After brain surgery to repair a blood vessel malformation, 9-year-old charges into 2001 without looking back

Because 9-year-old Trent Herrera has always been the kind of kid who could play through pain, his mom knew something was seriously wrong when the sudden onset of unbearable headaches made him scream.

He started mentioning that his head hurt in early November, according to his mom, Ina Thorner of Westchester, CA, and their pediatrician ordered a series of tests. But before the results came back, the Thanksgiving holiday was upon them, the pediatrician was out of town, and the pain in Trent’s head seemed to explode.

“He started having screaming pain, just severe pain, so I took him to the emergency room at Cedars-Sinai, our hospital. He was born there and he’s had prior treatment there,” says Ina (pronounced “eena”).

Trent had been treated seven years earlier for cancer in his abdomen. And now, on Thanksgiving Day, an emergency CT scan showed a mass in Trent’s brain.

“I was sick with fear because he has a past medical history of a childhood cancer called neuroblastoma. I was just praying it wasn’t a relapse. He had been through surgeries, chemotherapy, radiation, a bone marrow transplant and isolation at 18 months of age when he was diagnosed. But he has been totally healthy since April of 1993 when he had the bone marrow transplant at Cedars-Sinai. We hadn’t been back to the hospital since,” says Ina, who has two other boys, Claudio, 7, and Hunter, 1.

Trent was admitted for additional testing and to begin treatment for pain and swelling within his brain. Magnetic resonance imaging confirmed the presence of a mass, and Ina and Trent met neurosurgeon Moise Danielpour, M.D., who recently launched the Pediatric Program for Neurosurgery at Cedars-Sinai’s Maxine Dunitz Neurosurgical Institute.

“Not only is Dr. Danielpour a gifted surgeon, he is the most warm, wonderful person. He hugged me and tried to calm me down and tried to really make me feel better. He was patient and just really, really kind,” says Ina. “Instead of being abrupt and curt and cold, he made sure he answered all my questions and that I understood what was going on.”

Physicians and surgeons at the Institute specialize in treating all types of abnormalities of the brain and spinal cord – from tumors to nerve injuries to blood vessel defects. Dr. Danielpour’s surgical and research experience have extended these services to include childhood conditions such as congenital malformations, epilepsy, craniofacial disorders and hydrocephalus. He is one of a few pediatric neurosurgeons in the Los Angeles area; one of the very few in the world capable of performing surgery on unborn babies to treat a form of spina bifida called myelomeningocele.

In Trent’s case, based on the MRI and other scans, Dr. Danielpour and his colleagues suspected that a clump of malformed blood vessels called a cavernoma had ruptured, leaking blood into the brain. Although cavernomas are sometimes present from birth, they occasionally develop in patients who have undergone radiation therapy. Often, the mass of blood vessels grows undetected, posing little threat unless it hemorrhages or affects a critical area of the brain.

On the Wednesday after Thanksgiving, Dr. Danielpour and Wouter Schievink, M.D., an Institute neurosurgeon who specializes in repairing vascular abnormalities, operated on Trent while Ina prayed in the waiting room that the earlier cancer had not returned. “I still get worry and fear and doubt,” she says. “It’s like, only God knows. They don’t really know until they get in there and see.”

Her fears instantly vanished when she saw Dr. Danielpour’s expression after the surgery. “I’ll never forget when he sat there next to me and I said, ‘You’re smiling. Must be good news.’” Indeed, the cavernoma had been removed and proper blood flow restored. There would be no lingering neurological deficits or even a need for rehabilitation.

“Trent looks great. He’s perfect,” Dr. Danielpour says. “He went home a couple of days after being in the hospital, cured.”

Although Ina’s decision to take Trent to Cedars-Sinai was based on proximity and their previous experiences, when the diagnostic tests pointed to a mass in his brain, she began asking friends and family members for recommendations. She had no previous knowledge of Dr. Danielpour’s program, which opened in September, and she was unaware of the brain cancer research being conducted by Institute Director Keith Black, M.D., and a team of scientists. “We quickly found out that if you ever have anything like this happen to you or anybody you love, that’s the best place to be. That’s what everybody was telling me,” she says.

Trent, who will celebrate his 10th birthday on April 17, went back to school after the New Year break. He’s still a great student, according to a relieved and proud mom – although he was a bit grumpy when he had to make up the schoolwork he missed. “Trent had to stay home from school for three to four weeks but I had to practically sit on him to keep him from bouncing around.”

His headaches are completely gone, and his curly hair covers a neat, nicely healing incision line. He quickly resumed his everyday routine, which includes riding bikes, scooters and skateboards, and playing video games and handball.

“I’m so happy it went so well,” says Ina. “I was teetering on the verge of a nervous breakdown. Dr. Danielpour pulled me back.”

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