The Challenge: Arteriovenous Malformation (AVM)
Crystal Kreitzbender is no stranger to migraines. She started suffering from them as early as 13 years old.
Even in adulthood, migraines continued to be a problem. And, at age 50, Crystal saw a neurologist for treatment at her local hospital.
"I just knew, within five minutes of meeting him, he was the one I wanted to do my surgery." — Crystal
She had a brain MRI, which came back with some surprising results.
“I got the MRI at 1:15,” Crystal recalls. “Much to my surprise, the neurologist’s office called me three hours later that afternoon. I was on my way home and pulled over on the side of the highway. It felt like my life stopped right then. I thought, if they’re calling me this quickly after an MRI, something’s got to be up.”
Crystal was right. She had an AVM.
An AVM is an inborn defect that affects the connection between arteries and veins and disrupts the flow of blood between them.
Crystal’s AVM was an abnormal, berry-like patch of blood vessels in her brain. Without treatment, it could rupture and cause brain damage.
The Path to UPMC for AVM Treatment
Though Crystal was a nurse, she wasn't familiar with AVMs, and she was nervous about the diagnosis. She sought out an expert opinion for treatments.
Treatment options include microsurgery to remove the AVM or embolization to block blood flow to the AVM.
Crystal lives in northwest Pa., near the Ohio border. She first consulted with doctors in Cleveland before a friend suggested Robert M. Friedlander, MD.
Dr. Friedlander is chair of UPMC's Department of Neurosurgery.
“I read Dr. Friedlander’s bio and was just floored at the things he had accomplished and the research he’s done,” Crystal says.
In December 2019, Crystal met Dr. Friedlander for the first time to talk about her AVM.
Still scared for her health and worried about the potential outcomes, Crystal noticed something about Dr. Friedlander that put her at ease. He had such a calm and humble presence.
"I just knew, within five minutes of meeting him, he was the one I wanted to do my surgery," Crystal says.
UPMC’s use of magnetencephalography (MEG) further strengthened Crystal’s resolve.
MEG is a noninvasive brain-mapping technique that records brain activity with great accuracy, based on the magnetic fields produced by the brain.
Before brain surgery, doctors can use MEG to help locate and avoid areas of the brain responsible for vital functions such as:
- The senses
Knowing she would have the benefit of advanced brain mapping, along with Dr. Friedlander’s expertise, Crystal was ready for surgery.
The Solution: Microsurgical Resection
Crystal had microsurgical resection to remove the AVM one week later.
With the help of a microscope, Dr. Friedlander cut off the blood supply to the AVM. He then carefully separated it from the surrounding tissue.
After eight hours in surgery, he had successfully removed the AVM.
Crystal returned home with her boyfriend, who spent the first week post-surgery helping her take care of her three dogs.
She had some residual head and jaw pain, but nothing she couldn’t handle.
The Results: Back to Her Normal Routine
Despite a few minor setbacks since surgery and follow-up appointments with Dr. Friedlander, Crystal feels like she’s back to her normal routine.
She will go back to work as a nurse once she has clavicle surgery. Crystal's doctor postponed it because of her AVM issues.
“I feel so fortunate,” Crystal says. “Dr. Friedlander and his team calmed me down when I felt on edge. They helped me through a very anxious time in my life. I felt like I was in the best hands.”
Our patient stories profile a number of patients who have had minimally invasive brain surgery at UPMC. Although everyone's care experience is unique, we hope that sharing these stories will help other prospective patients and their families better understand these procedures and their potential benefits.
Crystal’s treatment and results may not be representative of all similar cases.