'He had a golf ball-sized mass'

There are certain dates you’ll always remember – your wedding day, graduation or a best friend’s birthday. For one Crawfordville,  Fla., mother, that memorable day was the day her son had emergency brain surgery.

March 14, 2019.

Up until that Thursday afternoon, Amy Atkins described her son Ethan as a typical teenager. The 15-year-old Wakulla High School sophomore loves duck hunting with his brother and spending time on the family boat. But on March 14, a single text from Ethan’s older brother, Kaleb, sent a wave crashing onto the family.

“Mom, you need to come home,” the text message read.

Atkins called Kaleb and heard terror and urgency in his voice. “Ethan is having trouble walking,” Kaleb told his mother.

“I didn’t know what to think,” Atkins said. “Everything had been perfectly fine when Ethan left for school that morning.”

Atkins left work immediately and took Ethan to a local urgent care facility. Ethan was having weakness in his right leg and difficulty walking. While they were waiting to be seen, Ethan had a focal seizure, limited to his right leg. The urgent care medical team called for an ambulance and had Ethan transported to the Tallahassee Memorial HealthCare Emergency Center – Northeast.

At the Emergency Center – Northeast, Ethan was examined by emergency physician Gregory Peters, MD. Dr. Peters ordered a CT scan.

“We frequently see patients present with first-time seizures, but they are usually generalized, suggesting there is not a focal lesion,” commented Dr. Peters. “Ethan's seizures involved just his right leg, suggesting a lesion in the left brain, which, unfortunately, is what we found on CT imaging.”

Dr. Peters then consulted with Narlin Beaty, MD, neurosurgeon with Tallahassee Memorial HealthCare (TMH) and Tallahassee Neurological Clinic (TNC). The CT scan confirmed Ethan had a brain lesion and his life depended on brain surgery.

“Dr. Peters told us our son had a mass on his brain,” Amy Atkins said. “He showed us on the computer screen that he had what appeared to be a golf ball-sized tumor.”

After consulting with Dr. Peters, Dr. Beaty recommended Ethan be examined by a specialized pediatric neurosurgeon.

“I am grateful to have a strong, ongoing relationship with the neuro team at Wolfson Children’s,” said Dr. Beaty. “Having this partnership, which allows us to conveniently consult with and transfer patients to their very specialized pediatric physicians and staff, makes us a stronger health care system overall.”

Dr. Beaty reached out to his pediatric neurosurgery colleague at Wolfson Children’s Hospital of Jacksonville, Nathan Ranalli, MD. Dr. Ranalli is with the Stys Neuroscience Institute at Wolfson Children’s, which provides comprehensive pediatric neurological and neurosurgical treatment and care to children of all ages from North Florida, South Georgia and beyond. The relationship between TMH and Wolfson Children’s helped facilitate rapid coordination of care for Ethan, who was transferred from TMH to Wolfson Children’s with his mom by his side.

“Before Ethan arrived, Dr. Beaty sent me Ethan’s CT scan and notified the emergency department at Wolfson Children’s,” said Dr. Ranalli, who is also an assistant professor in the Division of Pediatric Neurosurgery at the UF College of Medicine – Jacksonville. “Dr. Beaty and I discussed Ethan’s sudden onset of a seizure and weakness in his right leg in an otherwise healthy teen.”

When they arrived, they were met by Dr. Ranalli and the medical team at Wolfson Children’s. “When the ambulance door opened, the doctors were ready and waiting to take care of my son,” said Amy.

Dr. Ranalli ordered an MRI, which showed that Ethan had a large vascular lesion on the front left side of his brain. In medical terms, Ethan had a rare condition called a cavernous malformation or cavernoma, an abnormal collection of blood vessels in the brain. A portion of the large mass had ruptured and was producing pressure on the part of Ethan’s brain responsible for movement on the right side of his body, and the cause of his seizure and the weakness in his right leg.

Because of the cavernoma’s size and the sudden onset of symptoms, Dr. Ranalli recommended Ethan have surgery immediately to remove the mass. In the operating room, Dr. Ranalli used a stealth navigation system that is integrated with sophisticated imaging equipment to precisely locate the lesion and completely remove it. The procedure took approximately four hours.

“Fortunately, the cavernoma was separated from Ethan’s brain tissue,” said Dr. Ranalli. “Everything went well in surgery and we are pleased with the outcome.”

Ethan spent four days at Wolfson Children’s Hospital before he was discharged.

“Everything happened so fast. Within 24 hours, we went from being at urgent care to being in recovery for brain surgery,” said Atkins. “As a family, we have never had to experience anything like this and everyone at Wolfson Children’s was so helpful and kind. We were facing a challenging situation and their team helped to make it as easy as possible for us while providing excellent care.”

After two weeks of home care, Ethan was cleared to return to school. He will continue to receive follow-up care with Dr. Ranalli at Wolfson Children’s Hospital.

Wolfson Children’s Hospital's Stys Neuroscience Institute is a collaboration between Nemours Children’s Health, Jacksonville, and the UF College of Medicine – Jacksonville, plus other health care institutions that brings together a multispecialty team to help children with brain, spine, skull-base and other neurological conditions.

Wolfson Children’s Hospital has been ranked repeatedly by U.S. News & World Report as one of the 50 best children’s hospitals in the nation for neurology and neurosurgery. Its team is involved in research and clinical trials and provides treatment options based on the latest medical advancements. To learn more about the Walter and Michelle Stys Neuroscience Institute at Wolfson Children's Hospital and the conditions treated, call 904.697.3600 for neurology and 904.633.0780 for neurosurgery.