Will a previous stroke prohibit future surgery?

1 answer | Last updated: Oct 11, 2016
Danna l asked...

Hi, My sister had a stroke when she was 31 years old. They said it was a left brain stroke with a right sided hemiplegia with expressive aphasia and that on her angiogram it was noted she had an absent left middle cerebral artery. About 10 years ago she and another family member looked into her getting a breast reduction. However everyone turned her away because of her stroke and the fact that she is on blood thinners and high blood pressure medication. She really needs a breast reduction because the size is causing her a lot of problems. So my question is, has anything changed in the last 10 years so that she might be able to have this surgery? If so can you give me some suggestion or maybe point me in the right direction for her to get her the help she needs?? Thanks for your time Danna


Expert Answers

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

Unfortunately, it is very difficult to answer this question, as it would be extremely helpful to see the angiogram. An "absent" middle cerebral artery can be from a number of causes.

With regards to the blood thinners, if she is taking a drug called "Coumadin", otherwise known as "warfarin", there have been advances in the last 10 years that might allow for her to safely come off that medication for a surgery. Often, people who need to have their blood anti-coagulated by taking Coumadin can be temporarily switched to shots of a drug called "Lovenox", skipping 1-2 doses just before their surgery. However, without knowing the exact circumstances of her middle cerebral artery disease, I cannot say whether the surgery would be safe.

You should ask her doctor to review the angiogram and the "Coumadin" issue, to see if she might be able to get the surgery done by switching to "Lovenox" temporarily.

Good Luck!