The Gamplan

I'm sure many of you have asked the question, "how are they fixing this"?  I'm also sure many of you have searched the keywords of "cavernoma, cavernous angioma, cavernous malformation, cavernous hemangioma, ccm, avm" online and seen some interesting things...

Well, first off as with most medical related things our AVM (Cerebral arteriovenous malformation) isn't like everyone elses and everyone else's isn't like our AVM.

Dana's AVM is located in the temporal lobe.  The temporal lobe does a lot when it comes to hearing, speech perception and a little bit of memory.  Now, depending on what hand your dominate with will determine a multitude of things including how your brain stores information.  Dana's AVM is located in the right temporal lobe, Dana is also right hand dominate.  This is great news b/c that means her knowledge, who she is as a person and processing power is stored on the left side of her brain.  The right temporal lobe does a lot of functions, and I don't want to downplay the brain b/c it's amazing BUT lucky for us the functions the right temporal lobe aren't not doing as much as the left side (again because she is right hand dominate).

In a very brief overview here are the highlights of the operation =

• The operation will be around 3 hours long
• 1 hour to get to the brain, 1 hour for the procedure on the brain and 1 hour for putting it all back together again.
• Dana doesn't have to shave her head or a large portion of her hair, they will only need to trim a 1/2" wide by 3" long portion her hair just above her right temple.
• In the future Dana will set off every single metal detector she enters...I'm just kidding, this will never be an issue b/c we are using titanium (a non-ferrous non-magnetic metal) for the pins and plates.
• The size of the hole in her skull will be around the size of a 50 cent piece.
• In order to gain easy access to the area they want to go in at, we will need to shift one of her jaw muscles/bone down a tad.  Again, it's not as bad as it sounds but the jaw has some massive muscles (especially Dana's, she loves to eat)  in/around the skull and by shifting these down they'll be able to get to the skull quicker.  The jaw muscle/bone will be put back together with titanium pins and the muscle will only be sore for a couple days.
• The neurosurgeon will be using a tiny tube that has all the tiny tools they need to complete the operation (removal of blood, bad blood vessels and the ability to polish up her brain and remove any iron deposits).  
• What are these aforementioned iron deposits?  Blood has iron in it, iron is a precursor to seizures and if blood is sitting next to the brain there is a chance that iron has soaked into the brain.  If they see the brain is yellow then they will clean off the brain until it's white/grey again.  This will make sure we lessen the chances of seizures in the future.
• The neurosurgeon will not be entering her skull/brain via removing the top of her head and moving things around like you'd see on TV or with other types of surgeries.  It is a small hole with a bunch of tiny tools  and they get in/out very quickly.
• They will be using a computer-assist navigation system to help them get to the void. They made a ultra-high resolution MRI that is essentially a GPS mapping system of her brain and will allow them to be certain that they have arrived at the correct location.

I know for a lot of you (and including us at one point in time) this event is quite scary.  Ifeel this is mainly b/c we know so little about brain surgery.  However, when I know more about something and how it works I am less scared of it. This is particularly why I wanted to know as much as possible so I can process this and cope a little better. We're lucky that our neurosurgeon spent a good amount of time with us this past Tuesday morning explaining each and every step in great detail answering all our questions.  We're lucky to have the best Doctors in the world here in the US, we're lucky that medical science is as this advanced and we're lucky for all the prayers and thoughts coming our way.

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