The Patient, who had lost his ability to walk and speak, restored back to health after procedure.
Who:
Dr. Glen Beneby, former chief medical officer for the Bahamas, patient
Dr. Robert Starke, UHealth neurosurgeon and neuroradiologist, and co-director of endovascular neurosurgery at Jackson Memorial Hospital
What:
While attending an event in December 2016, Dr. Glen Beneby, chief medical officer for the Bahamas, suddenly blacked out, and collapsed.
“After that incident, I started experiencing cognitive decline,” said Dr. Beneby. “I didn’t feel fully aware of what was going on, but I also started experiencing weakness on my left side.”
Initially, doctors in the Bahamas suspected a brain tumor, but ruled that out a week later.
After undergoing a series of tests, including an MRI, doctors diagnosed him with dural venous sinus thrombosis, a condition that creates clots in the main veins in the brain. He was immediately placed on anticoagulants, commonly known as blood thinners.
Although he was taking medication, his condition worsened in a period of three months. Over the next year, he saw a variety of doctors and was thought to have progressive “dementia” of unclear etiology.
“I could no longer dress myself, and I began walking slowly,” remembers Dr. Beneby. “I was losing understanding of basic things; I also started having seizures.”
His wife could not bear the anguish of seeing her husband rapidly deteriorate.
“He was normally very active and sharp,” said Carolyn Beneby. “He could no longer carry a conversation, and he had lost his ability to smile and show any expression.”
In June 2017, Dr. Beneby was transferred to an area hospital in Miami, and was later referred to Dr. Robert Starke, UHealth – University of Miami Health System neurosurgeon and neuroradiologist, and co-director of endovascular neurosurgery at Jackson Memorial Hospital.
“When I first met Dr. Beneby, he was wheelchair-bound, and could only say his name,” recalls Dr. Starke. “As I took a closer look as his older MRIs, I was able to see hundreds of abnormal vessels and severe swelling in the brain.”
Dr. Starke immediately ordered an angiogram, which provides videos of the blood as it moves through the brain, and diagnosed Dr. Beneby with a rare condition called cerebral dural arteriovenous fistula (DAVF). DAVF is a vascular anomaly formed by an abnormal connection between an artery within the lining of the brain, and a vein that carries blood from the brain to back to the heart.
On average, this rare condition is diagnosed in patients in their 50s and 60s, and is classified by three types. Type I is considered benign and shows minor symptoms or none; type II may cause hemorrhage, seizures, and neuro deficits on patients; and type III may cause the patient to experience hemorrhage, seizures, stroke, and neurological deficits.
Dr. Beneby was diagnosed with Type III and even though he had not experienced any bleeding or a stroke, the end result could have been fatal if left untreated.
“Aside from experiencing seizures and severe cognitive decline, the patient was also experiencing swelling in the brain,” said Dr. Starke. “Luckily, his veins were able to compensate.”
Although this condition is rare and challenging to treat, Dr. Starke receives referrals and treats patients locally, nationally, internationally who have been diagnosed with abnormal brain and spinal vascular disorders. Dr. Starke is one of the few doctors that practices all treatment options including microsurgery, embolization, or focused radiation therapy. For each type of DAVF there is an optimal treatment.
Dr. Beneby underwent endovascular embolization, a minimally invasive procedure in which Dr. Starke placed a catheter through the leg and passed it through the artery until it reached the DAVF. The fistula was then plugged with glue to correct the abnormal pattern of blood flow.
Shortly after the procedure, Dr. Beneby underwent occupational, physical, and speech therapies at Jackson Rehabilitation Hospital for four weeks.
“Just a few weeks after the procedure, my husband was smiling again, and carrying conversations,” said Mrs. Beneby. “I felt so happy to have my husband back.”
Dr. Beneby returned to work in December 2017, and transitioned into a new role as director of special projects for the Health Department in the Bahamas.
“This whole experience truly confirmed my faith in God and life,” said Dr. Beneby. “I feel I have a special purpose in life. This is a transformation, and it’s a true miracle by definition.”
Dr. Beneby is excited to focus on continuing to create medical programs in his country, including providing better access to patients suffering from neurological conditions.
When:
10 a.m., Wednesday, May 16, 2018
Where:
Ryder Trauma Center
Room 121
1800 N.W. 10th Avenue
Miami, FL 33136
Editor’s Note:
Media can park in media lot of Ryder Trauma Center.
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Jackson Health System
1611 N.W. 12th Avenue Miami, FL 33136
