A Second Opinion at Duke Leads to Successful Removal of Cavernoma
Dressed in her favorite color, Camden Fisher, age 6, poses for a photo in her room in Concord, NC.
Camden Fisher was three years old when she was diagnosed with cavernous malformations, also known as cavernomas. The tangled bundles of small, thin-walled blood vessels can leak or hemorrhage, causing headaches, seizures, weakness, and stroke-like symptoms. Despite multiple surgeries, her symptoms persisted. After a second opinion at Duke Health, Duke neurosurgeons completely removed the cavernoma that caused her problems. “We’re just so grateful that she’s thriving,” said Camden’s mom, Sara Fisher.
A Family Connection
“My husband Greg and I looked at each other and we're like, ‘Oh my gosh, Greg has that,’" said Sara Fisher. Greg Fisher had been diagnosed with cavernous malformations as an adult, but never had symptoms besides headaches.
Cavernous malformations are rare. Sometimes medications can control the symptoms, or doctors might take a “watch and wait” approach. Surgery may be recommended if the cavernoma is unstable or has hemorrhaged, causing symptoms.
First Surgeries for Cavernoma
One of Camden’s cavernomas had hemorrhaged, causing blood to leak into her brain. “That’s why she was so sick,” said Sara Fisher. Doctors near their home performed a craniotomy. The surgical procedure removes a portion of the skull to access the brain. Then the doctors removed as much of the blood that had leaked into her brain as they could.
The surgery had some complications, and Camden developed hydrocephalus. That required a second surgery, in which the surgeons placed a shunt to relieve a buildup of fluid. “She ultimately did very well,” said Sara Fisher, “until she was five.”
Cavernoma Symptoms Persist
On July 31, 2023, Camden and her family were leaving the park when her head began to pound and she began projectile vomiting. “Immediately I knew something wasn’t right,” said Sara Fisher. She drove Camden back to the hospital, where scans showed the same area in Camden’s brain was hemorrhaging again.
Surgeons performed a second, more aggressive craniotomy. “In hindsight, they didn’t get it all. But we didn’t know that at the time,” said Sara Fisher.
Camden’s troubles were not over. She needed another surgery to redo her shunt. Sara Fisher dove into cavernous malformation research, and learned about the Alliance to Cure Cavernous Malformation and its designated Centers of Excellence. Duke Health was the only one in North and South Carolina. She decided to get a second opinion on her daughter’s cavernoma.
A Second Opinion at Duke
Sara and Greg Fisher had a virtual visit with Duke neurosurgeon David M. Hasan, MD. “It was like telepathy,” said Sara Fisher. “We both knew in 20 minutes that Camden needed to go to Duke, even though it was two hours away.”
“We have the resources to diagnose and tackle nearly any cavernoma, including those affecting children, adults, pregnant women, and many other unique cases,” said Dr. Hasan.
Successful Surgery for Cavernoma
Hasan and Duke pediatric neurosurgeon Gerald A. Grant, MD, performed Camden’s surgery on December 7, 2023. “I’ll always remember Dr. Hasan coming in to check on Camden afterwards, and he's like, 'We don't want to celebrate yet. We’ve got to wait for the follow-up MRI to know for sure,' but he felt confident,” said Sara Fisher.
“The best part of it is that Camden went home after three days, with no complications,” said Dr. Hasan.
In March of 2024, a follow-up MRI showed that the cluster of blood vessels -- doctors call it a lesion -- was gone.
“Now we’re monitoring the other lesions she has, but that one was the largest,” said Sara Fisher, who has become a Duke Health evangelist. “The care at Duke is just different. They seem more knowledgeable, they seem more experienced, and they've just seen and done more than it seems like other programs have. The care seems more personal, too -- all the doctors and nurses got to know Camden well in the short time we were there.”
Today, Camden, 6, is thriving, and Greg Fisher has also transferred oversight of his cavernomas to Dr. Hasan. “She’s doing so well,” said Sara Fisher. “We’re just so thankful.”
