The Path to UPMC
Five-year-old Haley Spitznagel had been having chronic headaches for several months. Her neurological exam was normal. Haley's doctors were fairly confident that her headaches were due to sinus pressure and treated her for a sinus infection and strep throat. When she later had her tonsils removed, the headaches went away.
Then on July 4, on the way to watch fireworks, Haley was overcome with head pain and vomiting.
"No more headaches. She's looking forward to playing soccer, her favorite sport, in the spring" — Jill
Her pediatrician referred Haley to a neurologist, who treated her for migraine headaches, but the headaches and vomiting increased. At that point, Haley was referred to UPMC Children's Hospital of Pittsburgh, where an MRI scan of her brain showed a large lesion.
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Haley had a tumor affecting the pituitary gland at the base of her skull.
UPMC's team of brain surgeons was contacted immediately.
The Challenge
The MRI showed that Haley's tumor was a craniopharyngioma close to the pituitary gland.
This type of tumor has fluid-filled cysts within it, as well as a solid component. Haley's had ballooned up into the third ventricle, preventing her spinal fluid from draining normally. Her headaches and vomiting were caused by pressure building up from the blockage.
If the tumor grew just a little bit more, it could completely block the spinal fluid pathways and make Haley acutely ill.
She was admitted to the hospital immediately and surgery was scheduled.
The Solution
The traditional approach to lesions of this kind is an open craniotomy, which requires a large incision across the scalp and skull in order to reach the tumor. Instead of a craniotomy, Haley's surgical team recommended minimally invasive Endoscopic Endonasal Approach (EEA) surgery through the nose and sinuses.
With this minimally invasive approach, they removed the lesion entirely without disrupting Haley's brain, blood vessels, or critical nerves.
The Results
Following surgery at Children's Hospital, Haley's MRI showed no tumor.
Her recovery was pain-free, and after six weeks she was “back to herself — running, dancing, and back in preschool,” says her mother, Jill. “No more headaches. She's looking forward to playing soccer, her favorite sport, in the spring.”
Since her surgery, Haley now has another favorite sport — ice hockey.
“The highlight of her hospital stay was meeting Marc-André Fleury, goalie for the Pittsburgh Penguins,” says Jill.
Fleury gave Haley an autographed jersey when he visited the pediatric intensive care unit.
Now she watches Penguins games on TV with her family, all wearing Fleury jerseys, and she attended a game with her grandfather.
“When Fleury blocks a goal, Haley thinks it's the greatest thing in the world,” her mother says.
Our patient stories profile a number of patients who have had minimally invasive brain surgery at UPMC. Although everyone's care experience is unique, we hope that sharing these stories will help other prospective patients and their families better understand these procedures and their potential benefits.
Haley's treatment and results may not be representative of all similar cases.
