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June 10th, 2013
05:21 PM ET
Baby's brain aneurysm halted - by superglueChalk it up to a win for ingenuity: Doctors are crediting surgical superglue for saving the life of a 20-day-old girl in Kansas. Ashlyn Julian was born healthy and happy on May 16. Shortly after returning home from the hospital, however, her parents noticed something was wrong with their newest addition. “She was probably around 10 days old, and she was sleeping a lot, and I understand that babies sleep a lot, but to the point that you couldn't wake her up to feed her,” said Ashlyn’s mother, Gina Julian. Then abruptly, her behavior changed. “We (went) from a baby that was very quiet to a baby that was screaming all the time and throwing up, and at that point we knew something was very wrong," Julian said.
Ashlyn’s parents twice rushed her to the emergency room at Children’s Mercy Hospital in Kansas City, where doctors noticed her fontanel (the soft spot on a newborn’s head) was raised. Undecided between meningitis and something in her head, doctors decided to conduct an ultrasound. “The ultrasound was as far as we made it because they saw something in her head at that point in time, so they decided to transfer her to a hospital that was better equipped for what was going on,” said Julian. That place was The University of Kansas Hospital, also in Kansas City. Once there, doctors found an aneurysm the size of an almond lurking in Ashlyn’s newborn brain. “We did not know what the right answer was. This was not a textbook case,” said Dr. Koji Ebersole, an endovascular neurosurgeon. “If you try to treat the baby without closing the aneurysm ... most of those babies can’t survive. So we had a strong reason to develop a plan to close the aneurysm.” By the time doctors at KU Hospital got to Ashlyn, she had already experienced one bleed from the aneurysm, and before her surgery she would experience a second. The standard treatment for brain aneurysms is to open the skull, but in a baby as young as Ashlyn, that wasn’t the preferred option. “It was absolutely a strong consideration for us, and possibly even the primary plan," Ebersole said. "The difficulty is, on a child so small, any amount of blood loss represents a significant percentage of her overall blood volume. So a surgery on the brain to approach something that wants to bleed – we could have been in a situation with bleeding we could not keep up with, and that would have been life-threatening.” After studying MRI images of Ashlyn’s brain, Ebersole was fairly certain that he would be able to image the aneurysm itself using an angiogram – a process that allows doctors to view the flow of different blood vessels in the body. Based on the location of Ashlyn’s aneurysm, he decided to take an unorthodox course of treatment. Ebersole was determined to close the aneurysm using surgical superglue - a method previously utilized only on adults. Because bleeding in the brain is so rare in infants, there aren't even tools for the procedure. So Ebersole improvised, using a micro-catheter as thin as a strand of hair inserted into Ashlyn’s neck to access the aneurysm and deposit the glue. The minimally invasive, groundbreaking procedure worked. Just one day after her aneurysm was eradicated, Ashlyn’s breathing tube was removed – exceeding even the expectations of her surgeon. “Oh, we're thrilled! The breathing tube was taken out the very next day," Ebersole said. "I did not know that she'd be ready that fast, and I think she's been making steady strides since, so we're all very happy.” Doctors expect Ashlyn could be released from the hospital in as little as a week and a half, and even more amazingly, they expect her long-term prognosis to be just fine.
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love. Recent Comments
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Cudo's to you doc, as well as all involved. Just goes to show a little common sense is all you need to save the day.
Medically knowledge helps too.
Yes, Common Sense is what told the doctor to use a micro catheter to put medical grade superglue on the baby's brain.
and by the way it's Kudos, not Cudo's.
Yes, Shannon. If you were faced with this situation, you would say "Ah ha! I'll just use some super glue to fix this. It's common sense!".
What a lame comment. It made me crack up. Those 11 years of study it took me to become a doctor–what a waste. I just needed some common sense!!!
dsavio – no need to be such a first rate twit. I've worked in the medical field for 30 years and I'd agree. Common sense – from the surgeon's perspective is exactly what was applied. That and their skill in performing the procedure.
Doc – you too. Really? You know that this is an option and that this was a stroke of inspired common sense. You'd know, for instance that sutureless anastomoses using cyanoacrylate has been quite widely reported and that these surgeons had cyanoacrylate handy because it's used in certain vascular surgical applications.
@Doc Oh my! Since you have 11 years in the medical field and can't comprehend what I'm saying, I'll try to break it down a little more.... I know the glue was surgical glue and not just random glue off the secretary's desk. The reason I say (and I'm correct) that he used common sense is because he had two options... 1) To use the standard way by opening the skull which would have likely been fatal due to blood loss. Or, 2. Use the catheter thru the neck and surgical glue to close it. So yes, I would go with common sense because he chose the option that had never been done before over the one that’s standard operating procedure because it would be less evasive than option one and a bigger chance that the baby would survive.
P.S. Remind me to never come see you for my medical needs...
It's naive to think that all it took was common sense. This surgeon is very obviously a gifted doctor who thinks outside to box to solve problems...and he indeed solved it!
"Superglue" was submitted for use as a medical adhesive in the 1960s ... nothing new here.
Can't we all just get along?
I love the internet! Dumb arguments like this get me through boring days at work. Thanks to all involved!
common sense: sound practical judgment that is independent of specialized knowledge, training, or the like; normal native intelligence
They are right in your misuse of the phrase "common sense". Why not just admit it was a dumb mistake and move on? Trying to justify the usage and make it fit the scenario only makes you appear to be ignorant.
I heard about this procedure 20 years ago being done in Canada. What took us so long?
Way to go, Dr. Ebersole! Creative thinking saves the day!
I can't even imagine how scary that was for the family, and for the ingenuity of the medical professionals, it's awe inspiring.
So glad they were able to help this baby.she must have been in terrible pain. They used Onxy 500 on my wife 15 months ago. She suffered an aneurysm in January of 2012. Thank God for all of the caring doctors. More research needs to be done on aneurysms!!!
Congratulations to your wife for surviving one. It's not an easy road. How did you know about it? Did she have a sentinel bleed?
PS Agree 100% that more research needs to be done.
Hope the best for the family and the little one! Good thinking doctors!
Yet nurses still think they know better than doctors
@Giggity: How dare you politicize this story.
Obama would have said the cost-to-chance for success ratio wasn't worth the medical expense.
'Fritwick McGee – Obama would have said the cost-to-chance for success ratio wasn't worth the medical expense.'
Whereas the current system would have had her refused coverage for it being a pre-existing condition.
Im glad the little sweetie is going to be great and grow up fine. Great going Dr. We need more drs like him.
Wrong move with a genetic defect ,like this baby has got, there will be multiple aneurysms popping up and lil baby will not live beyond a year or two
@lui xi ung: You're right. That baby, just like anybody who has had an aneurysm, is at higher risk than the general population. Since you can see into the future, I have a question for you. I had a cerebral aneurysm in my low 30s–extremely young for such a condition. I have many friends who have survived aneurysms or AVMs (which, unlike aneurysms, is genetic 100% of the time)–one of them even younger than I was. Should we all be euthanized?
Thank you so much for your opinion, but you are not a doctor. The doctors say she will be fine from here on out. Yes, she will be more susceptible to getting them in the future, however, I know that my little sister, Ashlyn, is alive today because of what Dr.Ebersole has done for her. We were all terrified she wouldn't make it through the procedure. Yet she is getting better everyday. If you are going to be negative, please take your opinion elsewhere.
Unless you are the baby's doctor, P-off!
until the spot is healed and the "chunk" of glue falls off and becomes stuck in or blocks shunt, or it disrupts brain growth, which I hope that neither occur for the baby and families sake. serious brain injury is not something easily lived with for the patient or family. It is an extremely difficult road.
I'm happy the baby will be okay; great doctors
These docs stuck their necks out knowing they might get chopped off if this went bad. Kudos.
Whew ! Thrilling and Bravo to such a creative solultion.
My 53 year old mother had 3 brain aneurysms. One burst and almost killed her. I cannot imagine a newborn baby going through all that my mother did. So happy this little girl has a good prognosis and survived this first aneurysm. Hopefully she will not have any more in her future.
Thank goodness the doctor(s) were willing to think outside the box. There are doctors...and then there are Doctors! These folks did what was necessary, but more importantly, they understood that the "usual rules" just didn't apply, and decided to play the game by a different set of rules. Thanks, folks, for having the guts to try...and getting it right.
Thank You Doctors for giving this little one a chance to be held by her Mother and Father again. Time of life is never a certainty with medicine, but if Doctorr's had to be afraid that someone was not going to make it, than none of us would have a chance, because there would be no trial
and errorr, only losses. Doctors once told me that I was a good candidate for something brand new, that might help me to save my leg from below me hip, but there was no gaurantee. what choice do you think I took? Nineteen weeks in a hospital, many surgeries, and problems even after leaving the hospital, but that was 1986...and I still have my leg, and I can walk without a walker or cane. My leg may look ugly, but it is mine, because Doctor's took chance. Everyone not in agreement with what this Doctor did, please be quiet, and keep your opinions quiet for a change. Allow the parents of this little girl to be happy with what the Doctor(s) were able to do, no matter what you think might happen in the long run. Miracles happen because o doctor's giving into chances, My ability to walk with my own leg is a miracle I will always be Thankful some doctor's, one in particular, Dr. Trafton, Providence Rhode Island Training Hospital, having taken a chance.
and errorr, only losses. Doctors once told me that I was a good candidate for something brand new, that might help me to save my leg from below me hip, but there was no gaurantee. what choice do you think I took? Nineteen weeks in a hospital, many surgeries, and problems even after leaving the hospital, but that was 1986...and I still have my leg, and I can walk without a walker or cane. My leg may look ugly, but it is mine, because Doctor's took chance. Everyone not in agreement with what this Doctor did, please be quiet, and keep your opinions quiet for a change. Allow the parents of this little girl to be happy with what the Doctor(s) were able to do, no matter what you think might happen in the long run. Miracles happen because of a doctor's giving into chances, My ability to walk with my own leg is a miracle. I will always be Thankful some doctor's, one in particular, Dr. Trafton, Providence Rhode Island Training Hospital, took a chance on me, and gave me the ability to walk with my own leg back, because I WAS AN EXPERIMENT.
Way to go Doctor! It is this sort of creative thinking that we should applaud and recognize as essential in our society, whether to save this baby, or a teacher mentoring a kid in HS. Also, thank you super glue. It kept my chest together after bypass surgery.
@Doc Oh my! Since you have 11 years in the medical field and can't comprehend what I'm saying, I'll try to break it down a little more.... I know the glue was surgical glue and not just random glue off the secretary's desk. The reason I say (and I'm correct) that he used common sense is because he had two options... 1) To use the standard way by opening the skull which would have likely been fatal due to blood loss. Or, 2. Use the catheter thru the neck and surgical glue to close it. So yes, I would go with common sense because he chose the option that had never been done before over the one that’s standard operating procedure because it would be less evasive than option one and a bigger chance that the baby would survive.
P.S. Remind me to never come see you for my medical needs...
Shanoon ,, ur too smart and u have the guts to think immeditly in such situations ,, actually what the DR. did is a great thing and creative .. he saved a new life and returns the happinese again to the parents , so pls don't underestimate what others done . and big thanx for that brave DR. ...
the doctor does not get the credit. Praise be to GOD for saving this baby THROUGH MIRACLE!
The problem with that sarcasm is that it is too close to what people will actually claim.
Its like House meets Macgyver –
I need some superglue, and an espresso straw!! STAT! lol.
I am surprised that the Super Glue treatment was covered by their insurance.
Great work by the doc! This procedure was first originated in the early 70s by Dr. Zanetti and Dr. Sherman. It has come a long way... A link to the original medical journal: http://thejns.org/doi/abs/10.3171/jns.1972.36.1.0072?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed&
Would be nice to know who manufactured this miracle brain glue. I work for a company that makes similar material. I was hoping we made the glue that saved this precious new life.
Actually brain bleeds are very common in babies – premature babies that is. I am surprised that they do not acknowledge that.
What an incredible story obvious like someone was thinking outside of the box. We need more people like this doctor on this world maybe we can clone him.
Wasn't one of the uses for medical glue used, when doctors started to do surgery on the liver – remove a portion – then use the glue to close the cut? An old commonsense method of stopping the bleeding on a cut – I was at an upholstery shop of a friend, helping him and cut my finger real bad with the scissors. He went into his little kitchen, poured some red vinegar in a small glass, had me stick my finger down in the glass for a few minutes until the bleeding stopped. He went and cut a small piece of brown paper, wrapped it around my finger, put scotch tape around the paper. Told me it would heal with out a scar. It did, that was 53 years ago.
How cool! I had not heard of that trick. Thanks!
Kudos to proactive physicians! Yay!
Uh, hello! CA (super glue) was originally developed as a medical adhesive. This is nothing new, folks.
WoW, just WoW. Respect to the doctors and nurses involved. This is such a serious and delicate problem. Good job.
Medical science into surgical proceedurs like these are simply amazing!!:)
It's so great to read a story about something good happening to somebody, for a change! I'm happy for this family and hope their little girl lives a long, healthy life!
Does anyone not know the history of how "superglue" was developed in the 40's to rapidly close combat wounds on the battlefield.
Why is it everytime someone mentions Sarah Palin I think of slope-headed inbreds with more guns than teeth? Trailer trash goobers who wear beany-copter hats and drink out of mason-jars. Low lifes whose idea of a night out is taking their cousin to a Chick-fil-A. ( I also think of nascar )
Hey, what's it like being stuck in 2008?
A little view of the future for ya...Although the recession will be bad in 2010, the economy will be in recovery by 2013.
Read this article, great story. UMKC & Children's Mercy hospitals involved.
Superglue probably alot less toxic than the vaccines this baby will face....I hope she gets well...
Okay, so first let me get my bragging rights in like the rest of you. I have worked in medicine for 41 years. This glue, medical-grade cyanoacrylate is used in many surgical procedures, including sealing skin, vascular procedures, anastomosis, etc. it is also used in the dental arena as well. Its been around since the early 60s. Its nothing new. This doc knew what he was doing. It was a bit of a risk on a 10-day old infant, but the risks outweighed the benefits.
What a great story
I think people give these surgeons too much credit for their "brilliant" solutions. When faced with a pediatric problem it should be obvious to look to the same procedures used in adults and to try to find a device that is scaled down in size with which to perform the procedure.
vaccines.