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Princeton Football Player Thanks Surgeons Who Saved His Life

Khamal Brown, a Princeton University football player, watched as Dr. Mandy Binning pointed to a radiological image of his brain – taken just two months earlier when he arrived, fast losing consciousness, at the Capital Health Regional Medical Center's Center for Neurologic Emergency Medicine in Trenton.

Dr. Mandy Binning

 “This image shows blood spilling into the section of the brain where spinal fluid should be,” Dr. Binning, a cerebrovascular neurosurgeon, explained to the student. “Brain cells are dying by the second from too much pressure in the brain. We knew if we did not operate, you would die.”

Khamal and his father, Kevin Brown, looked on in amazement and gratitude. The image showed just how devastating the brain emergency could have been -- and how the team at Capital Health saved the football player.

“I’m a pretty lucky guy and thankful to be here,” the younger Brown said.

The Center for Neurologic Emergency Medicine is the nation’s only ER specifically dedicated to the treatment of brain emergencies.

On that fall afternoon, Khamal arrived at the brain emergency department unresponsive and losing consciousness. Doctors quickly performed a CT scan right at the bedside with a revolutionary portable CT scanner at their state of the art facilities. An arteriovenous malformation (AVM), an abnormal connection between veins and arteries, probably present at birth, had ruptured, spilling blood into the space in the brain reserved for spinal fluid. Within minutes of diagnosis, Khamal was then taken to Capital’s closed neuro ICU.

At the bedside, using neurologic technology and assisted by specially trained neuro professionals, the dual-trained neurosurgeon performed a life-saving drainage procedure called an external ventriculostomy, drilling a hole in the student’s skull to drain fluid and relieve the mounting pressure. Once he was stabilized, Dr. Binning performed a diagnostic cerebral angiogram to visualize and evaluate Khamal’s detailed cerebrovascular anatomy. She then performed another brain surgery to correct the arteriovenous malformation, or AVM.

Dr. Binning said the training and experience of physicians and experts at the center prompted them to recognize that this young man was not experiencing concussion or brain trauma.

“Others may have just assumed that he's a football player, was hit in the head during practice and suffered a concussion. However, we realized his symptoms and CT findings were consistent with a vascular problem, unrelated to what he did on the field that day,” Dr. Binning said.

Khamal's father, Kevin Brown, who lives in Atlanta and works as a records coordinator at the Georgia Tech library, accompanied his son for the follow-up visit.

“I saw Dr. Binning who reached out her hand to me, but I just opened my arms and hugged her,” he said. “I am so grateful my son was directed to Capital Health.”

Dr. Binning examined Khamal at his follow-up visit and said he is recovering beautifully and can return to school- even play football again if he so chooses. 

Erol Veznedaroglu, MD, Chairman of Capital Health’s Department of Neurosurgery, said the Center for Neurologic Emergency Medicine is now working to educate first responders in the field to recognize the signs of stroke and notify their ER to begin medical preparations even before patients reach the hospital. The purpose of this “pre-hospital stroke alert” is to reduce time between the patient's arrival at the hospital and testing and treatment.

“We continually look at how we can take the level of neurological care available in the region to the next level,” said Dr. Veznedaroglu. “Our commitment to rapid assessment of symptoms and quick diagnosis allows our medical teams to more quickly determine and administer the most appropriate treatment.”

The Center for Neurologic Emergency Medicine is led by Dr. Michael D’Ambrosio, trained in both emergency medicine and neurology, a rare combination necessary to rapidly assess, diagnose and treat neuro-emergencies. The new program is also benefiting from the expertise of the director of neurology for the Capital Institute for Neurosciences, Dr. Mitch Rubin, a neurologist. It treats patients with head or spine trauma or injury, change in mental status, vision problems, vertigo, numbness, headaches, and seizures, all symptoms that may indicate a neurologic emergency.

More than eighty hospitals in the region transfer emergency neurologic patients to the Capital Institute for Neurosciences because of its unique specialized services including the Neuro ER. This has resulted in the Institute treating more patients requiring brain surgery – and more aneurysms – than any other hospital in New Jersey. In fact, it’s one of only 8 hospitals in the nation – the only one in New Jersey, Pennsylvania and Delaware – to be recognized by the Joint Commission as a 2011 Top Performer for Stroke, Dr. Veznedaroglu said.

The Institute includes the latest technology, including advanced treatments that allow surgeons to remove blood clots from the brain by threading a catheter through an artery beginning in the leg as well as performing state-of-the-art treatments, including high-tech “glue”, to repair aneurysms. It includes dedicated, “closed” neuroscience units for both intensive and intermediate care, neuro-imaging and laboratory services, advanced diagnostics including CT perfusion and cerebral angiography, the latest in neurosurgical techniques and access to research in the area of neurovascular care.

Dr. Binning is available for appointments by calling 609-537-7300. Signs or symptoms of stroke or other emergency, call 911!

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