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Monday, April 20, 2015

Brain Power: How MidHudson Regional Hospital Saved Hit-and-Run Victim Katarina Napolitani

Posted By: Advancing Care

On the night of a fierce lightning storm, Katarina Napolitani’s life changed in a flash.

It was July 8, 2012, and the 19-year-old from New Windsor, New York, was leaving a friend’s party in Newburgh when a moving car struck her in the street, throwing her more than 15 feet in the air.

Katarina was rushed to MidHudson Regional Hospital (then Saint Francis Hospital). In 30 minutes, she had arrived and Dr. Michael Cho was on his way to the hospital.

“Getting her here expeditiously was of the utmost importance,” says Dr. Cho, Neurosurgeon at MidHudson Regional Hospital, recalling how the CAT scan revealed bilateral depressed skull fractures and several areas of hemorrhage within the brain substance, as well as overlying epidural hematomas. These blood clots, between the skull and brain, were more than two centimeters in diameter and “life-threatening,” says Dr. Cho. Her brain had been compressed and pushed from right to left, unnaturally forced across a protective membrane.

“Dr. Cho pulled my parents aside before the surgery and said, ‘We truly don’t know if she’ll make it,’” says Katarina, whose parents recounted the grave conversation to her after months had passed.

During surgery, a craniotomy, Dr. Cho decided not to risk interfering with the smaller hematomas, knowing they would be reabsorbed into the brain over time and disappear.

Donny Napolitani will never forget the six hours his daughter was in surgery. “There is no worse feeling in the world,” he recalls. “I wasn’t thinking the worst on the drive to the hospital. But when you get there and you’re told your daughter is having emergency surgery, her head is fractured in multiple locations, and there’s a 50 percent chance she won’t come out of surgery—your heart just drops. We just had to have faith and pray. We held onto every hope.”

After surgery, Katarina was placed in an induced coma to allow her still-fragile brain to rest and recover.

As the hospital monitored Katarina, uncertainty plagued her family’s vigil. “We had no idea what would happen once her brain stabilized,” says Donny. “Would she have slurred speech? Would she be able to see and hear? And what would her memory be like?” At the bedside, her parents would speak to her: “Katarina, if you can hear me, move your hand.” Donny says he will never forget when his daughter stirred enough to squeeze his finger.

Ten days after the accident, there was more cause to rejoice. “I was with Katarina when she first opened her eyes,” Donny says. “I was the first one she saw; and when she realized it was me, she smiled.”

Upon emerging from the coma, Katarina says she felt as though she’d only been asleep for the night. “I woke up to the stitches being taken out of my head,” she says. “I felt my head; I was bald. I touched my scalp, confused, and I remember asking: ‘Where are my clothes? Why am I wearing a hospital gown?’”

After her experience with Dr. Cho, Katarina decided she wanted to be a neurologist.

After her experience with Dr. Cho, Katarina decided she wanted to be a neurologist.

“Day by day, little by little, we breathed more sighs of relief,” says Donny. “We knew she could see us, hear us, squeeze our hands.”

In a matter of weeks, says Donny, she was speaking loud and clear: “‘Dad, I want to go home!’”

“She was home four weeks after the accident, which is unbelievable,” says her father. “Her hair had only just started to grow back in.”

“She was home four weeks after the accident, which is unbelievable.”  — Donny Napolitani, Katarina’s father

“She was home four weeks after the accident, which is unbelievable.” — Donny Napolitani, Katarina’s father

Katarina has only a foggy recollection of the accident and the days leading up to it. Newspaper articles giving details of the hit-and-run help to jog her memory—and led to the arrest of the driver three days after the incident. Her childhood memories are also patchy; but by looking at photo albums and hearing family stories, she is rebuilding the associations to help her remember. Dr. Cho says that Katarina’s brain is recovering “like any injured body part,” in this case through the healing of severed connections in the brain. “In Katarina’s case, the injury was reversible. There are some people who have irreversible head injury, and they don’t recover. She was lucky,” he says.

“For the most part she’s remembered all the important things,” says Donny. “We look at pictures of happy things, like the times I took her camping, and we talk about them. I think those memories are coming back to her.”

For now, she has lost her sense of smell and taste, which Dr. Cho says is a common aftereffect of brain trauma due to impact upon the olfactory nerve. (“I’ll eat clams and mussels and meatloaf now, but I still won’t eat beans.”) She has occasional headaches and anxiety. Yet she holds fast to her goal of becoming a doctor, refusing to let the accident lead her off-track. Now a senior at Mercy College with a 4.0 GPA, she is studying for the MCATs and hopes to become a neurologist.

“To see her today…it’s almost like nothing ever happened until you run your hands through her hair and feel the scars. She’s put it behind her,” says Donny.

On follow-ups with Dr. Cho, Katarina appreciates his attention, wry humor and reassurance. “He’s honestly amazing,” she says. “Some doctors don’t have time to sit down, talk and explain. He always pulls up the CAT scan and points out the findings.”

And while Dr. Cho always reminds her she is “one lucky girl,” Katarina credits his quick thinking and surgical skill with saving her life. “The fact that she’s made a full recovery is remarkable,” Dr. Cho says.

For Katarina, who jokes she breaks a bone “every time I trip in a pothole,” it’s a miracle that it was “only” her brain that sustained damage. On a more serious note, she has learned “life is too short to stress or be unhappy.”

“Two seconds can change everything—you never really know what tomorrow brings,” she says. “That’s why I take each day as it comes. I want to be a brain surgeon because my own brain surgeon changed my life.”

Visit us at MidHudson Regional Hospital, a member of Westchester Medical Center Health Network, to learn more. Advancing Care. Here.