Inside Brandon’s Head

Many people want to know what’s going on inside their baby’s head. Now we know. Last week Brandon had an appointment with the neurologist to go over his MRI and MRA. There weren’t any real surprises. It was exactly what we had expected - he had a stroke when he was about 3 months old. However, it was a very strange experience in several ways. I felt a wide variety of emotions.

First of all, here is what we had confirmed:

Before Brandon’s second operation they attempted to put in a PIC line. This is very common in the NICU. It’s a line that goes from the arm into the chest and near the heart. This allows the doctors to easily administer drugs and take blood, and most importantly deliver quality nutrition. Just before the operation they tried twice to place a PIC line and where unsuccessful both times. As he went into the operation and they still couldn’t get the line in they choose instead to use a Broviac line. It is very similar but it is surgically placed directly into the chest.

A while later they discovered that Brandon had a blood clot attached to the end of this line. This was very dangerous. They gave him some medication to help break it up and in a couple of days it was gone. We knew there were a lot of risks involved. About a week later it came back and they gave him some more medications and then eventually pulled it. The only reason that we even found out about it is because they were doing echos to follow his pulminary hypertension. (which is oficially gone now!)

It appears that this clot or a piece of it must have dislodged and traveled up into the right side of Brandon’s head where it restricted the blood flow to part of his brain. Without the blood flow to this area of the brain this section of the brain ceased to function. It was in the area that is responsible for motor control on his left side.

One other possibility going in to the MRI would have been that Brandon had some bleeding in the brain. This is a common problem for very premature babies. The blood vessels in the brain are so small and sensitive that they often bleed becuase of the early exposure to oxygen. This bleeding can be responsible for a lot of brain damage. We had never seen bleeding in Brandon’s head when they had checked while he was in the NICU. Also, we knew he had the blood clot so this was the result we were expecting. It didn’t appear that this was the problem.

Here is an image the doctor printed from the MRA. They are taken from below as if you were looking from his feet up into his head. It shows the blood vessels and you can plainly see the lack of blood vessels in the circled area of the Right side of the brain. It should look similar to the left half.



This is an image from the MRA. On each of these procedures they would take a picture and then move up about a quarter inch and take another one. This resulted in images that are like peeling away a layer each time a new image is taken. It’s like removing a slice of bread each time from a loaf of bread. Once they moved up to the right height, we could see the extra fluid that filed in the places where the blood flow had been restricted.


The damaged area is contained in the motor skills area. All of his learning and other areas of the brain seem to be OK. We will have to watch vision because there are a couple of vision areas that run through this section of the brain. They could potentially result in blind spots on his left side but it appears that the problem is pretty localized. The good news is that it’s not something that will get worse. In fact, as we have seen with Brandon’s progress, it is likely to improve. If an adult suffered a similar stroke, we wouldn’t be likely to regain the motor control. However babies adapt well and other parts of the brain may take over the lost function.


The human body is amazing:

I have learned a lot with these babies. While I sat and looked at these pictures I was once again amazed. First, there are so many things that can go wrong it’s amazing that anyone survives. It is also surprising how something so small and seemingly insignificant as a blood clot could be so harmful. On the other hand, it is incredible how resilient the body. If part of the brain is damaged another part can just take over. Wow.

Encouraging:

It was encouraging news. Brandon is progressing really well and it appears that he is learning how to use his left hand. The doctor was very positive and so am I. I always joke with Amy that our baby who was 1lb. 7oz. at birth will end up playing in the NFL. She is optimistic too but she thinks I’m crazy. However, I really believe that as he grows up, no one will believe his story because he will do so well. In fact, your casual observer wouldn’t even notice a problem now (other than his delay stuff like crawling).

Upsetting:

I sat at looked at images of brain damage of this little boy I love so much. It’s almost hard to share these images and show everyone that there is something wrong with his brain. It’s hard to admit that he isn’t in perfect condition. It also appears to be such a large section and is so obvious that even I can see it in the MRI. Despite the encourage outlook, it’s not an easy thing to see as a parent, even if it what I had expected.

New Outlook

As we visited the pediatric neurologist’s office I could look around and see many kids that have some obvious neurological problems. I know that Brandon’s problem is minor in comparison and I don’t really understand what these other families go through. However, as I mentioned in a previous post, I can’t help but feel more empathy for these families.