Best wishes to Ryan and his family.

What limited information I've seen seems to be suggesting this is going to be pretty treatable but...Jesus, it's brain surgery. Seconded on the best wishes to Ryan and friends and family.

That will affect his prospect status.

Holy ####. Allow me to add my best wishes to him and his family.

just think he he was in the mets system they would use leeches, or just amputate

I guess John Olerud's brain hemorrhage and aneurysm were maybe the last major head injuries suffered by a MLB player?

Brad Ziegler's two skull factures were more recent than Olerud, but there's probably a few more: Corey Koskie retired due to concussion issues, for example.

Christ, best of luck to an amazingly exciting prospect . . .

Oh God. I really hope this turns out well.

Bad time to be an American League CF prospect...

Jennings

Mitchell

Westmoreland

All the best to all of them.

He's almost certainly going to Phoenix to have it done by Dr. Robert Spetzler who is supposedly the best. He's carved open the brains of my sister, aunt and mother with no ill-effects thus far (the last one was two years ago). Forget about him playing this year though, or at least playing well.

Barrow Neurological is a wing at St. Joseph's in Phoenix and Spetzler pretty much built the place in order to try and have a single facility that was designed for neurosurgery specifically. The big thing they have is lots of really precise video equipment so they can train a greater number of surgeons during each procedure rather than being limited to looking over the surgeon's shoulder.

Spetzler trained under Charlie Wilson and is mentioned in this 1999 Gladwell article about Wilson, Wayne Gretzky and Yo-Yo Ma.

IOW, Westmoreland is certainly going to the right place. But obviously brain surgery is always dangerous so fingers crossed and so forth.

That's not a trivial surgery. Those lesions tend to bleed a lot, and if it's in high priced real estate, it could get complicated.

He's carved open the brains of my sister, aunt and mother

Not to derail the thread, but that's some awful luck for your family. Something hereditary?

Best wishes to the Westmorelands.

From Mayo Clinic:

Diagnosis

Cavernous malformations are relatively uncommon, as is the likelihood that they'll bleed seriously. These vascular malformations typically do not cause any symptoms, but instead are detected on a brain magnetic resonance imaging (MRI) scan done for unrelated reasons. In other cases, the cavernous malformation may lead to significant bleeding or hemorrhage into the brain tissue, causing weakness, numbness, difficulty in speaking, difficulty in seeing, gait unsteadiness or incoordination. Even the small amount of blood surrounding the cavernoma can cause irritation of the surrounding brain tissue, sometimes causing seizures.

About Cavernous Malformations

Cavernous malformations are vascular malformations in the brain or spinal cord. Also known as brain cavernous hemangiomas or cavernomas, cavernous malformations are groups of abnormally tiny and larger, thin-walled blood vessels filled with blood that may slowly seep into surrounding tissue. The leakage of blood from the cavernoma may be more significant and cause what is called a hemorrhage.

When viewed under a microscope, cavernous malformations appear as tiny blood-filled caverns in the brain. These blood vessel malformations may also occur in the spinal cord, the covering of the brain (dura) or the nerves of the skull.

Brain cavernous malformations range in size from less than one quarter-inch to the circumference of a small orange. They occur with equal frequency in men and women and have been found in people of all ages. The first symptoms generally occur when people are in their 30s.

The primary risk associated with cavernomas is bleeding into the brain tissue, also called an intracerebral hemorrhage. Seizures also may occur when the malformation is in the cortex (the surface layer of gray matter in the brain). Cavernous malformations can slowly enlarge because of repeated small hemorrhages or bleeding surrounding the lesion. Cavernomas are usually distinct from the surrounding brain tissue because they tend to push normal tissue aside.

Thanks for posting that, villageidiom.

Not to derail the thread, but that's some awful luck for your family. Something hereditary?

Don't know. They were all aneurysms though only my sister's ruptured (the other two were found before they ruptured). It's probably a combination of genetics, gender and lifestyle habits (all three are/were smokers).

So far I'm all clear.

This is awful news. My best wishes to him and the Westmoreland family. It sounds like he is in excellent hands and at the best place for the surgery.

I know what it's like to be in that waiting room... All I wanted was for my son to still be "my son" coming out of surgery--that his personality, his humor, his "self" would emerge from brain surgery intact; I didn't care about the physical deficits that may have resulted--I just wanted him to be the same kid he was before surgery.

So regardless of whether or not Westmoreland can play baseball again after all of this, I sincerely hope for his sake, and for his family, friends, etc. that he comes out of surgery the same person as he was when he went in.

TE,

One scary thing is, everybody comes out of brain surgery all sorts of goofy. For a couple days it seems like those fears are being realized. But then if all has gone well, the swelling subsides and they return to normal.

But those couple of days are very scary.

Voros,

Very true. The doctors warned us that it could take a week or more for the swelling to go down, and you're on so much (non-performance enhancing) steroids and other meds after brain surgery you're goofy in all kinds of ways from the swelling and the drugs. It's a frightening time. Even physical deficits are really impossible to determine in the immediate aftermath of surgery, because so much post-surgery healing happens in the brain before things are "normalized" to whatever the "new normal" is physically.

It's an awful time, though, and no matter how much the doctors warn you to expect it, when you have to watch someone you love go through it, it's terrible.

The ESPN article by Edes:

ESPN link

places the malformation on the brain stem, which is probably the last place you'd ever want to do brain surgery--anything goes wrong surgically in that area at all (even a small thing) can lead to disastrous consequences. It also indicates that there was already an episode of bleeding on the brain in the location, which may have led to the symptoms he seems to have had (headaches, numbness) prior to diagnosis.

Yikes.

Bad time to be an American League CF prospect...

Jennings

Mitchell

Westmoreland

All the best to all of them.

was Grant Desme a CF, and would he belong on this list?

If only it were Papelbon. He could have his brain removed and be none the worse for wear.

not the time.

I dunno Darren it's possible the Westmoreland family is making plenty of jokes right now. That's how a lot of folks (my family included) handle it. When it comes to jokes about removing brains, the jokes kind of write themselves.

Then your family is wrong about everything. :)

That's scary. Best of luck. Hope he comes through as well as Lester did with the whole cancer deal.

From the ESPN article in #20.

The condition was discovered, according to a team source, after Westmoreland began experiencing headaches and exhibiting other neurological symptoms, including numbness.

...

The malformation is located on the brain stem, according to multiple sources, and there has been an episode of bleeding in the brain. Typically, any further bleeding could cause severe neurological damage, according to Dr. Joseph Maroon, the vice chairman of the Department of Neurosurgery at the University of Pittsburgh Medical Center and team neurosurgeon for the Pittsburgh Steelers.

I'm glad to see he's getting the best care available. My dad's had two brain surgeries, and the 2nd one especially took a lot away from him. I wouldn't wish this on anyone, especially someone so young. Hopefully he'll not only get through this but will be able to come back and reach his enormous potential (preferably for a different team).

The Projo had an article that said there's reason to be optimistic about the kid getting back out there again just 3 months(!) after the operation.
I'm hanging my hat on that. Pollyanna? So what?

Just rub some dirt on it, ya big baby.

Geez -- best of luck to the kid, of course.

That said, "Cavernous Malformation" is playing for one of the NCAA Tournament teams this Friday, I think.

When it comes to jokes about removing brains, the jokes kind of write themselves.

Well, with the brain gone, jokes that write themselves are all you have left.


Seriously, best wishes to the kid and to anyone else here going through stuff like this. I do think humor is important to keep in these situations, so long as it's clear to all that it's laugh with, not at. The kid has a lot more to worry about right now than playing baseball, but I hope it goes well enough he can continue trying to make it.

I dunno Darren it's possible the Westmoreland family is making plenty of jokes right now. That's how a lot of folks (my family included) handle it. When it comes to jokes about removing brains, the jokes kind of write themselves.

I think saying "Yahoo" about it is pretty insensitive, even so.

One scary thing is, everybody comes out of brain surgery all sorts of goofy. For a couple days it seems like those fears are being realized. But then if all has gone well, the swelling subsides and they return to normal.

We are still waiting on Dial.

It's probably a combination of genetics, gender and lifestyle habits (all three are/were smokers).

Now, now, Voros. Dial has already used the statistically meaningful sample of his family to dismiss all problems related to smoking as being non-existent. Shame on you for not knowing and acknowledging this!


On a much more serious note, I wish they would convey where the VM is in his brainstem, or where the numbness was located. Each possible location (e.g., face vs. limbs vs. trunk) would carry a different set of risks.... [Part of my doctoral training in neuroimaging was under some MGH neurologists, so while I'm not competent enough to practice, I have a decent working knowledge of the real estate in question.]

Regardless, given that VMs tend to recur (seems one is generally genetically predisposed to them), this is a really, really bad place for them to find it.

(And...the curse of being on my prospect player list strikes, yet again!)

Westmoreland comes through surgery

The first hurdle, it seems, has been cleared. There will be many more ahead, but with surgery like this, the first is always the biggest. Don't make too much of the intensive care placement; it's standard practice after surgery like this, and he could be there for several days or a week, depending on if complications arise.

Update on Westmoreland

Kinda vague, but you can't expect anything else at this point. Really, the biggest thing in the immediate aftermath of brain surgery you fear are infection and something happening in there as a result of the surgery itself. No news is good news in that regard.

Where I think folks are going to be a little confused is a few months down the road (if all continues to go well). The reality is that he will have everything he needs physically to play minor league baseball or instructional league ball.

The problem is this soon after the surgery he's likely to be absolutely miserable while doing so. The headaches come without warning and can be just awful. I'm not sure precisely whether where in his brain the procedure was done could affect his vision. I do know that my three relatives all had greatly impaired vision for well over half a year afterward. Something as innocuous as a terrible itch where the incision scar is might be enough to throw you off your game a little.

The good news is he may not have to play well to get the benefits from playing, but I think it's important for the Red Sox to know this and express this to him so that he's not discouraged by it. If everything proceeds as planned, he should be fully good to go by ST in 2011 even if there's minor reminders here and there that pop up.

Voros--You're exactly right. The vision thing would be a big concern, but it's such a fluid thing post-surgery that it could take upwards of a full year to figure out exactly what is coming back and what it not.

In my son's case, the tumor was in the thalamus, and to get to it you have to "move aside" the optic nerve, and, as a result, his vision was a godawful mess coming out of surgery--he could see, but saw double and his pupils would bounce all over the place; pretty frightening stuff (and it sounds like you're unfortunately familiar with this). But he's come a long way since then. He has to wear glasses now with mild prisms to help correct the double-vision issues (and the docs hope this will be more temporary than permanent) and while his pupils probably will not ever react normally to light again, he's gotten back full range of motion (he had pretty bad Parinaud's syndrome for about 4 months post-op). All in all, if you didn't know what he went through, it would be hard know anything was amiss with his vision.

We were warned--a lot--prior to surgery about what we'd likely encounter post-op; hopefully Westmoreland and his family were as well, but of course it's hard to keep that in mind those first few days/weeks/months.

I give up. The stupid apostrophe is messing up the link to the Wikipedia description of Parinaud's syndrome. I can't get it to work.

In my case we were a little luckier, everyone but my sister's came back fully. And my sister's vision loss was pretty minor. She doesn't even wear glasses so how bad could it be?

The basic issue is that generations of natural selection of made it so that your body tends to not be too pleased when folks start hacking into your skull and so even if everything goes 100% perfect, it's gonna let you now not to make a habit out of this kinda crap. And I guess my point is simply that Westmoreland is in for a pretty unpleasant year ahead of him even if everything goes smoothly. That should be taken into account if he starts playing again later this summer.

Nature is a mad scientist.