When a patient presents with neurologic complaints of headaches and numbness, it is always cause for concern. If the patient is a healthy young professional athlete, it is alarming.
Last week, a cavernous angioma was discovered to be the reason for similar symptoms in Red Sox prospect Ryan Westmoreland.
A cavernous angioma is an abnormal mass of blood vessels. Although often inherited, the condition can be seen sporadically. The shape is similar to a raspberry with dilated areas where blood pools. Small hemorrhage is often the first symptom as opposed to an aneurysm where bleeding is explosive.
Location of this mass of blood vessels dictates the surgical difficulty. In the case of Westmoreland, it was located in the brain stem, making the situation more challenging.
The brain stem is the lower part of the brain where vital reflex functions like breathing and heart rate are regulated. Coordinated eye movements are also controlled in this delicate network of nerves and blood vessels.
Dr. Gregory Criscuolo, a neurosurgeon on the Backus Hospital Medical Staff who practices at Eastern Connecticut Neurosurgery, has operated on a similar lesion in another patient. “Surgery is potentially curable but there is a high likelihood of some permanent deficit,” said Criscuolo.
Hitting a baseball demands extremely precise eye-hand coordination to visualize the spin and direction of a high velocity pitch and to react appropriately. Any neurologic deficits like disequilibrium or double vision are career-ending in baseball.
Even in the best clinical situation, where there is no neurologic deficit, it is unlikely that Westmoreland will return to full activity this season.
The potentially life-threatening nature of this condition will make Westmoreland’s recovery and hopeful return to professional baseball exciting to watch.