Neurosciences

More than Just a Headache

GRAND RAPIDS, Mich., March 7, 2011 – Emily Stauch knew this headache was different.

In November 2009, the 26-year-old Grand Haven resident came down with a headache at work so intense that over-the counter pain relievers had little effect. It hadn’t gone away by the next day when her husband, Dan, noticed that Emily was repeating herself and couldn’t remember what she had just said or done. The couple rushed to a nearby hospital emergency department where a CT scan identified a large arteriovenous malformation, or AVM, in Emily’s brain.

Hear Emily’s story here:

 

An AVM is an abnormal tangle of blood vessels in the brain that competes with surrounding brain tissue for oxygen from the blood. AVMs can result in headaches, seizures and stroke-like symptoms. The most serious complication is a rupture that leads to a hemorrhage, or bleed. Bleeding in the brain can damage surrounding tissue and, in severe cases, can even result in death.

Tests confirmed that Emily experienced a brain bleed due to her AVM. She was referred to Bryan Figueroa, MD, a cerebrovascular and skull base neurosurgeon in Grand Rapids and immediately transferred to Spectrum Health Butterworth Hospital. Figueroa, who completed his neurosurgical training in Boston at the Harvard Medical School Brigham & Women’s Hospital, came to Spectrum Health two years ago.

Spectrum Health is West Michigan’s only provider of complex neurovascular treatments for disorders like AVM and aneurysms that require a unique combination of expertise, technology and specialized care.

Because of the intricacy of the structure of an AVM, surgery is a complex and delicate procedure. To prepare, Figueroa worked with Spectrum Health neuroradiologists to “map out” Emily’s brain using functional magnetic resonance imaging (fMRI). This neuroimaging technique measures blood flow to the brain as the patient is involved in a task or emotion. It provides the surgeon with precise information to guide the surgery to avoid impact on vital language, motor and cognitive centers in the brain.

While in the hospital, Emily experienced a second brain bleed that moved her into a higher risk category. Her surgery took place in two parts, after waiting several days for the blood from the second bleed to drain naturally from Emily’s brain.

On December 2, 2009, N. Thomas Peterson, MD, an interventional neuroradiologist with Advanced Radiology Services, performed an endovascular embolization. This is a less invasive procedure using a catheter inside the blood vessel itself to reach the AVM and inject a special glue-like material to shut down the blood flow to the AVM before surgery.

Figueroa and his team performed the open-skull surgery on December 3. It took 19 hours to completely remove the AVM. Emily was admitted to Spectrum Health’s Neurosciences Intensive Care Unit and placed into a medically induced coma for five days. This helped minimize brain swelling during the recovery process.

Listen to Dr. Figueroa talk about his background and cerebrovascular care.

Interview #1
Interview #2
Interview #3

After surgery, Emily experienced partial paralysis on her left side. Today, her left side is back to normal after both inpatient and outpatient physical rehabilitation. By February 2010, she was able to return to work as an actuary part time and was back to full time by March.

“Complete cerebrovascular care requires a team approach. Interventional neuroradiology, neurosurgery and neurorehabilitation combined efforts to help Emily through this,” said Figueroa. “We are very fortunate to have a highly skilled team of professionals available in Grand Rapids who have a great deal of expertise at this level.”

“I still get headaches every so often which Dr. Figueroa says is part of my brain healing,” said Emily, who is fully active and even recently ran in a 10K race. “People who don’t know me really don’t have any idea that anything was ever wrong.”

“My co-workers are in awe. They tell me that I got my ‘Get out of jail free card’, which is absolutely true. I got a second chance at life, and I give God the glory for working through Dr. Figueroa and his team to make that possible.”

Spectrum Health is a not-for-profit health system in West Michigan that offers a full continuum of care through the Spectrum Health Hospital Group, nine hospitals and more than 170 service sites; the Spectrum Health Medical Group and West Michigan Heart, physician groups with more than 600 providers; and Priority Health, a health plan with 600,000 members. Spectrum Health’s 17,000 employees, 1,500 medical staff members and 2,350 volunteers are committed to delivering the highest quality care. The organization provided $115.9 million in community benefit during its 2010 fiscal year. In 2010, Spectrum Health was named a Top 10 Health System by Thomson Reuters.

www.spectrum-health.org