High school senior Brittany Krebs of Pasadena didn’t know what to make of her worsening headaches and dizzy spells. Her headaches soon turned into seizures but it wasn’t until November 2014 that she realized there was something medically wrong, when one of her sisters found her during a seizure. Her family called 911 and the ambulance took her to UM Baltimore Washington Medical Center.
After swift emergency care and imaging tests, an MRI revealed that Brittany had a noncancerous tumor the size of a pingpong ball in the middle of the left hemisphere of her brain. Several days later, she was scheduled to have a craniotomy to remove the tumor, performed by neurosurgeon Danny Liang, MD, director of neurosurgical oncology at UM BWMC and clinical assistant professor of neurosurgery at the University of Maryland School of Medicine.
“Brittany had a benign tumor in a very bad location,” says Dr. Liang. “Her tumor appeared to be a meningioma, which is the most common tumor that occurs in the brain. They usually arise from the covering of the brain, in a superficial location, and slowly push into the brain, causing symptoms. Brittany’s, however, was a meningioma that emanated from the ventricle, which is a fluid cavity in the middle of her brain. This only occurs in about 0.5 to 1 percent of meningiomas.”
This rare condition presented multiple challenges to tackle during surgery. “The first was that there is normal, functional brain all around the tumor,” explains Dr. Liang. “The second challenge was that this is her dominant side, meaning the brain around it controls speech, language, naming, calculation, visual spatial processing and movement of her right side. Thus, going through this part of the brain to get to the tumor could render damage to those skills.”
After a thorough discussion with Brittany and her mother about various treatment options, they decided to attempt complete surgical removal.
“Using a specialized approach, we were able to monitor her brain function intraoperatively and sneak through ‘silent areas’ of her brain to reach the tumor. By cutting off the blood supply through one corridor, and then killing the rest of the tumor and removing it from another [corridor], we were able to achieve a complete resection,” says Dr. Liang.
Brittany spent eight days in UM BWMC’s critical care unit, with frequent visits from Dr. Liang and physician assistant Sean Lanehart, PA-C. She worked with nurses who helped to keep her comfortable and minimize her headaches, along with physical therapists and speech therapists.
After making great progress in her recovery, Brittany returned home the day before Thanksgiving - much sooner than she predicted. In addition to continuing her physical, speech and cognitive therapies, resuming school and graduating on time became high priorities. She pushed herself as much as she could to be able to walk on stage next to her sisters in May 2015. She home-schooled for a period of time to stay on track and up to date with her assignments.
In the spring, Brittany returned to Northeast High School and resumed her normal life. She purchased her cap and gown and walked across the stage on graduation day, on time and in high heels, alongside her two sisters.
To avoid more seizures, Brittany takes preventive medicine and follows up with Dr. Liang and the Spine and Neuroscience Center team at UM BWMC twice a year for MRIs and checkups.
“Brittany will always be one of my most special patients,” says Dr. Liang. “She was scared, but was also remarkably bright-eyed and ready to tackle any challenge to get back to her life and her dreams that lie ahead. With a great attitude and a great team that cared for her here at UM BWMC, she made a wonderful recovery from her surgery.”
“When I heard she went back to school, took AP classes, and graduated on time with her sisters and friends, it made it all the more special to me. This exemplifies what we strive for and why we do what we do. We hope to tackle difficult medical problems and help all our patients return to healthy, happy lives.”
Mary Ann Byrnes
For years, Mary Ann Byrnes lived with back pain. She couldn’t bend to cook or work in the yard. Even walking was difficult. With collapsing discs, the West River resident said she needed “super glue” to put her back together again. "That and a little “spirit.”
The glue arrived on the day of Byrnes’ back surgery. So did her spirit – neurosurgeon and co-director of the UM Baltimore Washington Spine and Neuroscience Center,Dr. Clifford Solomon.
“He helped me,” Byrnes said of Dr. Solomon. “He gave me my second chance. I call him my spirit.”
Byrnes, 76, had previous surgeries at other hospitals to ease her neck and back pain, and she doubted another one would make a difference. But Dr. Solomon said he could help. In his office, he explained what was wrong with Byrnes and how surgery could fix it. He also listened, Byrnes said.
“Sitting with the patient and really listening and being quiet is helpful,” Dr. Solomon said. “It has nothing to do with neurosurgery. That’s part of being a good doctor.” The day of the surgery, everyone from the nursing and support staff to Dr. Solomon and the anesthesiologist, eased Byrnes’ nerves, she said. Post-surgery, the high level of care continued with the nurses on the fifth floor, as well as the occupational and physical therapy staff, Byrnes said. “They couldn’t have been any nicer to me at that great hospital,” she said. “Everybody’s a friend up there. Everyone helps everyone else.”
Today, Byrnes can walk pain free. She is even back to cooking again. “I’m healthy, and I thank God and Dr. Solomon for that every day,” she said. “I would go back to that hospital in a heartbeat if I had to.”