Belinda Everett and her grandson, Darren Martinez, have been looking forward to August 2019 for years. That’s when Darren will finally be a student in Everett’s fourth grade math class at Benavides Elementary School in South Texas.
“He began talking about it when he was in first grade,” Everett said. “Darren would ask, ‘Gram, can’t I just skip a grade?’”
That future was in doubt after Darren was hospitalized twice in a five-month period due to a rare and life-threatening vascular condition that eventually required brain surgery at Children’s Memorial Hermann Hospital.
Sudden Pain Escalates To An Emergency Situation
On a sunny Tuesday morning in late March 2018, Darren felt an intense pain in his head while on the school playground during gym class. The pain increased so rapidly that Darren vomited on the way to the school nurse’s office. Minutes later, Darren suffered a seizure.
Everett rushed from her classroom, which overlooks the playground Darren had just left, to find him unconscious in the school nurse’s office. Darren’s skin was pale and there was purplish discoloration around his mouth.
“I put him on my lap and kept trying to wake him up,” Everett said.
Darren’s mother, Katrina Perez, arrived soon after to ride with her son in an ambulance to a nearby hospital.
“We weren’t sure what would happen to him,” Perez said.
A Rare Condition Is Discovered
After Darren was transferred to a larger hospital locally, it was discovered that his sudden change in health was caused by a brain arteriovenous malformation (AVM), an abnormal collection of arteries and veins that can disrupt normal blood flow.
“AVMs under high pressure can bleed,” said David Sandberg, MD, director of pediatric neurosurgery at Children’s Memorial Hermann Hospital. “Bleeding on the brain can press on other structures and be life-threatening.”
The symptoms of AVM range from headaches and dizziness, to seizures or altered consciousness. The presence of an AVM is typically confirmed through advanced imaging such as an MRI or cerebral angiography.
Only one of every 100,000 people are born with an AVM, according to the American Association of Neurological Surgeons. Each year, 2 to 4 percent of people with a brain AVM experience a hemorrhage. That yearly risk can add up to be very dangerous over the course of a lifetime.
A Short-Lived Recovery
Darren underwent a five-hour surgery to address the AVM at his local hospital and regained consciousness three days later.
Perez kept Darren home for the remainder of the school year as he recovered. He completed second grade at home and rested throughout the summer, awaiting the 2018-19 school year.
Darren’s return to school came with mixed emotions for Perez.
“We were obviously happy Darren was going back to school,” Perez said. “But as a parent, you’re nervous. You don’t want to let your child out of your sight after you go through what we did.”
Perez’s reservations were validated the first day of the school year. While in the science lab, Darren began feeling pain in his right eye and was taken immediately to Everett’s classroom. Darren lost consciousness and was again rushed to the hospital.
“We were devastated,” Everett said.
A decision was made to transport Darren to Children’s Memorial Hermann Hospital in Houston.
Addressing a Challenging Condition
Tests revealed that a small portion of Darren’s AVM, located in an area at the back of the brain called the posterior fossa, still remained and had hemorrhaged again, causing a mass of blood to block fluid circulation.
“Darren’s AVM was challenging because it was located in a very high-risk area,” Dr. Sandberg said. “A mass lesion in that area of the brain can cause compression of the brain stem, which controls vital functions like heart rate, blood pressure and breathing.”
It was critical to safely remove the remaining AVM as soon as possible.
“As blood clots get bigger in that area of the brain, patients can deteriorate rapidly and their life is in danger,” Dr. Sandberg said. “I feel so lucky to work in a center together with a team of experts who see challenging cases like this day in and day out.”
Dr. Sandberg teamed up with renowned vascular neurosurgeon Arthur Day, MD. Together, Drs. Sandberg and Day were able to remove the rest of Darren’s AVM without additional complications. With near certainty, Darren is now cured of the AVM forever.
“I’m so happy and thankful we were able to meet with Dr. Sandberg,” Perez said. “I don’t want to think about what could have happened if we had waited.”
Looking Forward To Next School Year
Darren has returned to school and attends church with his family every week. He regularly attends physical therapy, occupational therapy and speech therapy sessions.
His hair has grown over the scar on his head from surgery and he no longer wears a baseball cap to school.
Darren also checks in with his grandmother every day.
“If something worse had happened with Darren, I don’t know if I could have ever gone back to the school,” Everett said. “We are so grateful he is doing well.”
Darren is also on schedule to finish third grade and start fourth grade on time in August.
“I’ll be really happy to have Darren in my classroom,” Everett said.
Click here to contact the Children’s Neuroscience Center at Children’s Memorial Hermann Hospital.