April 26, 2010 -- Sheryl Wolfe was only 18 when she died of a stroke on April 19 -- something very rare for someone so young, and it got extra attention because she was also the reigning Miss Teen Hawaii.
But her death was followed by word that, by signing up to become an organ donor, she had given life to others. Her kidneys, pancreas and liver have been given to patients awaiting transplants.
"She's always been healthy," her father, Allen Wolfe, told ABC News affiliate KITV in Honolulu. "It's just kind of totally unexpected, out of the blue."
But he expressed some comfort in what his daughter decided to do.
"There's going to be four recipients today that'll have new starts," Wolfe said.
Wolfe's parents told the Honolulu Star-Bulletin that their daughter had suffered a hemorrhagic stroke, one in which an artery in the brain tears open and blood escapes.
Hemorrhagic stroke is different from -- and more rare than -- an ischemic stroke, in which the artery is blocked and brain tissue dies for lack of blood and oxygen.
Both types of stroke are exceedingly rare in young people, with only a few cases per hundred thousand children. The majority of cases that do occur are not fatal, with death often being related to the size of the stroke.
"This young lady, in addition to being victimized by something unusual -- [doctors] didn't have the opportunity to prevent a second stroke," said Dr. E. Steve Roach, who added that most patients survive and can be treated to prevent a future occurrence.
Roach, the chief of the division of neurology at Nationwide Children's Hospital in Columbus, Ohio, did not treat Wolfe, but is an expert on pediatric stroke.
Unfortunately, he said, the rarity of pediatric stroke cases means there is very little screening done to prevent the cases that do occur when there isn't a prior warning of trouble.
"The problem, of course, is the frequency is so low that you just can't terrify everybody or justify having massive testing done on everybody," he said.
He said that when doctors do find a potential problem before a stroke, it is typically because of either headaches or epileptic seizures.
But unfortunately, Roach said, in many cases, "Looking back on it, there was nothing you could tease out and say there was something you could have done different."
Young Beauty Queen Dies of Stroke, but Gives Gift of Life
Sheryl Wolfe took steps to become an organ donor, indicating it on her driver's license. Many Americans do not do that.
"This was her wish if something happened to her, she was a registered donor," Stephen Kula, executive director of the Organ Donor Center of Hawaii, told ABCNews.com.
Kula said organ donation is complicated in Hawaii, in part because of the distance from the islands to anywhere else.
There is one transplant center in Hawaii, and it does not do heart or lung transplants, so patients in need must go to the mainland United States.
"It is a challenge for us -- that's probably one of our biggest challenges," said Kula.
He said there is a waiting list of roughly 400 people for organs, but there are only around 120 transplants each year.
But Kula expressed some optimism about a group which will, hopefully, not need to make good on their commitment, at least not soon -- high school students his organization reaches out to.
"A lot of them are registered donors," he said. "This is what a lot of them want to do."