Tiana was a healthy, happy 14-year-old girl enjoying her summer vacation, just like any other teenager. A year prior, she moved from Jamaica to the United States with her mom, Jonielle, and her little brother. She had settled into her new home and was beginning to dream big about her future. Her sights were set on an acting career. That was until her life was forever changed one summer evening in June 2024.
The night everything changed
After Jonielle arrived home from work, Tiana said she had a headache. She went to bed, hoping that would help. It didn’t. After waking up at 3 a.m. with intensified pain, her mom suggested tea and more Tylenol. Tiana then vomited twice, which seemed to temporarily help.
“As a mother, you know your child better than anyone else. My daughter rarely got headaches, let alone severe ones that would cause this kind of pain,” Jonielle said. “I knew something was really wrong.” Feeling uneasy, she continued to check on Tiana. Her responses lacked her usual spirit and soon, she fell unconscious.
After a panicked 911 call, paramedics and two police officers arrived. They moved Tiana from her bedroom to the couch to complete a medical exam and check vitals. By this time, she began to seize. They worked to stabilize her as she continued to drift in and out of consciousness. It was clear an ambulance ride to the emergency department (ED) was needed.
Life-saving care
After arriving at the Children’s Minnesota ED in Minneapolis, a flurry of nurses and doctors were ready to provide life-saving care. Tiana quickly got an
MRI, where doctors found a ruptured brain arteriovenous malformation (AVM) and a large brain bleed. An AVM is when a group of blood vessels form incorrectly. In Tiana’s case, these blood vessels burst, causing blood to pool between her brain and her skull.
“Because I had my toddler son with me at home, Tiana’s grandma and grandpa were the ones to meet her at the hospital. I was getting all of these updates secondhand,” Jonielle shared. “I really wished I could be there too, but I knew regardless, she was getting the best care.”
Undergoing emergency surgery
Few updates are scarier than hearing your daughter needs to undergo emergency brain surgery. Her life saving procedure was performed by Dr. Meysam Kebriaei, medical director of pediatric neurosurgery and the lead neurosurgeon for the multidisciplinary pediatric cerebrovascular program at Children’s Minnesota. He has extensive experience treating patients like Tiana, and others with vascular malformations of the brain.
In a 48-minute operation, Dr. Kebriaei and his team removed part of Tiana’s skull to allow her brain to safely swell. They also removed blood from her brain
tissue to prevent further swelling and provide more space for her brain to re-expand. Lastly, the team placed a drain to help monitor and manage the pressure in her head. About two weeks later, Tiana would have another surgery where Dr. Kebriaei replaced her skull bone so she could continue her road to recovery.
Tiana’s condition is extremely rare. Only about 0.1% to 0.5% of the population has an arteriovenous malformation (AVM). “We know that AVMs form when babies are in the womb, but we don’t know the cause. Often patients don’t find out they have an AVM until it causes a seizure or bleeds, like it did in Tiana’s case,” said Dr. Kebriaei. “However, if they bleed, they can be fatal if not treated by a surgery team that specializes in vascular malformations of the brain.”
Post-op care
Tiana spent about three weeks in the pediatric intensive care unit (PICU) while recovering.
“The PICU nurses, staff and our neurosurgery team really loved taking care of Tiana,” said Sheridan Byrne, physician assistant
in Children’s Minnesota’s neurosurgery program. “I was able to watch her squeeze mom and grandma’s hand for the first time after surgery and it was a really incredible moment.”
During recovery, she received physical and occupational therapy to ensure she could perform day-to-day functions like walking, talking and eating.
“I would give the whole team a 10 out of 10. They gave the constant communication and reassurance that our family needed during this time,” Jonielle said. “Also, when Tiana’s dad ran out of time off from work, the social worker went above and beyond. She drafted and faxed letters and other documents so he could get extra time off to be there to support Tiana.”
Once Tiana regained most of her independence, she received further rehabilitative care before returning home.
Tiana today
Tiana is on the mend and full speed ahead! Thankfully, she’s back to her old self, but with new aspirations in sight. She now dreams of becoming a pediatric
nurse.
“This experience has changed her life plan. She wants to help kids who face similar challenges that she did,” Jonielle shared. “We’re so grateful she’s able to dream about her future. If her brain bleed happened before living here, I’m not sure I’d still have a daughter.”
Tiana has an appointment in December where she’ll get another MRI to check on the malformed blood vessels in her brain. Tiana, her family and the care team will then review management options, including another surgery, a minimally invasive procedure or radiation. With all options, the goal is to prevent Tiana from ever having a brain bleed again. She will receive follow-up care at the Children’s Minnesota neurosurgery clinic for the next decade.
