“About a year ago, I started hearing a churning, like a whooshing noise, in my ears,” says Dan Broden. “At first I actually thought it was in my heart because the noise was in sync with my heartbeat.”
At 46, Dan is healthy, fit and active. He is married with two ten-year-old twin girls who, he says, are the light of his life. He is the founder and president of Broden Communications, where he trains executives, celebrities, doctors and athletes for media interviews and public speaking events.
A year ago, except for this odd symptom, Dan had no real cause to worry about his heart or any other aspect of his health. The pulsing in his ears was disconcerting though, so he went to see an internist he knew in Manhattan.
His heart turned out to be fine. In fact, the doctor didn’t find anything at all wrong with him. Dan lived with the noise for another month or two and then went to see another internist.
This time, the doctor told him to get an MRI of his head immediately; the pulsing in his ear could be a symptom of something more serious in his brain. The MRI did pick up an abnormality. Right behind his eyes in the Dura, or outer lining of the brain, was a large tangle of blood vessels that looked like an arteriovenous malformation (AVM).
An AVM is a bundle of veins and arteries that have become abnormally inter-connected. The malformation alters blood flow and can damage surrounding neurons. More seriously, it can rupture and cause a stroke or death.
A neurologist in Westchester, where Dan lives, highly recommended he see Dr. Philip Meyers, Clinical Co-Director of Neuroendovascular Services at Columbia Presbyterian Medical Center.
Dan met with Dr. Meyers in early August of 2012. “He had an Extraordinary bedside manner,” says Dan. “A super nice guy. Incredibly clear about the very very detailed and complex condition that I supposedly had. I remember he used a lot of analogies which is just a very clear way to explain things.”
Dr. Meyers performed an angiogram to confirm the dural AVM. After the angiogram, Dr. Meyers fine tuned Dan’s diagnosis to dural arteriovenous fistula (AVF). According to Dr. Meyers, “A fistula is an acquired blood vessel abnormality that develops during life resulting in abnormal and excessive blood flow whereas an arteriovenous malformation is a developmental blood vessel abnormality occurring in the uterus resulting in similarly abnormal and excessive blood flow. However, both types can cause stroke or death.”
He told Dan there was no doubt that the fistula was causing the whooshing noise in his ears and there was a danger of rupture.
Dr. Meyers explained to Dan that he had two treatment options: one was open brain surgery to place a clip at the base of the fistula, the other was embolization. Here, in a process similar to an angiogram, a micro-catheter is inserted through an artery in the groin and navigated to the brain. A small amount of glue is then injected into the fistula to cut off its blood supply.
Embolization carries less risk than open brain surgery as it is less invasive, but Dr. Meyers explained to Dan that in his case, he would have to pass very close to one of his eyes, and there was a chance of blindness.
Dan weighed the risks and opted for embolization. The surgery went perfectly. When Dan woke up, he could see out of both eyes and the whooshing noise was gone. He spent just one day monitored in the intensive care unit and was sent home.
“That’s it, it worked,” says Dan. “I have not since had any noise in my ears. No side effects from the procedure at all. And then even during the procedure he just made me feel so calm. Dr. Meyers is wonderful. Something as scary as this, you want somebody like him at your side. You know, ever since, I just want to sing his praises.”