Kyle Crossen would occasionally get migraines as a teenager in Palm Beach, Florida. They struck at the beginning of cross-country or lacrosse season, after he hadn’t been active for a while, and started with an aura. A squiggly line would arise in the center of his vision and slowly expand to the point that he couldn’t read unless he saw the words through his peripheral vision.
Then a migraine would set in. He would take over-the-counter medicine, nap, and feel better. “I never really thought much of it,” he says. He had asthma and frequent sinus issues, so this was just one more condition to manage.
The pattern continued after he graduated from Wake Forest University, where he met his future wife, Melanie, and moved to Charlotte for a job in software engineering. He loved his work, which felt like solving puzzles all day. They had two young children: Charlie, born in 2016, and Laurel, born in 2017.
Melanie noticed subtle personality changes in her husband following Laurel’s birth. The easygoing man she knew in college had become a little more impatient and short-tempered. By 2018, he was getting intense sinus headaches. He told Melanie the following year that he was feeling depressed at times.
The challenges came to a head in 2020. Kyle and Melanie endured several deaths in their extended family. Kyle’s company decided to furlough about 60% of his department during the pandemic. They had a lot going on with Kyle working at home plus parenting two young children during COVID-19.
Melanie worried that something didn’t seem quite right with Kyle. One morning, he took offense to a work-related email and typed a testy response that he asked her to proofread. “Melanie pretty much talked me down from it and convinced me that there was no ill intent,” Kyle says. The whole episode was uncharacteristic of him.
Melanie figured it might be stress. Kyle’s migraines had increased to two or three a week. He almost expected them sometimes. Still, neither could imagine they would soon became intimately acquainted with neurological surgeon Dr. Greg Imbarrato at Novant Health Brain and Spine Surgery - Cotswold in Charlotte, and that Kyle, only 31, would get a diagnosis of a brain tumor.
“Dig the pain out of my head”
Mountain biking was a pastime Kyle could still safely pursue during the first months of COVID-19. He drove to meet a friend at the U.S. National Whitewater Center in Charlotte in early July 2020 when he started feeling dizzy. He crumpled and vomited in the parking lot. Kyle looked so bad, his friend quietly began praying. “Something felt so different and wrong,” Kyle recalled.
Kyle and Melanie had planned a long-awaited hiking weekend, just the two of them, to the Black Mountain area two weeks later. They decided to go. At breakfast on their first morning away, another aura kicked in. Kyle vomited and moaned for hours: “I wanted to dig the pain out of my head.” They drove back to Charlotte.
Once home, Melanie knew something wasn’t right. She insisted Kyle get checked out at Novant Health Huntersville Medical Center. Following tests, he was sent by ambulance to Novant Health Presbyterian Medical Center in Charlotte to obtain an MRI and be evaluated by Imbarrato and the neurological team.
All the evidence pointed to a likely meningioma, a primary central nervous system tumor which begins in the brain or spinal cord. Kyle’s appeared on the left side of his brain. Migraines can be a symptom.
Meningiomas are one of the most common tumors within the skull. Mostly benign and slow-growing, if they grow at all, they are usually smaller than three centimeters and don’t require surgery. Kyle’s tumor was seven centimeters at its largest point. It had been pushing on his brain, including large arteries that supply blood. It had even invaded the cranial bones of his skull.
“The problem with this type of brain mass is even though it’s benign, it’s in some pretty high value real estate,” Imbarrato said. A tumor that size can cause the brain to misfire, displace the brain, or damage the brain’s physical structure if left untreated.
No more migraines; a new titanium plate
Imbarrato used a small catheter to cut off blood supply to the tumor the day before surgery to make surgery safer and more efficient. Computer navigation would allow him to map the exact location of the mass to determine the best spot for the incision, and avoid large blood vessels to help ensure Kyle didn’t have a stroke.
Over six hours in the operating room, Imbarrato opened a large portion of Kyle’s skull. He dissected and removed the mass, then cut away a portion of the dura – the covering of the brain – and a large portion of Kyle’s skull. Those steps were necessary to prevent the meningioma from coming back. Finally, Imbarrato incorporated a titanium plate to replace the missing piece of skull.
Kyle remembers waking up midafternoon and seeing Melanie. He was able to talk. Doctors were surprised at how composed he was. He relished his first hospital meal, pulled pork with a side of mac and cheese, as “the best thing in the world.”
Kyle stayed in the hospital for just two days. Imaging confirmed that Imbarrato had successfully extracted the whole mass. The chance of recurrence is about 10% over Kyle’s lifetime. Even if that happens, it’s unlikely to grow enough to cause symptoms.
Melanie says the relaxed, light-hearted, talkative man she remembered from the college – the man she married – is back. Kyle’s hair has grown over the titanium plate. “I can sometimes feel the bolts or the plate,” he says, “but it doesn’t bother me.”
There is no known way to prevent a meningioma. Patients are usually in their 50s to 70s. Exposure to radiation or specific medications at a young age can make someone more predisposed to meningioma, as can a genetic condition called neurofibromatosis type 2, in which tumors grow on the inner ear. Kyle didn’t have any of those risk factors.
He has not had a migraine since the surgery and was back at work full time a month later. He still participates in sports from mountain biking to tennis. Yearly check-ups provide reassurance that the meningioma has not crept back.
The only glitch in his recovery: Eight months post-surgery, he experienced a grand mal seizure while asleep. He’s had two more during the night. Neurologists are determining the correct treatment. The tumor’s pressure likely caused irritation to the brain tissue, leading to the seizures.
Given all they've been through, Kyle and Melanie feel great joy for the family life they have now. They appreciate the little moments more and take bumps in the road with just a bit more grace. As scary as the diagnosis and the surgery were, Kyle said, it also opened their eyes to all they have.
