When Molly Schmand crumpled to the floor, she wasn&#8217t thinking brain attack.

To the 18-year-old from Buffalo, strokes were something that happened to old people.

Not so, she learned.

Less than an hour after the episode she was in a hospital, where doctors threaded a tiny

catheter into her brain to examine a clot that threatened to leave her crippled or dead.

The longer blood flow to the brain is cut off, the greater the damage. So every minute

counts with stroke. And, in this case, quick action by Schmand&#8217s parents, a neighbor and

her dog made a big difference.

Indeed, it&#8217s likely Annie, a mixed coonhound from the SPCA Serving Erie County, will

never lack for affection or dog biscuits because of the role she played.

&#8220Teenagers act as though they&#8217re invincible. They would never think this is going

to happen to them,&#8221 said Schmand, whose life is starting to return to normal since she

suffered the stroke in April and underwent surgery in June.

Stroke in children and young adults is not as common as in the elderly, but it&#8217s more

common than physicians once thought.

The causes and symptoms can be different, too, all of which has led to misdiagnosis and

delays in treatment, according to studies.

Therefore, stroke in young people is getting more attention from the medical community.

Among other things, the American Heart Association/American Stroke Association in 2008

issued its first scientific statement on the treatment of stroke in children.

A 2009 study in California found that the rate of stroke in children may be twice as high

as current estimates, and a paper presented earlier this year at the International Stroke

Conference offered the first hard numbers on what looks like a rising number of stroke cases

among younger adults in the U.S.

&#8220If our data is useful for anything, it raises awareness. People need to know that

stroke is possible in the young,&#8221 said Dr. Brett Kissela, the University of Cincinnati

neurologist who led the study.

Schmand knew stroke was possible in the young.

One of her neighbors is a close relative of Nick Giangreco, who was partially disabled at

age 14 after suffering a near-fatal stroke on the bench at a St. Joseph&#8217s Collegiate

Institute football game in 2006.

She just never thought it could happen to her.

It was April 1, her first day home for spring break from Canisius College, where she lived

on campus. Her parents, Liz, a nurse practitioner, and Michael, executive director of Buffalo

Place, were at work.

Schmand &#8212 an athlete who played soccer, basketball and softball when she attended high

school at Sacred Heart Academy &#8212 headed to the basement to work out with a punching bag.

As she walked by Annie, who was snoozing on Schmand&#8217s bed, she remembers jokingly calling

out, &#8220You are such a bum.&#8221

Soon after Schmand started punching the bag, everything went dark. She had passed out.

Her next memory was of waking up to Annie licking her face, something Annie was not known

to do.

&#8220I think she revived me,&#8221 said Schmand.

It was clear something was wrong. The right side of Schmand&#8217s body felt numb, and her

head throbbed. She couldn&#8217t see out of her right eye, and her left eye had trouble making

out objects in the room.

Schmand was scared but didn&#8217t panic. She climbed the stairs to the first floor but

isn&#8217t sure how she did it. She couldn&#8217t identify a telephone, yet remembered one of

them was lime green, so she searched for the color and somehow made a call to her mom.

&#8220I knew it was a stroke immediately, and I knew we only had minutes to react,&#8221

said Liz Schmand, who called a neighbor to stay by her daughter&#8217s side until an ambulance

arrived.

After word got to Michael Schmand, they both rushed home, waited for the ambulance, called

about its whereabouts, waited a little longer, and then took matters into their own hands.

They carried Molly to their car and raced to Millard Fillmore Hospital, a state-designated

stroke center that also specializes in minimally invasive procedures to treat and prevent the

condition.

Stroke centers organize teams that train to respond to cases as quickly as possible.

&#8220I remember being rushed from test to test. People were running. It was like out of a

movie,&#8221 said Schmand.

Her mother described what she witnessed as &#8220a finely tuned machine.&#8221

A stroke occurs when a blood vessel that brings oxygen and nutrients to the brain bursts in

a hemorrhagic stroke or is clogged by a blood clot in an ischemic stroke. Each year about

795,000 people experience a stroke, making it the third-leading cause of death in the U.S. and

a leading cause of disability.

Starved for oxygen, brain tissue will eventually die, so the more quickly blood flow

returns to normal, the better the outcome for patients.

Highly detailed images of Schmand&#8217s blood vessels revealed a clot in an artery in the

base of her brain. Doctors decided against a procedure to remove the clot, noticing that her

vision was starting to improve and fearing it might release debris that would penetrate

farther into the brain.

Instead, they put her on medications aimed at dissolving the clot, and the treatment

worked.

Doctors would eventually trace the origin of Schmand&#8217s stroke to a condition known as

patent foramen ovale.

As babies grow in the womb, there is an opening between the upper chambers of the heart

that naturally closes soon after birth. But the hole remains, usually undetected, in about 25

percent of the population. It&#8217s linked to stroke in about 1 percent of those with the

condition, especially in patients under age 55.

Schmand had the hole surgically repaired with a patch made of Gore-Tex.

The right side of her body still feels numb, and she struggles with focusing her mind and

remembering things she has read. But life is starting to return to the way it was. She even

recently went for a run.

&#8220It could take two years to get over most of this. I&#8217m just so glad to have my

vision back,&#8221 she said.

Children and adults younger than 45 account for 5 percent to 10 percent of all stroke

cases, according to experts.

But Kissela&#8217s research suggests the incidence of stroke is rising among individuals

under 45. He attributes the increase in stroke to increasing rates of obesity and diabetes

from poor diet and lack of exercise.

&#8220The lifestyle decisions we make early in life have consequences,&#8221 he said.

On average, it takes 12 to 24 hours for adults to get to the hospital after recognizing the

first symptom of stroke, but much longer for children and young adults, mainly because

symptoms can go unrecognized or be attributed to something else, according to the National

Stroke Association.

&#8220Diagnosing stroke can be a challenge. In a third of cases, you never find a cause,

and it can be misdiagnosed because there are other conditions that have similar

symptoms,&#8221 said Dr. Catalina Ionita, director of neurocritical care at the Catholic

Health System.

Doctors know much more about how stroke affects individuals differently, depending on their

age, race and gender. Evidence indicates that young patients make ideal candidates for

procedures that open clogged arteries and other aggressive therapies.

&#8220If any population is good it is the young patient. The anatomy of a young person is

more robust and, because of their age, a successful intervention has a huge impact on their

lives,&#8221 said Dr. Elad Levy, one of the leaders of the neurosurgical team at Millard

Fillmore.

After her experience, Schmand agreed to participate in a hospital advertising campaign

about stroke care. She wants to share her experience, hopeful it will raise awareness among

others her age.

&#8220What gets me now, is how your life can take a completely different turn in just one

second,&#8221 she said.