Ottawa woman's remarkable recovery raises hope about landmark stroke research

When Deanna Longfield walked out of the hospital less than a week after having a potentially deadly stroke in 2021, she didn’t give it much thought. She had cheated death before, says the active 81-year-old, and that seemed about par for the course.

The head of stroke research at The Ottawa Hospital feels differently about the Stittsville resident’s remarkable recovery, though. In fact Dr. Dar Dowlatshahi can barely contain his excitement.

Dowlatshahi is leading the Canadian arm of a global clinical drug trial that he says could represent a long hoped-for breakthrough in the treatment of hemorrhagic strokes — the most deadly kind.

“We are hoping this is going to be the first big landmark discovery that changes this disease,” he said.

In 2021, Longfield, while fighting for her life after the stroke, became the first patient in the world enrolled in the study.

While there has been important progress in recent decades in treating the more common ischaemic strokes, which are caused by blood clots, there has not been the same progress in treating hemorrhagic strokes. Also known as intracerebral hemorrhage, the strokes cause sudden bleeding in the brain that can rapidly result in severe damage or death.

Forty per cent of people who experience a hemorrhagic stroke will die within a month. Of those who survive, around 80 per cent will have significant disabilities, often requiring full-time care, said Dowlatshahi, who is also a professor at the University of Ottawa.

When Longfield arrived at the hospital, less than two hours after becoming suddenly ill and faint while shopping, she was given one of two treatments as part of the trial, either a placebo or the blood-clotting agent called Factor rVIIa. She doesn’t remember much about the following days.

Because it is a randomized placebo-controlled trial, no one knows yet whether Longfield received the trial drug or the placebo, but her remarkable recovery, and a similarly quick recovery of the second Ottawa patient enrolled, gives Dowlatshahi hope.

Both Longfield and the second patient enrolled in the study walked out of the hospital around a week later with few or no lingering deficits. That is not something doctors ever see with hemorrhagic strokes, said Dowlatshahi.

“Either this is just really lucky, or something spectacular is happening here,” he said.

“I want to have some cautious optimism, but we had the first two get the product and walk out a week later and go home. If that is not a game-changer, I don’t know what is.”

Researchers in the study, which is called FASTEST (Factor VII for Acute hemorrhagic Stroke Administered at Earliest Time), are hoping the blood clotting agent used to treat other illnesses including hemophilia will improve survival and reduce disability in those who have hemorrhagic strokes. They hypothesize that administering the drug within 120 minutes of a stroke’s onset will improve outcomes compared to current standard therapy.

The clinical trial is funded by the U.S. National Institutes of Health. Researchers are aiming to enrol 860 patients at about 100 hospital sites, including The Ottawa Hospital, which is the Canadian coordinating centre for the trial.

Longfield was not aware she was the first patient in the world enrolled in the trial. She wasn’t even clear how seriously ill she had been until she spoke with Dowlatshahi late last year.

She learned that her daughters had rushed to the hospital to see her because they were told she was dying. “I didn’t know I was dying. I wasn’t in any pain.”

She recalls seeing one of her daughters by the side of her hospital bed, dressed in her outdoor clothes and repeatedly asking why she was there, but getting no response. Later, her daughter told her she hadn’t been speaking, just making sounds.

She does have some after-affects. Longfield said her right foot drags a bit and she had difficulty with her right hand, although that is getting better.

Otherwise, she said, she continues to be active and had even considered looking for a job, but she is a bit weaker than she used to be and has arthritis.

“I don’t look like an 80 year old and I don’t act it.”

Longfield raised four children on her own, working days as a school music teacher and evenings at Canada Revenue Agency at one period of her life. She has had close calls with her health before.

“I have been so lucky so many times, you wouldn’t believe it. What the hospital calls a medical miracle.”

That includes a bout with necrotizing faciitis — flesh-eating bacteria — which can cause death. She came close to having a leg and hip amputated to save her life, she says, but then the infection began to recede. She also suffered cardiac arrest during an unrelated surgery.

Although her stroke could contribute to research that leads to a medical breakthrough, it is not something she dwells on. When Dowlatshahi called to speak with her about the study in December, she responded “what stroke?” he recalled with a laugh.

“I have had a few things happen when I have been told I was dying but I didn’t,” said Longfield. “This is another one to add to the list.”

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