As Ursula McMaster recently watched her three-year-old son, Jack, run lengths of the gym floor at his preschool orientation she was reminded of how far he’s come.
Jack was born with an incredibly rare condition known as the vein of Galen malformation and has undergone brain surgery twice in his short life. There have only been five or six children diagnosed with this condition at BC Children’s Hospital in the past decade.
“It’s a specific name for a vein in the head that is supposed to change in its development (where the arteries connect into the vein) and these changes didn’t actually finish in Jack’s case,” says Dr. Manraj Heran, whose Interventional Radiology team at BC Children’s diagnosed and treated Jack. The result is too much blood flow in this part of the brain, which starves other tissues in the brain and body of blood and puts excessive strain on the heart.
When he was six months old Jack was the first child to undergo treatment for this condition in BC. Prior to him, kids were flown to Toronto, but the diverse medical experience available to children at the hospital today makes interventional radiology procedures like Jack’s possible in-province.
Avoiding the risks in transporting sick kids across the country is a huge win, says Dr. Heran, who led Jack’s non-invasive procedure. Using a tiny catheter about the size of a small piece of spaghetti, he and his team entered Jack’s circulatory system through an artery in his groin, travelling all the way up to the malformed vein in his brain by following a path mapped out using an angiogram – an X-ray that uses a special dye and camera – of the blood flow going to his head. Using a type of intravascular crazy glue they closed-off some of the problematic vein connections, like rivers being dammed, allowing the blood to be rerouted to the correct parts of his brain.
This operation and the one that followed when Jack was 18 months old were successful and have reduced the pressure on his heart. His father, Grant, recalls his astonishment at how quickly his son bounced back from the second operation:
“He has basically eight hours of brain surgery on the Friday, after which they have him sedated, because of the incision in the groin, and because you can’t tell a two-year-old not to kick around, and then he’s in the playroom on Saturday morning.
Now off all medication and suffering no developmental delays, Jack will be monitored by Dr. Heran and BC Children’s cardiologist Dr. Shu Sanatani, to see if his body corrects itself as a result of the treatment he’s received at Children’s, or if he requires more treatments when he is bigger. Either way, their collective goal is to cure him of this condition.
To learn more about Jack, read his story in Speaking of Children magazine.