Brain hemorrhage threatens to put a hockey career on ice

Wyatt skating for the elite Boston Junior Eagles team before a cavernous brain malformation caused a seizure and threatened to paralyze him
Wyatt skating for the elite Boston Junior Eagles team before a cavernous brain malformation caused a seizure and threatened to paralyze him

Wyatt Schlaht’s passion for hockey is what brought the Schlaht family to Boston from Colorado two years ago. His father was able to get a job relocation to help Wyatt realize his dreams.

“I wanted to play hockey for the Boston Junior Eagles,” says Wyatt, 14.

Playing on a AAA Elite team, in a big-time hockey town, has helped Wyatt hone his skills. But on February 18, everything skated to a halt.

“My dad and I were driving to hockey practice one night when I suddenly had a seizure,” says Wyatt. The next thing he remembers is waking up in the emergency room.

The doctors there ran a series of initial tests and decided to send Wyatt to Boston Children’s Hospital. During the seizure, Wyatt’s left hand and arm—which he shoots with—had become very weak.

By the time he got to Boston Children’s emergency department (ED), however, he seemed better. A battery of tests—looking at balance, coordination, vision, cognitive ability—showed no deficiencies. So the ED team discharged Wyatt home with orders for a brain MRI and electroencephalogram (EEG) in the next two days.

“They thought it could be sleep deprivation or possibly epilepsy,” says Candace, Wyatt’s mother. Sleep deprivation, as well as adolescent growth spurts, can be seizure triggers in children with epilepsy, the Schlahts learned.

But just an hour after the brain scan, the Schlahts received a call from Boston Children’s. “They saw something on the MRI,” says Wyatt’s father Keith. “They said it was life-threatening and that we had to come back right away.”

A tangle of vessels

What they saw was a large blood clot in the right frontal lobe of Wyatt’s brain. Something had caused a brain hemorrhage perilously close to the motor area, resulting in his seizure and weakness.

Wyatt was immediately admitted to Boston Children’s and soon was meeting with Neurosurgeon-in-Chief Alan Cohen, MD. Cohen wanted to operate to take pressure off the brain and determine what had caused the bleeding. The 6.5-hour operation took place on February 27, a Friday.

“It didn’t seem like a big deal because they made me feel very comfortable,” says Wyatt. “They didn’t panic, I didn’t panic, and there was no reason to blow it out of proportion. They were just going to take it out, and I was going to get on with the rest of my life.”

Wyatt with his uncle John the day before surgery, after both got buzz cuts
Wyatt with his uncle John the day before surgery, after both got buzz cuts

His mother had a different take. “We were very scared, very confused and had a lot of questions,” she says. “There weren’t going to be a lot of answers until after the surgery. But everyone had their arms around us and was very communicative.”

The surgical team used stereotactic navigation—essentially, an image-guided GPS system—to get to the blood clot without harming the motor area. Cohen then discovered the source of the bleeding: a cavernous malformation, a tangle of blood vessels forming a mass in the right frontal lobe of Wyatt’s brain. He and his team carefully took out the malformation, along with the blood clot, and did an MRI scan in the operating room to verify their work.

“From a neurosurgical point of view, this was a dangerous lesion,” says Cohen. “It was a malformation that had already ruptured and hemorrhaged right next to his motor cortex. It could have rendered him paralyzed on his entire left side.”

An athlete’s determination

Wyatt was still half asleep from the anesthesia when Cohen came into the recovery room. “Wyatt, lift your left hand, lift your left arm,” he demanded, trying to rouse him.

The weakness had returned. “I couldn’t move anything on the left side of my body,” Wyatt recalls.

Cohen told the Schlahts that this was probably temporary and caused by swelling of the brain, putting pressure on the motor areas. But he kept at Wyatt, urging him to try to move.

“He got Wyatt to focus, and it was a fantastic moment knowing he did not have paralysis,” says Candace. “I was in awe of Dr. Cohen and how direct he was in his expectations.”

“We were a little bit on eggshells,” Cohen says now. “If it didn’t get better, then we would have to determine what happened, whether we would have to go back in.”

brain cavernous malformation
Wyatt with Cohen four weeks after surgery

It took two days for Wyatt’s arm movement to fully recover, but it did. Wyatt impressed his parents and his Boston Children’s care team with his tenacity.

“The same determination that made him a first-class athlete got him through the recuperation,” Cohen says. “He’s very mature, he worked very hard, they did a great job at physical therapy, and we had a little bit of luck.”

By Monday, Wyatt was ready to go home. “I call it drive-through brain surgery,” Cohen joked.

“Everyone we dealt with at the hospital was very sincere and compassionate,” says Keith, Wyatt’s father. “There was phenomenal care and attention to Wyatt throughout the experience.”

Back on the ice

Wyatt had two weeks of continued physical therapy at Spaulding Rehabilitation Center. His hockey teammates showed their support by wearing #91 on their helmets at the National Championship Tournament in Buffalo, NY.

As of April 8, Wyatt is back playing ice hockey—with no contact for now, to allow his brain to heal. He will have a follow-up MRI in June, and assuming all is well, he’ll be ready to fully participate when the hockey season begins in August.

“My reflexes are 1,000 percent, they’re totally fine,” he says. “I can do everything I want to do.”

Learn more about neurosurgical care at Boston Children’s Hospital.