Not many people consider a concussion the beginning of a miracle.
But 12-year-old Brianna Laux believes a blow to her head became a life-saver. It set in motion a chain of events that led doctors to discover a malformation in her brain’s blood vessels that could have killed her.
“I might not be alive if it wasn’t for that concussion,” Brianna said as she waited to be discharged from Spectrum Health Helen DeVos Children’s Hospital. “It freaks me out a little.”
Stretched out on her hospital bed, her long hair in braids and her chin propped in her hands, she looked relaxed and cheerful. Two spots on her scalp gave clues to her ordeal: a short tuft of hair on top of her head showed where a brain drain had been inserted, and a long scar behind her left ear showed where surgery was performed.
“It was like a perfect storm,” said her mother, Jennifer Laux. “I get chills every time I think of it.”
Just six days after brain surgery, Brianna plotted her return to the archery range. A seventh-grader at Lowell Middle School, she also is a nationally ranked archer who dreams of Olympic gold.
“She has no deficits,” her mother marveled. As a registered nurse who has worked in neurosurgery, Jennifer understands more than most the dangers her daughter dodged.
A rapid decline
Brianna, the youngest of Jennifer and Chad Laux’s three children, showed no sign of medical problems during her active childhood. She played basketball and tennis, performed percussion in the school band, shot trap and skeet.
She especially loved archery. Nothing captivated her more than aiming an arrow at the X that marks the center of the bull’s eye. She competed in tournaments around the country and earned a spot on a regional Junior Olympics archery team.
“I was very healthy,” Brianna said. “I’m a very healthy person. And then, when I’m not healthy—it’s a grand slam.”
I was just so thankful she was still breathing. The gravity of the whole situation was overwhelming.
In the blood vessels of her brain, Brianna had an arteriovenous malformation, commonly called an AVM. The rare condition, which occurs in one in 200 to 300 people, likely was present since birth.
The arteries, which deliver blood to the brain, and the veins, which transport it back to the heart, normally connect through brain tissue and small capillaries. But in an AVM, they jumble together, like a messy ball of twine.
The high-pressured blood from the arteries pumps directly into the veins, straining those weaker blood vessels.
An AVM can exist for years without causing any symptoms and then, one day, begin to bleed.
For Brianna, that day came on Thursday, Feb. 16.
During a basketball game with her seventh-grade team, she collided with another girl as they both went after the ball. She caught an elbow in her head, near the temple. She shook it off and continued to play.
But as she waited for another player to shoot a free throw, she had trouble breathing. A teammate notified the coach, who pulled her from the game.
Alarmed, Jennifer Laux made her way across the gym to see her daughter.
“Did you see stars?” she asked.
“Yeah, a little bit,” Brianna said.
Worried about a concussion, Jennifer prepared to drive Brianna to a doctor’s office. But Brianna’s condition quickly deteriorated. She vomited repeatedly and had trouble walking. And she suffered intense pain.
“It felt like someone was trying to stab a stake into my head,” she said.
Jennifer called for an ambulance.
The problem revealed
At Helen DeVos Children’s Hospital, pediatric neurosurgeon Artur Szymczak, MD, ordered a CT scan. It showed bleeding on the brain.
The first step was to relieve the pressure caused by the build-up of fluid, to prevent it from crushing the brain and causing lasting damage. Dr. Szymczak inserted an external ventricular drain―a tube that drained fluid to a receptacle placed near Brianna’s head.
He then requested an angiogram to determine the source of the bleeding. It revealed the AVM. The tangle of blood vessels lay deep in the left side of the brain, “but not so deep that we couldn’t get access to it,” Dr. Szymczak said.
In the middle of the AVM was an aneurysm―an out-pouching of the blood vessel wall―which also posed a bleeding risk.
“That blood vessel isn’t as strong as the rest of the blood vessels,” Dr. Szymczak said. “It can bleed a little or a lot―it can bleed catastrophically.”
That night, as the news went from bad to worse, Brianna’s parents struggled to understand how quickly their active, athletic daughter had become a fragile patient with a life-threatening condition.
“That was the biggest shock to our system,” Jennifer said. “It was horrifying.”
They vowed to Brianna that she would pull through.
“I promise you we are not leaving the hospital without you,” Jennifer said.
‘It’s OK, Dad’
For the next steps, Dr. Szymczak worked with Justin Singer, MD, Spectrum Health Medical Group’s director of vascular neurosurgery, who specializes in minimally invasive neuro-endovascular surgery.
They waited a couple of days for the brain swelling to subside. On Monday, Dr. Singer used a catheter inserted through an artery to deliver a bio-glue to the arteries that fed the tangled blood vessels. The adhesive blocked the blood flow and stopped the bleeding into her brain.
On Tuesday, the neurosurgeons operated to remove the AVM.
Because the AVM lay near the speech center of the brain, Drs. Singer and Szymczak positioned Brianna’s head so they could operate from underneath, to avoid damaging that area. They also used neuro-navigation―computer-assisted technology―to guide them.
It’s just a miracle in itself. We are very, very fortunate.
“It helps us make things safer and decreases the guesswork,” Dr. Szymczak said. “We don’t like guessing at all in neurosurgery. We like to know.”
Jennifer, worried about how the surgery would affect her daughter, waited anxiously to see if she was able to speak after the operation. She didn’t have to wait long.
“Hi Mom and Dad,” Brianna said when she opened her eyes. “My head hurts.”
Brianna’s dad, Chad Laux, doesn’t recall those specific words.
“I was just so thankful she was still breathing,” he said, as he sat near his daughter’s hospital bed. “The gravity of the whole situation was overwhelming.”
He stopped, too choked up to speak.
“It’s OK, Dad. It’s OK,” Brianna said, wiping away a tear. “I’m better now.”
Chad walked over to his daughter and wrapped his arms around her.
“I’m not crying because I’m sad,” he said. And they both laughed through their tears.
‘All the stars were aligned’
Following Brianna’s brain surgery, her parents watched her grow stronger and more stable every day. At first, she couldn’t get out of bed by herself or walk without wobbling. Six days later, as she prepared to go home, she stood steadily on two feet, although a parent always stayed nearby in case she needed help.
Jennifer credited Brianna’s strength, athleticism and the mental training involved in archery with helping her bounce back after surgery.
“She’s a fighter,” she said. “She’s determined.”
As to her daughter’s survival, Jennifer believes “all the stars were aligned” for a good outcome.
“It’s just a miracle in itself,” she said. “We are very, very fortunate. She has a guardian angel looking out for her.”
She can’t help but wonder what would have happened if she had not been at Brianna’s basketball game and seen her get a concussion. She believes she would have assumed her daughter had the flu. She likely would not have brought her to the hospital.
“She wouldn’t have woken up Friday morning,” Jennifer said, her voice breaking with emotion. “Her brain would have swelled until it stopped, and all functioning would have stopped.”
Smiling at her daughter, she said, “I keep telling her every day, ‘I’m so lucky to be your mom.’”
Brianna smiled back. “I’m lucky,” she said.
Like Brianna’s parents, her neurosurgeons are gratified to see how well she has recovered.
“She’s gone through more than any 12-year-old should have to go through,” Dr. Singer said. “She’s doing great. She looks great. And what we did was curative, so she shouldn’t have a problem with this ever again.”
He and Brianna exchanged a high-five.
Asked what pulled her through her ordeal, Brianna said she has much to accomplish in life.
“I have a plan to go to the Olympics for archery,” she said. “I think that might be part of why I’m still here. I didn’t complete some of the things that I need to yet.
“It’s not a good time to leave, because I still have work to do.”