“She had never complained about one before (headaches) and we blew it off,” Michelle Vidikan, Keira’s mother, told ABC News. “But the next day, she came home from school and complained about the same thing.”
Keira’s parents attributed her first headache to nerves. But then, when she complained about it again, they wondered if it might be a vision problem. As optometrists, they’d seen such issues in children countless times.
“They are usually not severe, and you continue to monitor and give them an eye exam,” Michelle said.
Then, a few days later, Keira fell off a bar stool at the kitchen counter. But other than the fall, she seemed to be perfectly fine.
“She took a bath and did her homework,” Michelle said.
Little did Keira’s parents know, Keira’s condition was about to get progressively worse, and fast.
“The next day, December 7th, everything went wrong. In the morning, we went to school and she had a hard time putting her right arm thorugh the jacket of her coat sleeve.”
That same day, Keira “stumbled out” of the van after arriving at school. Then, at dinner last night, her parents noticed that she wasn’t using her right arm to eat, and she had a limp.
“We started to get concerned,” Michelle said, but she added that it still didn’t seem life-threatening. “Maybe she hurt herself in the fall.”
It would be the next morning when Keira’s parents would finally realize that something was seriously wrong with their daughter. Added to the lack of arm use and limp, Keira’s speech was now noticeably slurred. It was in that moment that Keira’s parents realized they were dealing with something more serious.
“We just knew,” Michelle said.
Michelle and her husband, Mario, took Keira to the local emergency room. Doctors performed an x-ray, but everything looked normal, so they were told to go home.
“But within five minutes, he came back into our room and drew the curtain and turned off the TV,” Michelle said. “The radiologist found a problem in the brain stem.”
At first, doctors thought that Keira had a glioma – an aggressive form of brain cancer – but there was nothing that could be done until the bleeding stopped, so they sent the family home with a referral to the Cleveland Clinic. Over the weekend, while they waited for their appointment, Keira’s condition worsened.
“She was very, very drowsy and lethargic, and her strength was going,” Michelle said.
By the time she reached the Cleveland Clinic on Monday, Keira had almost complete paralysis on the entire right side of her body, including her face, and her speech was slurred.
“The most noticeable thing was that she was becoming very lethargic,” Dr. Peter Rasmussen, director of Cleveland Clinic’s Cerebrovascular Center and Keira’s neurosurgeon told ABC News. “The brain stem area of the brain coordinates wakefulness. She had such pressure and distortion of the brain stem that she was heading toward coma.”
Doctors needed to find a solution to Keira’s condition, and fast. They performed test after test. All the while, Keira’s parents waited anxiously at the hospital to find out if their daughter could be helped.
“I think this was the darkest night we will ever have,” Michelle said.
But that bleak night would turn into a slightly brighter morning. After six hours of testing, Keira’s parents were given a ray of hope. She didn’t have cancer; she had cavernoma, a rare form of a family of conditions commonly referred to as arteriovenous malformations, or AVMs.
This circulatory defect affects somewhere around 300,000 Americans. Thought to arise during embryonic or fetal development or soon after delivery, the condition is most common in women in their 40’s. While most patients are treated with steroids and observation, AVMs that develop in the brain or spinal cord often require more a more aggressive approach, like surgery, because of the potentially devastating effects. Unfortunately, that has risks as well.
“The brain stem sits right smack dab in the middle of your head, and you’ve got to get into that area,” Rasmussen said. “The brain stem is sort of like an octopus with arms and nerves that provide movement to the face, eyes, mouth and lips, so you have to be able to work in between the nerves to get in to the substance of the brain itself and move it and pull it out of there.”
But Keira’s condition was getting progressively worse. Doctors feared that, without surgery, she would likely suffer from a stroke and die.
“No one really understands these cavernomas very well,” Rasmussen said. “A lot of them grow and stabilize at a small size…She was pretty bad off…She also had an unusual subset that was progressively enlarging over time. She was four or five weeks into this, and hers was just growing like an aggressive tumor.”
So, on December 20th, she underwent the risky procedure. Brain images after the surgery showed the lesion had been completely removed. By Christmas Eve, Keira was discharged from the hospital.
“It was a great Christmas present for everyone,” Rasmussen said.
According to Keira’s mother, the results were nothing short of a “miracle.”
“Literally, within hours, she was regaining neurological function,” Michelle said. “It’s amazing how quickly it was. We thought she would always have a limp and slow speech, and maybe not have use of her arm again. But Christmas Eve, hour by hour, she was moving her fingertips and moving her arm.”
Now, just weeks later, Michelle says that Keira is “back to running, dancing, jumping and skipped her way out of the clinic today.” And her parents couldn’t be happier.
“She’s absolutely a real fire plug and clearly the darling of her parents,” Rasmussen, who was completely surprised at Keira’s quick recovery, said. “She’s an absolute gem.”
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