Eau Claire boy recovers from deadly bleeding in the brain

For 11-year-old David Loveland of Eau Claire, a February 2007 incident at his brother Tom's wrestling match when he was nine years old had him wrestling with an arteriovenous malformation, or AVM. An AVM is a tangle of abnormal blood vessels in the brain that disrupts normal blood flow in the brain by pooling blood in the AVM's dense center. It's formed during embryonic development. When it ruptures, it's the leading cause of stroke in young people.

At the wrestling match, David felt nauseated and went to the bathroom. When his mother Jessica Loveland checked on him, she found him unconscious. When she tried to rouse him, David fell in and out of consciousness and complained of severe headache. Jessica called her fiancée Richard Pletz, a paramedic, who said to call 911 right away.

"David didn't have any prior symptoms," says Jessica. "I didn't notice anything that needed medical attention before he collapsed."

Quick Diagnosis and Expert Treatment
David was taken to the Emergency Department at Lakeland Hospital in St. Joseph. A CT scan of his head showed bleeding in his brain. It was later discovered that his bleeding was due to a ruptured AVM. He was transferred to The Children's Hospital at Bronson, southwest Michigan's only children's hospital. He spent the next 17 days in the pediatric intensive care unit.

"The doctors kept us well informed of how things were going and what we could look forward to," says Jessica. "All the nurses were great. The day nurse, Mike, was our favorite."

George England, MD, a neurosurgeon with Bronson Neurological Services, inserted two external ventricular drains to remove excess fluid from David's brain and an intercranial pressure bolt to monitor pressure inside David's head.

Patrick Noonan, MD, a neurointerventional radiologist with Advanced Radiology Services - Kalamazoo Division, diagnosed and located the ruptured AVM that was the source of David's bleeding. Dr. Noonan performed an AVM embolization, blocking the abnormal blood vessels with a special glue specifically approved for AVM embolization. A week later he embolized another AVM that hadn't yet ruptured. The embolizations reduced the risk of bleeding, allowing David to recover enough to have radiosurgery at a later date.

Road to Recovery
After leaving The Children's Hospital at Bronson in March 2007, David was transferred to another facility specializing in inpatient rehabilitation. He was there for 12 days and continued to improve.

In summer 2007, a multidisciplinary team from the West Michigan Cancer Center, including Dr. England, created a long-term plan for David that included stereotactic radiosurgery (SRS). SRS is a noninvasive way to perform brain surgery using targeted radiation. The blood vessels in his AVM will eventually thicken and close off following the one-time treatment. David had the procedure in November, and it was free of complications. Today David is doing well and has no signs of re-bleeding or major complications.

While being treated for his AVM, two aneurysms were found in David's brain. An aneurysm is a weakened part of a blood vessel that balloons out. After school gets out for the summer, David will see Dr. Noonan for embolization of his aneurysms. This will reduce David's brain hemorrhage risk even more.