Taking away the ache
Children frequently complain of headaches. But how do parents know when the headache their child complains of is more than just a headache? Ask the Cavalieris.
Emily Cavalieri had long suffered headaches. "I thought they were hereditary because my mom gets migraines," she says.
"No one expects headaches to be serious," adds her mother, Wendy. "When Emily started having hers, I thought they were because of stress, school or typical teenage things."
But during the spring of her sophomore year of high school, Emily's headaches became completely debilitating. Barely able to lift her head from her pillow, suffering from blurred vision and loss of feeling in her fingers, the Cavalieri's knew their daughter had more than just a headache. They turned to Children's Hospital Boston for answers.
An MRI revealed that Emily had a condition called a Chiari malformation—a congenital defect in which the cerebellum portion of the brain crowds the connection of the brain and spinal cord at the back of the head, which can be life threatening depending on its severity. Although other forms of Chiari malformation are diagnosed in infancy, Emily's condition went completely unnoticed until just over a year ago when her symptoms developed.
"Pediatricians and neurologists see many patients with headaches, and their cause is not always easy to diagnose," says Neurosurgeon-in-Chief R. Michael Scott, MD. "In Emily's case, the headaches were very typical of the Chiari disorder—brief, intense, and related to physical stress and active behavior of any type."
To treat the disorder, Scott recommended surgery to remove a small portion of bone from Emily's skull and part of a vertebra. "The goal is to correct all of the compression," says Scott. "The procedure opens the bony tissue at the base of the skull and the membranes that wrap around the brain tissue in that area."
"Surgery for this condition is one or our special interests here in Neurosurgery at Children's," he adds. "This surgical technique has been refined by decades of experience with the Chiari malformation."
Emily faced her surgery head-on. "I knew it had to be done," she says. "My biggest fear was whether they would shave my head, remember I was 16 years old, but they did it in such a way that you couldn't tell."
As Emily was wheeled into surgery on July 19, 2004, she gave her parents the thumbs up sign. "She said ’ÄòLet's get this thing over,' " says her father, Jim. Four hours later, she was well on her way to being headache-free.
After a week in the hospital and several months of recovery, Emily returned to school this September. "Right after the surgery, I wasn't able to play field hockey, and that was devastating because I love the sport," she says. "But I wasn't about to give up, so I went to every practice and every game just to help out and watch from the sidelines. I didn't want to lose touch with my teammates."
This year, her senior year, the field hockey team made Emily captain, which was a big honor for her. And now she's looking ahead to college. "I never allowed myself to think the worst," she says. "I have such a different outlook on life now. I feel lucky and blessed."
"Emily has continued to fill our hopes and dreams every day," says Wendy. "We hope she can continue to live a healthy and normal life."
Jim puts it best, "If your own kid could be your hero, she's mine."
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