MORGANTOWN, W.Va. – When schools closed because of COVID, Logan Channel, then 17 of Philippi, decided to accept a job working for a local conservation district to make some money and spend time with his friends. He was mowing and trimming trees in Pennsboro on a hot day when he started to get a headache.
“I sat down and drank some water because I thought I was getting overheated,” Logan said. “I don’t remember much of what happened, but the guys I worked with told me they didn’t see me for five or 10 minutes, so they came to check on me. I was laying on the ground kind of in and out of consciousness.”
Logan’s coworkers put him in a truck and took him to the nearest urgent care, which was about an hour away. The urgent care transferred him to WVU Medicine Camden Clark Medical Center, where he received a CT scan showing he had a brain bleed. He was then transferred to WVU Medicine Children's.
He was diagnosed with a ruptured arteriovenous malformation (AVM), which is a tangle of arteries and veins that is usually present at birth. They can occur anywhere but are most common in the brain or spine. This condition can go undetected until it causes issues like it did for Logan.
“AVMs are present in about 25,000 people in the United States. Like Logan, many go undetected until they bleed. They cause problems when they affect the flow of oxygen-rich blood to the brain, leading to seizures, headaches, hemorrhage, or stroke,” Kimberly Hamilton, M.D., WVU Medicine Children’s and WVU Rockefeller Neuroscience Institute pediatric neurosurgeon, said.
“Logan’s CT scan showed that he had hemorrhaged inside his brain, and it extended into the ventricles, or the fluid-filled spaces of the brain. When that happens, the fluid backs up because the hemorrhage blocks the normal fluid pathways.”
After placing a drainage tube into Logan’s brain to relieve the fluid blockage, Dr. Hamilton directed him to the Department of Neuroradiology within the WVU Rockefeller Neuroscience Institute to allow his medical team to better visualize the AVM and determine the best course of treatment. Ultimately, surgical removal of the malformation was the goal.
First, the interventional radiologists were able to inject glue into the AVM to slow the blood flow and help make the surgery safer.
The day after his AVM was glued, Logan was taken into surgery to remove the malformation completely. While Logan was under anesthesia, Hamilton made an incision on his scalp, created a window in the skull, opened the covering of the brain, and examined the tangle of abnormal blood vessels. She was able to carefully separate the abnormal vessels from the brain tissue and remove them. The surgical team closed the covering of the brain and secured the section of skull with tiny plates and screws. After the six-hour surgery, Logan was sent to the pediatric intensive care unit (PICU) to recover.
“AVM patients need to stay in the PICU after surgery so we can closely monitor their blood pressure and recovery,” Hamilton said. “An AVM is like a faucet that is always on – it’s constantly funneling blood through its tangle of vessels, so the body has to work hard to feed it plenty of blood flow. When you take it out, the body is used to sending a lot of blood to the brain, but now it has nowhere to go. That’s why we manage him carefully in the PICU to control his blood pressure, and the blood flow to the brain, until the body can reset itself. He almost had to relearn how much blood flow should be happening. That usually takes about five days, and you watch as the patients need fewer and fewer blood pressure medicines. Close monitoring in the PICU allows us to make sure the body and brain are kept safe during the reset process.”
Logan, now 19, has recovered from his life-threatening AVM and now only experiences reduced peripheral vision as a result of the hemorrhage. He was able to complete high school and graduate on time with distance learning as well as help from his classmates who brought him his books and homework. He is also back to one of his favorite hobbies: deer hunting.
“I don’t have a lot of lasting problems from what I went through,” Logan said. “I’m able to drive, but my parents want me to practice before going out on my own to make sure I’m safe. Aside from the loss of vision, I don’t have any other limitations. I don’t have headaches anymore.”
The Department of Pediatric Neurosurgery at WVU Medicine allows patients to receive the specialized treatment and follow-up care they need without having to leave the state. The Department offers treatment for conditions including tumors, seizures, tethered spinal cords, hydrocephalus, and many others.
“Pediatric patients did nothing to ask for the hand they were dealt, whether that’s seizures, tumors, or a congenital anomaly like Logan’s,” Hamilton said. “At no point was this something they caused to happen.”