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Arteriovenous Malformation Results in Pediatric Intensive Care Unit Stay

Amidst the birthday celebration for Delaney Safro’s 10th birthday, something wasn’t right. It was the height of the pandemic on April 6, 2020, and the last place Delany expected to be was at The Valley Hospital in Ridgewood, NJ. But, as her mom Joy noted, it was the best place to be.

On the morning of her double-digit milestone, Delaney complained of pain above her right eye. An hour later, she was throwing up and began to have a seizure. Joy called 911 and when asked where she wanted to go, she immediately said Valley.

“When I was holding Delaney and the ambulance came, I was very panicked. It was the start of the pandemic so the paramedics couldn’t come into the house and everything was happening so quickly,” said Joy, who lives with her family in Paramus. “I immediately told them I wanted to go to Valley. I had previously had a great experience with their pediatric emergency room. I felt guided to go there.”

Doctors worked with Delaney in the emergency room as Joy waited alone in the waiting room. Richard Anderson, MD, pediatric neurosurgeon, said that after doing an MRI and CAT scan, they found Delaney had an arteriovenous malformation (AVM), and they needed to perform an angiogram.

On her 10th birthday, Delaney suffered a stroke.

Arteriovenous malformation is an abnormal tangle of blood vessels connecting arteries and veins, which disrupts normal blood flow and oxygen circulation.

“Dr. Anderson was so kind and calmed me down while explaining to me what was going on. He said that if I saw him in the middle of the night, then something serious was happening, but if I didn’t, then they could perform the angiogram. There were a lot of prayers that night, and I never saw him,” Joy said.

The angiogram was performed by Dorothea Altschul, MD, Director of Neurointerventional Surgery, to identify the size and location of the AVM. Delaney was put into a medically induced coma, put on a ventilator, and placed in the pediatric intensive care unit (PICU).

Before Delaney was taken into surgery, Joy spoke with Dr. Altschul. “She told me how sick Delaney was. I asked if I was

Delaney underwent a two-part surgery, with the first lasting 10 hours. To alleviate the pressure on her brain, they first inserted a shunt. After removing a piece of her skull at the base of her head, Dr. Anderson then removed the AVM.going to lose her, and she told me that while it was possible, she assured me that Delaney was in very good hands,” Joy said. “I asked what I could do, and she told me I just needed to be her mom. It was exactly what I needed to hear.”

A few days after the surgery, Delaney was hitting milestones and talking.

“The nurses in the PICU treated us like family. All of the nurses became second moms and dads to Delaney. They got her a birthday present and even celebrated Easter with her,” Joy said. “They went above and beyond.”

Today, Delaney is doing extremely well. She has some memory retention problems and an Individualized Education Program (IEP) but looking at her today you would never know how seriously ill she was. She participates in dance and plays soccer.

“Each year on her birthday, we now celebrate two births. She was born on April 6, and her life was saved on April 6. It is such a beautiful day,” said Joy. “We have so much to be thankful for, and we couldn’t have picked a more perfect place to be cared for than Valley.”

Pediatric Intensive Care at Valley

Valley’s Pediatric Intensive Care Unit provides advanced care for babies, children, and teens who have serious illnesses or medical conditions that require continuous monitoring and specialized care.

“Care is provided by a multidisciplinary team that includes fellowship-trained, board-certified pediatric intensive care physicians, and skilled PICU nursing and support staff,” said Dennis Coffey, MD, Director of Pediatric Critical Care at The Valley Hospital.

The PICU team works closely with the Pediatric Emergency Department’s board-certified emergency physicians and pediatric subspecialists to provide comprehensive care for children who require intensive care or follow-up specialty care for the gamut of pediatric illnesses, including:

The PICU also collaborates with each child’s personal pediatrician to ensure that patients receive continuity of care while at Valley and when they are discharged to their homes.