Leila Imhof, who turned 1 on December 4, is developing like any child her age. If it hadn’t been for the expert care she received at Cohen Children’s L Medical Center that might not be the case.
Her mother, Angela Imhof, knew something was terribly wrong shortly after Leila was born at Huntington Hospital. “From the first day, she made weird movements with her head,” Mrs. Imhof said.
Ms. Imhof used a smartphone to record a video of her daughter. When she showed the video to her pediatrician, he said Leila should go to Cohen Children’s immediately.
The medical staff in the Emergency Department at Cohen Children’s saw what Ms. Imhof was talking about. Leila, only 2 weeks old, was having seizures.
MRI IDENTIFIES MASS
Neonatologists in the neonatal intensive care unit (NICU) ordered a magnetic resonance imaging (MRI) of Leila’s brain to determine the cause of her seizures. The scan showed she had a mass — 2.7 by 2.5 centimeters — in her left parietal lobe. But was it a solid tumor or blood in her brain?
Hoping it was a blood clot, the neurology team at Cohen Children’s NICU administered medications and waited for her body to absorb the blood, which would control her seizures. “The neurologists tried a number of different medications,” said Leila’s father, Timothy Imhof. Unfortunately, none of the medications worked. “After about two weeks, she had another MRI and it showed nothing changed. If it was blood, it wasn’t going away.”
The next step was a biopsy, which showed the mass was indeed a tumor — a benign ganglioglioma. “It’s a rare tumor and rare in that age group,” said Mark Mittler, MD, co-chief of the Division of Pediatric Neurosurgery at Cohen Children’s. Treatment involves surgically removing the tumor. “It is especially unusual for seizures to be identified this early in development. Fortunately for Leila, her parents instinctively felt something was wrong and the medical staff took their concern very seriously.”
COMPLEX SURGERY TO REMOVE TUMOR
Dr. Mittler knew the surgery would be complex “because a newborn’s brain is very soft, almost like toothpaste,” he said. Also, Leila’s tumor wasn’t easily reachable. “The lesion was fairly deep,” Dr. Mittler added.
Leila’s seizures were getting worse and more frequent. As two of just a few pediatric neurosurgeons in the country, Dr. Mittler and his partner, Steven Schneider, MD, co-chief of the Department of Pediatric Neurosurgery, felt they had to operate despite Leila’s age.
Cohen Children’s Medical Center is equipped with the latest technology to take on challenges like this, Dr. Mittler said. “We have state-of-the-art intraoperative imaging available and have expertise in minimally invasive techniques,” he said. “We were able to remove Leila’s tumor in its entirety,” Dr. Mittler said.
The neurosurgeons operated together. “When we have an unusual case that’s difficult, we’ll put our heads and hands together to give it that level of expertise,” Dr. Mittler said.
The Imhofs were prepared. “They told us she might not have use of her right side because the left side of the brain controls the right side of the body,” Mr. Imhof said. Thankfully, Leila came through the procedure like a trouper. A slight fever disappeared after a few days.
“As soon as the tumor was removed, Leila stopped having seizures,” Dr. Mittler said. “She has a very, very slight weakness of her right hand, but she’s caught up on all her milestones,” he confirmed.
About a month after surgery, Leila came home to join her two older brothers, Liam, 6, and Eli, 4. “Everyone at Cohen’s was terrific throughout our ordeal,” Mr. Imhof said.
Read the next article in the Winter 2015 issue of Kids First: Cohen Children’s Medical Center Appoints Vice Chair of Research