Life After AVM Goes on for Teen
November 13, 2019
Brain surgery gave Allison Coreas a new chance at life three years ago - and she is forever grateful.
Coreas, who dreams of being a child psychologist, started experiencing strange symptoms shortly after arriving at her Orange County school one morning. She experienced dizziness, nausea and difficulty speaking, which left her - and her mother, Wendy - scared.
Coreas was rushed to the emergency room at a nearby hospital and examined. Doctors quickly determined that Coreas had a brain bleed, and she went into a coma.
She was transferred to UC Irvine hospital in hopes that she would get the critical care she needed.
Shortly after her arrival at UC Irvine, Coreas woke up and had brain surgery for an arteriovenous malformation, a tangle of abnormal blood vessels where arteries and veins connect in the brain.
While an AVM sounds scary and rare, according to the National Organization of Rare Disorders, around 30,000 people in the United States are affected by AVM every year.
Treating the condition is complicated, and failure to treat can result in stroke, seizures, brain damage and death. Survival requires a fast diagnosis and access to advanced neurological treatment.
And brain surgery for AVM can be just as dangerous.
"Any surgical brain procedure carries risks," said Dr. Faisal Jahangiri of AXIS Neuromonitoring in Richardson, Texas.
Like any other surgical procedure, risks and complications can mean severe lifelong implications for the patient.
These implications can mean that body processes and systems are impaired or affected, cognitive function and memory can be reduced, and patients are at risk of paralysis.
But these risks can be reduced by adding intraoperative neuromonitoring in the operating room.
What Is Intraoperative Neuromonitoring?
"Intraoperative neuromonitoring, also known as intraoperative neurophysiological monitoring or IONM, is the monitoring of the neural structures, such as the brain, brain stem, spinal cord, cranial nerves and peripheral nerves during high-risk surgery," Jahangiri said.
The ability to monitor these nerves and structures can mean the difference between complications and no complications.
"Surgeons cannot see the functional changes to patients that occur in other parts of the body based on what they're doing in the surgical area," Jahangiri said.
These changes include muscle weakness, full or partial paralysis, loss of function, sensations and changes to body processes, such as bowel and bladder control.
AXIS monitors patients using neurophysilogical diagnostic tools to test evoked potentials (EP), somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), brainstem auditory evoked potentials (BAEP), visual evoked potentials (VEP) and changes to the brain with electroencephalography (EEG) and muscles with electromyography (EMG).
Stabilizing After Surgery
During Coreas' AVM surgery, she was treated with a procedure known as embolization, in which the problem blood vessels were plugged. Once those vessels were treated, the AVM was surgically removed.
After the procedure, swelling on Coreas' brain was reduced, her blood pressure was stabilized, and she was moved into a stable condition.
Coreas woke up from her coma and was able to follow basic commands. In the weeks after waking up, she worked with experts to restore her physical and cognitive function.
She is currently working on her degree in child psychology at a college in California.
Source: NBC Los Angeles. Brain Surgery Gives Teen a Second Chance at Life. 20 October 2019.
