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Summer 2009 A Headache Unlike The RestAAMC Neurosurgeon Discovers and Treats Rare and Dangerous Brain CystJermaine Boston has had her share of headaches. The 36-year-old counselor eases the transition of adolescents into and out of foster homes in the greater Washington, D.C. metropolitan area.  Jermaine Boston, 36, has no more headaches after her surgery. A standard workday can be stippled with conflict resolution, group therapy sessions, and cultivating social skills in teenagers with societal odds stacked against them. Having already obtained a master’s degree in Counseling Psychology, Ms. Boston is working toward becoming a licensed professional counselor. Like any professional with a stressful career and in pursuit of higher education, she thought headaches came with the territory. But in 2008, the headaches became constant, progressively worsening month after month, unabated by any over-the- counter medication. “Initially, I thought these headaches could be attributed to stress; they just wouldn’t go away,” said Ms. Boston. “Mild pain had evolved into intense pain, reaching a nine out of 10 on the pain scale. The headaches had become debilitating.” The pain sent her to an emergency room at a hospital near her home in Temple Hills, Md. CT scans revealed the probable cause of her problem: A colloid cyst had developed in the third ventricle of her brain. 
MRI showing normal size ventricles.  MRI showing the obstructing colloid cyst and resulting mass dilation of the ventricles. “Colloid cysts are rare, gelatinous, benign tumors that comprise one percent or less of all intracranial tumors,” said AAMC neurosurgeon Brian J. Sullivan, M.D. “So not only was Ms. Boston’s condition absolutely rare, it was dangerous. As these tumors develop, their growth causes a damming effect, obstructing the flow of cerebrospinal fluid (CSF) through the brain, causing dramatic intracranial pressure.” Within normal brain cavities, CSF is circulated, in part, through the third ventricle into the cerebral aqueduct. In Ms. Boston’s brain, CSF was still being developed, but this flow had become completely blocked. Dr. Sullivan likens the effect to turning on a faucet above a drain that is completely clogged. A backup of CSF causes immense pressure, resulting in excruciating headaches and, in some cases, vertigo, behavioral disturbances, and even sudden death. Ms. Boston was transferred immediately to AAMC because of the medical center’s advanced neurosurgical facilities and the highly experienced neurosurgeons of Maryland Brain & Spine. Dr. Sullivan performed a craniotomy and drained the backup of fluid. Through a tiny “window” created at the pinnacle of Ms. Boston’s skull, Dr. Sullivan and his colleague, neurosurgeon Gary A. Dix, M.D., accessed the ventricular system with a combination of the operating microscope and neuro-endoscope to removed the cyst. Immediately, Ms. Boston’s brain exhibited signs of improvement. “The ventricles of the brain shrink back to their normal volume right away, alleviating the pressure,” said Dr. Sullivan. Ms. Boston’s headaches have disappeared. Her brain now has ample room for the success stories of the adolescents whose progress she oversees. “The care at AAMC was phenomenal, and now I’m able to keep doing the job I love, and keep helping these teenagers,” she said. “I feel blessed.” |
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