Little Eshaal Ahmad was very sick in 2012. Just shy of her second birthday, the Pakistani girl had suffered her first brain hemorrhage, leaving her partially paralyzed and suffering seizures.
Her condition – a tangle of abnormal and fragile blood vessels in her brain – was rare and not curable, doctors in Pakistan told her parents.
Eshaal then suffered two more hemorrhages, and her father, Jamshed Ahmad, vowed to do whatever it took to restore his little girl’s health.
He didn’t know the road to wellness would lead to Buffalo.
“I started talking to different doctors, getting opinions, but they were not quite hopeful,” Ahmad said Thursday morning during a news conference at Gates Vascular Institute on Ellicott Street. “Some doctors said she had a 50 percent chance of recovery. Others said 25 percent. We were faced with the possibility of brain surgery, and we were all very scared.”
Ahmad moved his family twice seeking medical treatment for Eshaal in Pakistan. Exhausting efforts eventually led the determined father to Dr. Adnan H. Siddiqui, a neurosurgeon at the vascular institute. Through a series of emails, father and surgeon – both Pakistan natives – hammered out a plan that brought the family here in late April.
Thursday, Eshaal was a ball of energy as she darted up and down the hallway leading to the fifth-floor meeting room where the news conference was held. Ahmad smiled as his daughter played.
“In Pakistan, everyone wanted to help me, but they wanted to do brain surgery,” said Ahmad. “(Siddiqui) was the only one who was quite confident that he could do it without surgery, and that was a relief.”
Doctors from Women & Children’s Hospital of Buffalo and Gates Vascular Institute teamed up to volunteer their services and treat Eshaal.
“We thought we could address this using the minimally invasive approaches available to us at Gates Vascular Institute,” said Siddiqui, vice chairman of the University at Buffalo department of neurosurgery and director of Kaleida Health stroke services. “We were able to arrange for her care, but unfortunately she was denied a visa not once, but twice. On the third attempt she was granted a visa.”
Eshaal, who is now 4, suffered from a rare type of arteriovenous malformation (AVM), a cluster of twisted vessels that short-circuit normal blood flow and frequently cause brain hemorrhages that can be disabling or fatal.
“The fact that she in her young life had already suffered three hemorrhages, the risk to her life was a lot higher,” Siddiqui said. “There was a 45 percent risk during the procedure of something else happening such as a bleeding blood vessel. So this was high risk, high stakes.”
With each event there is also a 10 percent risk of mortality and a 30 percent risk of major stroke. The risk of hemorrhage is lifelong and increases 2 to 4 percent each year.
Eshaal’s small stature required Siddiqui to delicately thread a tube into her leg, up through her body and to her brain, where the malformed vessels were located. Through a series of procedures, the tube was filled with platinum coils and glue to obstruct the dangerous flow.
Dr. Renee Reynolds, a pediatric neurosurgeon, oversaw Eshaal’s care at Women & Children’s, where the girl spent a total of 48 hours in the critical care unit.
“She was transported on a ventilator back to Women & Children’s via Rural/Metro ambulance,” Siddiqui said. “She was intubated to make sure no bleeding would occur from the entry site and to make sure the airway was secure.”
The deformity Eshaal suffered was congenital, her physicians said.
“She was born with it. It can present with a brain hemorrhage at any given time during a person’s life,” Siddiqui said. “They are frequent causes of hemorrhages in children, young adults and also in older people.”
Ahmad and his wife, Kiran, also have a daughter who is 3. The couple sold their business as well as their home to travel here, Ahmad said. After spending a few days in New York City, they will return to Pakistan and begin to rebuild their lives.
“Honestly, I cannot believe my daughter is feeling so well,” Ahmad said. “The nightmare hasn’t stopped since Eshaal’s first year. I have no words to express my gratitude. I can’t show my feelings.”