Symptoms lead to emergency neurosurgery

On Super Bowl Sunday 2014, 15-year-old Krysti Owens began to notice a strange feeling in her hands — a tingling, as if her fingers had fallen asleep and wouldn’t wake up.

At first, Krysti chalked it up to fatigue after a long weekend volleyball tournament. The active Virginia Beach teen, with a passion for tap dancing, outdoor adventures and volunteer work with her church, tried to tune out the annoying sensations. “Through the week, the tingling and numbness traveled up my arms and down into my feet,” Krysti says. “Then I started to have pain in my upper back. I remember trying to lay my head on my desk at school, but I couldn’t because it hurt too much.”

Visits to both her pediatrician and the emergency room had resulted in normal examinations with no loss of strength, balance issues or other concerning signs. “We assumed it was sports-related and something that would pass with a few days of rest,” says Krysti’s mother, Barbara. “They told us if her symptoms got worse, we should head to CHKD right away.”

Sunday morning – a week after her initial symptoms began – Krysti awoke feeling lightheaded and weak, with unsteadiness in her legs and numbness in her feet that made simply getting out of bed a struggle. “Almost overnight, I couldn’t stand up on my own or walk to the door without support,” says Krysti.

Barbara immediately helped Krysti to the car and headed to CHKD. “I got really scared. This no longer felt like a simple case of overdoing it on the volleyball court,” Krysti’s mom recalls. “At that point, we needed answers.”

When Dr. Michael Strunc, a pediatric neurologist at CHKD, evaluated Krysti in the emergency department, she was having difficulty walking and pain in her legs. “Her symptoms suggested an acute, severe injury to her spinal cord,” he says. “We needed to act quickly to establish a diagnosis and treat the underlying problem before any permanent damage occurred.”

When an MRI revealed a mass in Krysti’s spinal cord at the base of her neck, Dr. Strunc admitted her to the hospital and called for an evaluation by CHKD pediatric neurosurgeon, Dr. John Birknes.

After examining Krysti and reviewing her test results, Dr. Birknes met with her parents, Barbara and Barry. Barry had rushed to the hospital from a weekend out of town. Dr. Birknes explained that the abnormal growth was disrupting the nerves carrying signals from her brain to the rest of her body. Her only chance for recovery was surgery.

As Krysti’s mother and father sat in stunned silence, the sobering news continued. Dr. Birknes explained that there was a chance the tumor could be malignant. If so, chemotherapy would need to begin as soon after surgery as possible.

Shocked, Barbara left the hospital for home to gather some things her daughter would need during her stay at CHKD. As she opened the door to her car, she noticed Krysti’s tap shoes lying on the back seat. “It was at that moment the harsh reality set in,” she says. “The thought that my daughter may never dance again or do any of the things she loved was almost too much to bear.”

Dr. Birknes enlisted fellow CHKD neurosurgeon Dr. Joseph Dilustro to assist in the complex procedure. “Because the mass was inside the spinal cord, we had to remove sections of her cervical vertebrae, the spinal bones at the back of her neck, to get to it,” he says. “Then, we had to go into the spinal cord and remove as much of the tumor as we could safely get to without causing further damage to the surrounding nerves.”

The surgery took nearly six hours, but when Dr. Birknes joined the family in the waiting room, he had positive news to share. “The surgery went according to plan,” he said. “We were able to remove the majority, if not all, of the mass, and our neurophysiologic monitoring, which assesses the nerve signals through the spinal cord throughout surgery, showed no additional damage.” Within days, the news got even better as CHKD pathologists confirmed that the mass was a cavernoma – a cluster of abnormal blood vessels, not a malignant tumor.

The good news was a fleeting moment of celebration for Krysti’s family. “We were thrilled the surgery went well, and incredibly relieved she didn’t have cancer,” says Barbara. “But, we still didn’t know if Krysti would be able to walk at the end of this. The journey was far from over.”

After five days in the pediatric intensive care unit, Krysti was well enough to be moved to CHKD’s inpatient rehabilitation unit, the only one of its kind in Virginia, to begin the slow process of recovery. “At first, it was hard to watch her struggle to do the most basic things,” her mother says. ”But the rehab team was amazing, and Krysti was determined to succeed. As the nerves healed, everything began to come back to her.”

On March 5, a month after Krysti had to be wheeled into the CHKD emergency department, she was able to go home – walking with the aid of a walker, but walking nonetheless. She worked with CHKD sports medicine physical therapists for the next six months, but was back in school by April and able to return to most of her normal activities in time for summer.

With some residual numbness in her feet, Krysti’s next challenge would come in her return to dance, something she had loved for as long as she could remember. In September of that year, she ventured back into the studio for the first time. “I think I was holding my breath, but when Krysti came out after class, she was beaming,” Barbara says. “She told me it was just like old times, and I could tell she was thrilled. That was a moment I will never forget.”

Though Krysti will continue to be followed by the neurosurgeons at CHKD, she considers her recovery an extraordinary success. “You don’t realize your life can change in a second until it does,” she says. “Now that I can walk, jump and dance again, I will never take those abilities for granted. Not everyone gets the happy ending I did. I will be forever grateful to God and CHKD.”

Krysti’s family is also thankful to have found the expert care they needed so close to home. “I can’t say enough about CHKD. I don’t know what we would have done without them,” Barbara says. “I’ve driven by that place a thousand times without a second thought, but I’ll never pass it again without thinking of all the wonderful healing going on inside.”

Dr. John Birknes and Dr. Joseph Dilustro practice with CHKD's neurosurgery practice.