KANSAS CITY, Mo. — Surgery — and superglue — saved 3-week-old Ashlyn Julian’s life last week.
The little girl was suffering from a rare, life-threatening condition in infants, and a team of doctors at University of Kansas Hospital needed to stop bleeding in her brain. Surgical superglue was the answer.
Doctors at KU, led by pediatric neurosurgeon Koji Ebersole, believe fewer than 20 procedures similar to the one that saved Ashlyn’s life have been documented in medical literature. The procedure is so rare that this may be the first time superglue has been used to repair an aneurysm in an infant’s brain.
That was last Wednesday. On Friday, Ashlyn was recovering in a hospital room, trying to nap while outside the door her parents wiped away tears and thanked Ebersole.
“I can’t express how incredibly lucky and graced we are,” said Ashlyn’s mother, Gina Julian.
Ashlyn was born without complications on May 16. She was released to go home to Olathe, but in the following weeks it was clear something was wrong. She was tired and vomiting.
Her parents took her at least once to Children’s Mercy South before it became clear the problem was serious, Gina Julian said. An MRI at another Children’s Mercy location revealed an aneurysm the size of an olive.
Brain aneurysms in children are extremely rare because they typically develop over many years, Ebersole said. Doctors don’t know exactly why these aneurysms happen, and Ebersole explained they may never know why it happened to Ashlyn.
Because brain bleeding is so rare in infants, there aren’t even pediatric tools for the procedure. Instead, doctors must use the smallest adult equipment available.
Surgery to repair the aneurysm began Wednesday morning after Ashlyn experienced a second traumatic hemorrhage.
On Friday afternoon, Ebersole explained the procedure in detail to Ashlyn’s parents for the first time.
Doctors from several hospitals were on the team. Surgeons first inserted a tiny catheter into a blood vessel in Ashlyn’s right hip. From there, Ebersole navigated the catheter through Ashlyn’s blood vessels and up into her neck.
Using a sophisticated brain imaging machine that shows the brain’s highlighted blood vessels from two angles, Ebersole navigated a microcatheter through Ashlyn’s brain and up next to the aneurysm itself.
There, Ebersole was able to deposit the sterile surgical superglue on the affected blood vessel. The glue dried in seconds and created an internal cast, sealing the blood vessel.
“It’s literally the same compound as the superglue you’d find in the store,” Ebersole said.
The most common treatment for a brain aneurysm is to open a patient’s skull and operate on the aneurysm. But because Ashlyn is so young, the blood loss involved in open surgery would have put her at considerable risk, Ebersole said. Instead, Ebersole believed he could treat the bleeding from the inside.
The procedure took less than 45 minutes once the catheter was inserted.
“I can actually breathe for the first time in a week,” Gina Julian said.
Jill Chadwick, a spokeswoman for the University of Kansas Medical Center, said the procedure was so rare that Ebersole probably will never do it again. He does intend to write about it for the medical community, she said.
The next step for Ashlyn is to return to Children’s Mercy, where the blood spilled by the aneurysm into the brain’s spaces will continue to drain. In another six months, doctors will check on Ashlyn, but Ebersole says she will probably never have trouble with the aneurysm again.
“I think she’s going to have a perfectly normal life,” Ebersole said.
Lulling Ashlyn to sleep on Friday afternoon, Gina and Jared Julian breathed a sigh of relief.
“All right, sweetheart, you’re pretty amazing,” she said.