Tarik J Patient Story: Tarik

"I didn’t feel it except for where they put the frame on my head."

Tarik Jones never expected to spend his vacation in California in a hospital, but that is exactly what happened. The 13-year-old boy from East Brunswick, N.J. got a severe headache. Then he could not walk. Tarik’s family took him to a hospital, where doctors found a brain AVM (arteriovenous malformation), a tangle of abnormal arteries and veins that can cause headaches, seizures and bleeding in the brain. When an AVM bursts, like Tarik’s did, it can be deadly.

Doctors cut off blood supply to the AVM by injecting a glue-like substance into the arteries feeding it (embolization). But those blood vessels could reopen and if they did, Tarik’s AVM was likely to bleed or burst again.

Treatments to cure AVMs include open surgery and Gamma Knife radiosurgery — available at Robert Wood Johnson University Hospital (RWJ). Surgery was risky, since Tarik’s AVM was in a part of the brain that controls balance and coordination and was linked to his brainstem, which controls vital functions. “Tarik could have had difficulty with balance and walking or the surgery could have killed him,” said Neurosurgeon Shabbar Danish, MD, Assistant Professor of Neurosurgery at UMDNJ-Robert Wood Johnson Medical School (RWJMS) and Director of the Gamma Knife Program at RWJ.

Gamma Knife radiosurgery uses a high dose of precisely focused radiation to obliterate an AVM over time, with little effect on healthy brain tissue. “Tarik’s AVM was perfect for radiosurgery. It wasn’t very big and it was located where we felt it would be safe to treat it with radiosurgery,” said Atif Khan, MD, Assistant Professor of Radiation Oncology at RWJMS and a Radiation Oncologist at The Cancer Institute of New Jersey (for which RWJUH is the flagship hospital).

Tarik was the first child treated with the Gamma Knife at RWJ. Neil Butler, RN, Nurse Coordinator for the Gamma Knife Center, coordinated the appointments and made sure Tarik and his family had the care and support they needed. “We try to make the experience positive,” said Butler. Marc Stetson, RN, and Jennifer Owensby, MD, from the Bristol Myers Squibb Children’s Hospital (BMSCH) at RWJUH spent the day of the procedure with Tarik and his family.

Before Dr. Danish attached the frame that helps doctors guide the radiation, Dr. Owensby sedated Tarik. Afterwards, she brought him back to consciousness. She and Stetson took Tarik in a mobile pediatric intensive care ambulance from the Gamma Knife Center at RWJ to BMSCH for MRIs and an angiogram. Dr. Ownesby is part of BMSCH’s Pediatric Intensive Care Unit.

The Gamma Knife team used the scans to develop the treatment plan. Then Dr. Owensby sedated Tarik for the procedure. “It was like nothing even happened,” said Tarik. “I didn’t feel it except for where they put the frame on my head.”

A few hours later, Tarik went home. While it may take up to two years before doctors know if the AVM is completely gone, Tarik’s risk of bleeding in the brain was cut in half after the procedure.