Fighting back from a neonatal stroke
One-year-old Finley Marie Tidwell picked her Cheerios from a bowl one at a time, holding them proudly between her right thumb and forefinger. She lifted her right arm and pointed toward the toy she wanted. And with blonde curls bouncing, she gleefully took deliberate, balanced steps into the arms of her mother, Kristen.
Her actions brought smiles to CHKD occupational therapist Andrea Harris as she evaluated Finley’s remarkable recovery from the stroke she suffered at only three days old.
It started with seizures as the seemingly healthy 6-pound, 13-ounce newborn was being fed by her mom in a Williamsburg hospital. The frightening episodes rapidly worsened, affecting her right arm and leg. A call to Children’s Hospital resulted in Finley’s late-night transfer to the region’s highest level of neonatal intensive care.
“I knew the sickest babies went there; it was very scary for us,” the first-time mom said. The CHKD transport team placed Finley in an incubator and took a picture for the new parents. Kristen and Russell then followed CHKD’s rolling intensive care unit to Norfolk.
Once there, the family learned Finley had suffered a neonatal arterial stroke caused by a blood clot that formed in or found its way to the left side of her brain. It cut off the blood supply and killed a golf-ball size portion of brain tissue, causing the seizures.
Pediatric neurologist Larry White explained the danger and possible effects from the stroke – and how the entire CHKD team would take care of Finley over the next days, months and even years, if needed. Kristen recalls, “He was straightforward but very calming. He said the next few days were critical, and Finley would have to do her part and CHKD would do theirs.”
The Tidwells never knew a baby could have a stroke. But CHKD neurologists see it often. “Neonatal arterial stroke occurs in about one in 4,000 births,” Dr. White said. “It usually happens without warning within the first 30 days, and there’s no way to predict the outcome. We get the seizures under control, then look for a cause and treat any aftereffects.”
Finley suffered a significant injury to her brain that weakened her right side. But her recovery got off to a good start with medication to control the seizures. And tests of her heart and the other blood vessels in her brain to look for more clots or weakening showed no reason to believe another stroke would occur. In three days she was headed home to Williamsburg.
Later, blood tests helped determine there was no underlying cause for the clot.
Therapists at CHKD’s satellite facility in Williamsburg began therapy in June to help strengthen Finley’s right side. “We started early to make sure she didn’t try to compensate by using only her left arm and leg,” Harris said. “We want her to be able to point and pick up things with her right arm and hand, and develop muscle tone and right-sided skills so she can walk evenly and with balance.”
The therapist taught Kristen and Finley’s grandmother, Edna Lee Hooker, how to put their hands on Finley’s body to encourage specific movements and how to incorporate exercises into her daily life to make rehabilitation more effective.
“Today, you would never know anything was physically wrong with her,” Harris said during a rehab follow-up evaluation in January.
Finley continues to see CHKD’s neurology specialists and NICU follow-up team. During a recent visit with Dr. White, Finley demonstrated early progress in another important area. “She talked and talked while we were there,” Kristen said. “So, we hope her speech continues to develop normally.”
Finley has passed some very important milestones, but her journey isn’t over. “We’re all very proud of her and her family for their hard work, but there are some things we won’t know until she’s older,” Dr. White said. “We’ll be watching closely for signs that suggest speech or educational delays so we can intervene. We’ll relax when she’s in kindergarten and we can’t tell her from any other child. We do expect that to be the happy ending.”
Finley’s parents are grateful for CHKD’s efforts. For her first birthday in January, they held a “Party with a Purpose” to benefit CHKD and raised more than $800. “From the beginning, it was a comfort knowing CHKD was here for us,” Kristen said. “We couldn’t have asked for a better experience during such a stressful and traumatic time.”
Dr. White practices with Children’s Specialty Group PLLC at CHKD.