More than a Headache
William Dean had just arrived at football practice in fall 2022 when he suddenly got an intense headache. Brittany and Tyler Dean knew their 8-year-old needed immediate help.
“It came out of nowhere,” Brittany said. “He’d never had a headache like that.”
The Russell, Ky., family got to nearby UK King’s Daughters in Ashland, which stabilized him for transport to UK’s Albert B. Chandler Hospital. Soon after arriving, William had surgery for what UK HealthCare neurosurgeon Dr. David Dornbos described as “a massive brain hemorrhage” on his left frontal lobe.
“It was causing a lot of pressure on the rest of the brain and affecting his ability to breathe, to be awake, to be conscious at all,” said Dr. Dornbos, whose team first removed the left part of William’s skull to give his brain more room to swell.
In a patient as young as William, a brain bleed without head trauma is usually caused by a structural vascular issue. Many people with arteriovenous malformations (AVMs), like William’s, can go their whole life without symptoms. William suffered from occasional migraines, but his pediatrician had no indication those were attributable to anything as serious as an AVM prior to his sudden hospitalization. William’s AVM, while “very, very small,” had ruptured and became life-threatening.
It’s a scary-sounding diagnosis. While rare — they occur in about 1 in 100,000 people — Dr. Dornbos treats a new patient impacted by an AVM about once a week.
“I know that’s everyday normal (for Dr. Dornbos), but he talked to us in a way that we could understand and let us know, ‘OK, this is what we’re gonna do today, here’s the timeline for this,’” Brittany said. “There was never a time that Dr. Dornbos ever made us feel like we were asking questions that were silly. Everything we said, it felt like he took to heart.”
'A really great kid'
During a hospital stay that lasted more than a month, physical therapist Leah Mountain and occupational therapist Traci Meires “made a world of difference” in William’s return to form and making his parents feel more at ease.
“Whenever he was able to move, the first thing they asked was, ‘Do you want to give your mom a hug?’” Brittany said. “That was just the sweetest thing.”
William had a second surgery to remove the AVM once his swelling subsided, which cut his risk of another rupture in his lifetime “from 100 percent to zero overnight,” Dr. Dornbos said. Had the AVM not been removed, the chance of another life-threatening rupture in William’s lifetime was virtually guaranteed.
Also, during that surgery, the portion of William’s skull that was removed earlier was reattached. After he was cleared to go home, William’s recovery was smooth until the following summer, by which his care team discovered that his body was reabsorbing the bone of his reattached skull.
“That’s relatively rare,” Dr. Dornbos said. “It almost never happens, but in kids it will happen a bit more frequently. … His body interpreted it as a foreign body and just worked, basically, to break it down, make it go away.”
He had another surgery in July 2023 to install a 3D-printed custom implant. William was just the second patient for whom Dr. Dornbos had to have that done. “For him, we had to get a little creative because part of the bone was still there and part of the bone was gone,” Dr. Dornbos said.
Since then, William has had no hiccups in his recovery, but he has faced one significant hurdle. Unfortunately, due to the risk of head injury, William has had to give up his favorite sport, football, as well as other high-contact activities.
He comes from a football-loving family and dreamed of one day playing for his favorite NFL team, the Cincinnati Bengals. One of William’s nurses during his stay at UK HealthCare, Lauren Barcelona, brought William a signed football from her friend, Eastern Kentucky University quarterback Parker McKinney, and last fall arranged for the two to meet after one of EKU’s games. He’s an avid UK football fan, too, and reconnected with one of his physical therapists while attending a game last fall.
“It’s so crushing for us, because not only did he lose that, but not being part of a team kind of hurts,” Brittany said. “ … We’re trying different things to see what fits, but right now he’s not very into sports besides football. He’s just ate up with it.”
William’s taken up swimming to stay active, and might give baseball a chance down the road. Health-wise, he couldn’t be better. His year-after angiogram in late 2023 was all-clear; he’ll visit UK HealthCare annually for similar check-ins until he “graduates” and no longer needs to make those trips.
“I’m glad we get to stay in contact some way with Dr. Dornbos because he’s a lifesaver for us,” Brittany said. “I can’t thank him enough.”
The family wasn’t the only one who developed a close bond.
“His graduation day from my practice will be a little bittersweet,” said Dr. Dornbos. “At some point they won’t need to come see me, and even though I’d love to keep seeing them, it’s always a good day when you don’t need to see me anymore. They’re an awesome family and he’s just a really great kid.”
