom lip shifted to one side. Within minutes of Richa calling 9-1-1 and alerting the dispatcher that it was a stroke, a Stony Brook Mobile Stroke Unit arrived. Dr. Jason Mathew was the neurologist who examined Shashi on the Mobile Stroke Unit via telemedicine. He noted that in addition to aphasia (speech deficit), she also had severe weakness on her right side. A clot in Shashi’s brain was detected and Shashi was immediately brought to the Stony Brook Cerebrovascular Center. Thanks to a mechanical thrombectomy performed by Dr. David Fiorella, Shashi has regained the use of her body. She’s full of gratitude. And so are her daughter and grandson.  

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Nicole Perry, March 2022

Stroke survivor / mechanical thrombectomy performed by Dr. David Fiorella

Thanks to a caring friend who urged her to go to the hospital, a quick-thinking emergency department nurse at Stony Brook Southampton Hospital, and Dr. David Fiorella and his team at the Stony Brook Cerebrovascular Center, this chef and owner of Catering by A Small Affair in East Quogue is alive and well, enjoying life to the fullest again. 

“After my husband died last July, 2021, I threw myself into my work. I’m a chef. I own a catering company in East Quogue, and my husband was also my business partner. Soon, the pressure of having all these weddings to cater each weekend without him at my side started to get to me. Then one weekend in September, I woke up around 5 am to bake 30 cakes for a wedding. Before long, I started to see spots in front of my eyes, my words were coming out slurred and I felt dizzy. I called my neighbor, Mary, who’s a nurse and she came over right away with a blood pressure machine. My blood pressure was over 200! She kept telling me I needed to go to the hospital because I could be having a stroke, and I kept saying that I had a lot to do and no time to go the hospital. It wasn’t until she said, “None of this will matter if you die, Nicole!” that the seriousness of it all sunk in.

Mary rushed me to Stony Brook Southampton Hospital, where she explained to the people in the Emergency Department that I’d had a stroke. A CT scan confirmed this and the nurse there told me that time was of the essence and that they would be transferring me to Stony Brook University Hospital where there was a Neuro ICU.

Then, on my way to Stony Brook University Hospital, I had another stroke! The next thing I remember is waking up in the hospital. I learned that Dr. David Fiorella had performed a mechanical thrombectomy in my carotid artery. He had saved my life! I have to say, the care I got at Stony Brook was phenomenal. And over the next two weeks in the hospital, this wonderful nurse, Jose, helped me with my walking every day. He was so gentle and kind. All of the nurses were great, but he really stood out. They all made sure I was physically able to do occupational, physical and speech therapy before I left. I worked really hard and on October 1 st , I was discharged to a rehabilitation center.

When it came time for my three-month follow up visit, I couldn’t wait to meet Dr. Fiorella. When I saw him, I gave him the biggest hug and he said, “You made my day!” And I told him, “Are you kidding? You made my life!”  

When I look at the MRI of my brain activity during the stroke and then after the surgery, I’m amazed. During the stroke it was totally blank. And on the MRI after the surgery, you can see all the arteries. Dr. Fiorella is a genius. And he made my 27-year old daughter so happy that she still has her mother. She and I have been doing so many fun things together since I recovered from my stroke. I feel great. I exercise, walk, do yoga and Pilates. I’m baking cakes again and that makes me feel like the person I was before the stroke. I could never repay Dr. Fiorella. He gave me a second chance at life.”   - Nicole Perry

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Rosemarie Poirier,  February 2022

Stroke survivor / mechanical thrombectomy performed by Dr. David Fiorella

On a February morning that began like any other, this 73-year-old  Brentwood, Long Island resident  woke up feeling fine. But then, around noon, after her usual daily phone call with her brother in Florida, all that changed. As Rosemarie sat in the living room to watch TV with her husband Ed, she began to exhibit signs and symptoms of a stroke.  

"As I began to speak, the words didn’t come out right," explained Rosemarie. "So, I tried again. Still, the words didn’t come out right. In my garbled voice, I told my husband Ed that I was having a stroke and to call an ambulance. After 56 years of marriage, it didn’t take being a mind reader for Ed to know what I was trying to say. He frantically dialed 9-1-1, and told the dispatcher, ' My wife is having a stroke!' "

Within minutes, a Stony Brook  M obile  S troke  U nit (MSU) arrived at the Poirier home and Rosemaire was placed inside the unit. "They were so efficient. It was just amazing," said Rosemarie. "Especially the nurse, Juan. Every unit needs one of him! He was so thorough. It’s like he just knew it wasn’t just a TIA mini stroke." 

While the MSU crew monitored Rosemarie, a CT scan was performed. The stroke neurologist back at the hospital who examined her via telehealth while she was in the MSU, noted to the crew that additional testing was needed. It would turn out to be a large vessel occlusion in her carotid artery that had caused Rosemarie's acute ischemic stroke. She needed a mechanical thrombectomy, which is the gold standard of care in such instances. Time is brain when it comes to ischemic stroke, meaning that nearly two million neurons are lost each minute a stroke is left untreated. So, it was imperative for the MSU crew to bring Rosemarie to a comprehensive stroke center where her stroke could be assessed further, and appropriate care would be provided in a timely manner.

Rosemarie's husband Ed insisted that the MSU crew take his wife to Stony Brook University Hospital.

Upon arrival, Rosemarie was whisked into the OR and sedated. Neurointeventionalist, Dr. David Fiorella, who is an expert at performing mechanical thrombectomies and has successfully performed nearly a thousand of them, was on call that day. "My husband and I know that Dr. Fiorella and his team are the best at this, so my husband wanted me at Stony Brook," explained Rosemarie.

Once Dr. Fiorella performed the mechanical thrombectomy on Rosemarie, she was ready to be discharged just two days later. Ed and one of her daughters drove her home that Wednesday.

"My stroke didn’t change our lives. We’re still doing all the things we always do. All my angels were working. Everything was in place. Got the  M obile  S troke  U nit. Got to Stony Brook University Hospital. Dr. Fiorella was available. Divine intervention!”    
  - Rosemarie Poirier

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Tricia Restivo Saur, January 2022

Stroke survivor /mechanical thrombectomy performed by Dr. David Fiorella

While visiting her family on Long Island, this resident of Germany was at the beach with family when her 13-year old daughter noticed something wasn’t right and told her father who recognized stroke symptoms and told Tricia’s parents to call 9-1-1.

  “The stars were aligned that day. My daughter’s intuition and my husband’s awareness of stroke symptoms, being within the service area of the Mobile Stroke Unit Program, and that Dr. Fiorella was on service that day. As a dear friend said, I am the luckiest stroke patient.”   - Tricia Restivo Saur