Untangled

By Madison Loethen

Aaron Eckman was working on his Paris, Missouri family cattle farm when he began having vision issues. 

“All of the sudden when I would focus on an object, the object would start moving. It would last 5 to 30 seconds each time and it kept happening,” says Aaron. 

Aaron took a break. He went inside, washed his face off and rested a bit. He otherwise felt fine, but when the vision problems continued, he decided to visit his local family care practitioner. 

“My doctor examined me and didn’t find anything wrong. He recommended that I see an eye doctor,” says Aaron. 

Thankfully, Aaron was able to see an eye doctor rather quickly. Aaron had 20/20 vision, but because of the movement in his vision, the physician recommended Aaron get an MRI. 

“By now, my wife and I were getting pretty concerned. She works in the medical field and so within a day she had my MRI appointment scheduled,” says Aaron. 

Aaron underwent the MRI, and soon after, his family practice doctor called with the results. 

“He told me I had an AVM,” says Aaron.

An arteriovenous malformation, or AVM, is an abnormal short-circuit between arteries and veins that create a tangle of vessels in the brain or spinal cord. In Aaron’s case, these were stealing blood from other parts of the brain, causing his symptoms. AVMs can cause seizures or convulsions or burst and leak blood in and around the brain, which is known as a bleeding stroke. 

“We were really worried. We knew I needed to see a neurosurgeon so right away, I called our son’s pediatrician Holly Bondurant, MD. We have a close relationship with her, and knew her husband is neurosurgeon Charles Bondurant, MD,” says Aaron. 

They were able to make an appointment with Dr. Bondurant. “When Dr. Bondurant looked at the MRI, he agreed it was an AVM, and he also noted that it was very close to my brain stem,” says Aaron.  

Dr. Bondurant went over the different AVM treatments with Aaron.

“Multiple treatment options exist for AVMs. Some are treated with surgery, some are treated with radiation, some are treated by clogging the short circuit with glue and some are treated with a combination of therapies,” says Dr. Bondurant. 

Because Aaron’s AVM was so close to his brain stem, Dr. Bondurant suggested a combined glue and radiation treatment plan. 

For the gluing procedure, Dr. Bondurant joined efforts with Boone Health Interventional Radiologist, Andrew Getzoff, MD, and a small catheter was guided through Aaron’s vessels into the AVM. A slurry of medical glue was then slowly injected into the lesion, working to clog the abnormal vessels feeding the lesion while also allowing the normal vessels to remain open. 

“This decreased the size of the AVM and thereby decreased the lesion’s ability to steal blood from Aaron’s brain,” says Dr. Bondurant. 

Though Aaron’s AVM was smaller and his symptoms had improved after the gluing procedure, residual AVM has the ability to regrow with time. With this in mind, Dr. Bondurant recommended following up with radiosurgery. Radiosurgery has the ability to shrink and destroy the residual AVM. 

During the radiation procedure, focused beams of radiation from different angles were directed at the AVM to concentrate radiation in the remaining abnormal vessels.

Aaron was monitored for years as the radiation slowly turned the abnormal vessels into scar tissue. However, some residual AVM still remained, so Aaron underwent a second dose of radiation to get rid of the remaining AVM.

“Every year, I was getting an MRI done to see how things were progressing. One year, Dr. Bondurant was out of the country when I had my MRI done, and he still called me with the results,” says Aaron. 

Aaron’s evaluations also included arteriograms. During his arteriograms, a small catheter was guided through Aaron’s vessels and X-ray contrast was injected and watched as it flowed.

“This last November, after an arteriogram, Dr. Bondurant came to see me in my hospital room, and I saw him kind of dancing in the hallway. He told me that my AVM was gone!” says Aaron. 

Now you will find Aaron back at the Paris Vet Clinic business, working on his family farm, or spending time with his wife and son. He says he will always appreciate the care he received from Dr. Bondurant and Boone Hospital during his health journey.