New MRI Helps Patients Stay Close to Home
Fredrica Douglas knew something was wrong with her 2-year-old. Nigel was dragging his right leg and favoring the left side of his body.
She and Nigel’s grandmother, Dorothy Smith, took him for checkups but didn’t get satisfactory answers until they came to Children’s Hospital of Greenville Health System (GHS). Magnetic resonance imaging (MRI) showed that Nigel had a tumor on his brainstem.
“By the time we saw Nigel, he was essentially unable to move the right side of his body, and it was rapidly getting worse,” said Chris Troup, M.D., a pediatric neurosurgeon at GHS Children’s Hospital. “Once he had the MRI, we saw what was going on.”
Seeing the tumor didn’t mean an automatic solution, however.
“The tumor was deep,” Dr. Troup noted. “It took up about 70 percent of the space where the brainstem should be – there was very little brainstem there.”
Nigel couldn’t use his right arm and leg because the tumor pressed on nerves that sent signals to that side of his body. Fortunately, new technology at GHS allowed Dr. Troup and others to better understand the situation and gave them confidence to perform surgery.
Clear Views With 3-T
A few months before Dr. Troup saw Nigel, GHS added a 3-T MRI to its Radiology department. This machine, more commonly found in large academic centers such as Johns Hopkins than in community hospitals, gives physicians the best possible look at certain conditions.
“The 3-T has a stronger magnet, which allows us to acquire specialized pictures we couldn’t get before,” explained Naveen Parti, M.D., a neuroradiologist and director of MRI services at GHS. “It helps us further characterize lesions in the brain, so now we can do procedures that we couldn’t do in the past.”
In Nigel’s case, the 3-T MRI helped Drs. Troup and Parti see exactly where the tumor was and how it affected other parts of the brainstem. “Nigel’s tumor was so large we thought it might be invading everything and therefore be inoperable,” Dr. Parti stated.
“We needed to know if the tumor was pressing on normal fibers and pushing them away or if normal fibers were going through the tumor,” explained Dr. Troup. “The brainstem houses parts of the brain that control the things we don’t think about – swallowing, blinking, our heartbeat. If the fibers went through the tumor, surgery would be devastating to Nigel. But if the fibers went around the tumor, we could take it out.”
“The tumor was displacing the fibers,” he added. “Very few, if any, fibers were going through the tumor itself. The 3-T gave us a virtual roadmap of where the tumor and fibers were going.”
Before having the 3-T MRI, Drs. Troup and Parti could not have pinpointed the fiber locations. They would have referred Nigel to another hospital with more specialized equipment and hoped for the best. Having the 3-T allowed them to see that surgery was possible.
Dr. Troup performed Nigel’s operation less than a week after discovering the tumor’s extent. The physicians considered the procedure a huge success: “We took virtually every drop of the tumor out,” Dr. Troup said.
Nigel spent almost three months in the hospital.
“We were back and forth from ICU to pediatrics and back to ICU,” his mother said. “It was really hard, but everybody was great. Nigel loved all the staff who looked after him.”
Nigel was unable to move the right side of his body when the surgery took place, so he had to relearn how to do everything. He began physical and occupational therapy sessions while in the hospital and continued them for months afterward. He also continued seeing Dr. Troup and a pediatric neuro-oncologist for chemotherapy and other follow-up care.
“Neurologically speaking, he’s gotten a tremendous amount of function back,” Dr. Troup said. “He’s done remarkably well.”
Douglas and Smith found that incentives such as french fries encouraged Nigel to reach with and use his right arm. “He still doesn’t use his right side as much yet, but he’s walking and running,” Douglas said. “He’s not completely normal, but he’s almost there.”
The primary lesson his mother hopes other parents or caregivers will learn from Nigel’s experience is persistence. “Doctors kept telling me that one thing was wrong and then another, but none of it seemed right,” she recalled. “Keep on going to doctors until you know what’s really wrong with your child.”
On a similar note, Dr. Troup wants the community to know that the staff at GHS is prepared to help diagnose and treat virtually any medical problem: “GHS has an incredible MRI suite, the best you can get for routine imaging. The 3-T has some specific uses for stroke and tumor patients and for the vascular system. Adding it is just one more step toward making GHS the premier medical facility of South Carolina. You don’t need to go elsewhere for care.”
Douglas will always be thankful for those medical advances and for GHS having technology that many community hospitals don’t have.
“They kept telling me to prepare for the worst, but I wasn’t hoping for the worst,” she emphasized. “And now I’m really not. We got a miracle!”