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Brain Bleed During Pregnancy Leads to Sophisticated Procedure

Tsymuk Family

Sergy, Mary and Natalia Tsymuk

To Natalia Tsymuk, 31, and her husband, Sergy, her pregnancy was “a miracle,” she says. “We’d been trying to conceive for seven years, and we were so excited to become parents. I was 19 weeks pregnant in July 2012, and everything was looking fine.”

But one afternoon she suddenly felt dizzy, and her right arm started going numb. “By the time my neighbor helped me upstairs, my entire right side was paralyzed, and I could no longer speak,” she says.

The Northeast Philadelphia resident was taken to Abington Memorial Hospital. Even though she couldn’t speak, staff in the Emergency Trauma Center knew that she could still understand them. “They explained everything they were doing, and reassured me that my baby was okay,” she says.

Qaisar A. Shah, MD, director of Neurovascular and Neurocritical Care in the Neurosciences Institute, was the first to shed light on what had happened to her: A tangle of blood vessels in her brain, called an arteriovenous malformation or AVM, had started to bleed.

In most cases AVMs are treated quickly to avoid the chance of a second bleeding episode. But the treatment, which would include radiation and anesthesia, would pose unknown risks to the baby. So she and Sergy decided to wait until the baby was born. Natalia returned home after a month in the hospital, and her baby came a few weeks early, on November 4. On December 4, Natalia returned to Abington for a procedure to cure her AVM. First, Dr. Shah blocked off the abnormal blood vessels with a glue-like substance delivered through a catheter, in a procedure called an endovascular embolization. Then Steven J. Barrer, MD, chief of Neurosurgery and medical director of the Neurosciences Institute, performed open brain surgery, removing a portion of her skull and excising the AVM.

Natalia spent the next two weeks recovering at Abington and a local rehab facility. “At first, I was very weak and in a lot of pain, but every day, I got a little better. I was focused on getting home in time for Mary’s first Christmas.” She got her wish on December 19, just in time for the holiday. “A day later, Dr. Shah stopped by to meet Mary and deliver a Christmas gift.”

Today, Mary is a bright and happy baby who continues to inspire her mother’s recovery. Natalia’s speech has completely returned to normal, she can walk with minor difficulty, and she’s gradually regaining function in her shoulder and upper arm.

“I’m optimistic that I’ll continue to recover and even play the violin again, as I used to do,” she says. “I feel very grateful and very blessed.”


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