An Unusual Headache Leads to Stroke Diagnosis

According to the World Health Organization, headaches affect approximately 40% of the population, and are more common among females than to than men. While some suffer from recurring headaches, many people are lucky enough to only suffer from an occasional headache. For these fortunate individuals, a rare headache is often ignored during their busy day.

This was certainly true for Jacksonville resident Ann Webb nearly two years ago. However, what began as a headache was the first sign of stroke.

In late 2022, Webb made plans to accompany her sister and brother-in-law from Jacksonville to Gainesville for a doctor’s appointment. She woke up early that morning and didn’t give much thought to the rare headache and slightly muddled speech she was experiencing. As the trip progressed, the pain increased. What started as a mere annoyance, quickly became an overwhelming distraction. Once her brother-in-law had been admitted to the hospital she and her sister headed back to Jacksonville. By this time, Webb was in agony and phoned her husband to request he have her bed ready because she was going to lie down immediately.

“I’m very blessed not to have many headaches,” Webb said. “But this one, even that morning, I just had to hold my head. So, my husband knew, for me to need to lie down, the pain was serious. By 9 or 10 o’clock that night, I don’t really remember much. I knew something was going to have to give and we decided it was time to go to the emergency room at UF Health North.”

Upon her arrival at the UF Health North Emergency Department, Webb was assessed by physicians and it was determined her headache was a result of stroke and she needed to be transported to UF Health Jacksonville’s downtown campus.

UF Health Jacksonville is the headquarters of the UF Health Comprehensive Stroke Program and provides inpatient and outpatient services for the diagnosis, management and rehabilitation of stroke patients. Such integrated and sophisticated care is important because research shows patients improve faster and recover more completely when managed in a dedicated stroke facility. The program uses state-of-the-art methods for the treatment of stroke, such as the clot-busting drug tPA (tissue plasminogen activator) and interventional procedures. The interdisciplinary team of University of Florida physicians and specially trained UF Health Jacksonville staff includes experts in neurology, neurosurgery, vascular surgery, neuroradiology, emergency medicine, medical intensive care and rehabilitation services. The program is led by neurologist Scott Silliman, MD, who specializes in stroke, cerebrovascular disease and multiple sclerosis.

“Mrs. Webb underwent advanced imaging,” Silliman said. “We were able to get a picture of the brain. We were able to get vessel imaging by injecting dye. And, we were also able to conduct what’s called a CT perfusion scan, which looks at blood flow in the small arteries of the brain. There was a small core of dead tissue, unfortunately, which we see with stroke, but there was also a surrounding area of salvageable tissue. If we saved that area by performing a thrombectomy, or pulling out the clot, we could restore blood flow to that area of the brain and it revives itself.”

Ultimately, Webb had three clots removed from her neck and brain and spent five days under the supervision of the Comprehensive Stroke Center physicians. Dozens of staff members, from multiple divisions, contributed to her care, all working together to ensure the best outcomes for her treatment and recovery. Although there was significant damage to small areas of her brain tissue, blood flow was restored to the majority of the affected area and her recovery was fast. When Webb awoke, her excruciating headache was gone and she quickly regained her ability to speak and form sentences. Ultimately, she only suffered mild weakness on her right side.

“I was excited to be able to go home,” Webb recalled. “I was able to take short trips down the hallway at the hospital and thought, if I was able to that before I go home, I can do even more when I get there.”

Headaches can be a part of everyday life for some Americans but it's important to understand that extreme, uncommon pain or mental fog are often signs that something more serious is taking place. Not all strokes are the same and individuals may experience one symptom, which if not paired with multiple symptoms, could be easily disregarded as insignificant pain, weakness or confusion. For this reason, people may hesitate to seek medical attention. Physicians at the UF Health Comprehensive Stroke Program want patients to be vigilant when it comes to the warning signs of stroke and never wait to seek help.

Silliman said they see plenty of people who come into the Emergency Department and have what is called “mimics of stroke” where it turns out not to be a stroke. They do not mind taking care of those patients, as it is better to come in and get checked instead of waiting for symptoms to get worse.

“You are not going to bother us if you think you’re having a stroke,” Silliman said. “We see some patients who wait too long. You know, the numbness in my arm, I thought it was a pinched nerve. I didn’t want to bother the doctors and they come in at day two, and, unfortunately, now the stroke is beyond a timeframe where we can intervene.”

Ann Webb is happy she took action and sought help at UF Health for her debilitating head pain.

“Now I’m able to do my normal household chores. I can make breakfast and make dinner. I can take showers on my own. Everything is coming back to me,” Webb said.