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Awake Brain Surgery Gives Dad the Ability to Play Another Day

3 min read  |  January 23, 2024  | 

A Father’s Day trip ended in the ICU when Fernando Vera suffered a seizure.

“I had bitten my tongue, foam, twitch on my left side, and then enter just a catatonic state,” says Fernando.

He met with Dr. Robert Starke, M.D., a Tenured Associate Professor of Clinical Neurosurgery and Neuroradiology at the University of Miami Miller School of Medicine, who specializes in treating blood vessel and vascular problems of the brain.

An MRI revealed Fernando had a cavernoma or vascular malformation.

“So that can be any sort of abnormal connections in the blood vessels of the brain… that can cause bleeding or other problems in the brain like seizures or weakness. He has a very high risk of having future bleeds in his lifetime, which could leave him without the ability to talk, move. We talked about a number of treatment options, but in his case, I thought the best one was to go in and remove this vascular malformation,” Dr. Starke says.

Pioneering awake craniotomy for cavernous malformations

At UHealth, Dr. Starke performs a rare surgical procedure where the patient is literally awake during surgery. This is done in order to avoid harming critical areas of the brain such as speech.

“He’s talking to us the entire time, and we can stimulate those areas to define which are the problematic areas that need to be removed, and which are the areas that are very important and vital and need to be preserved,” says Dr. Starke.

The Angioma Alliance recognizes the University of Miami as an Overall Center of Excellence for cavernous malformations.

“Part of that is banding together clinicians that see these rare things on a daily basis. And that includes people like myself in neurosurgery and endovascular neuroradiology, but it also includes people in genetics, stroke neurologists, seizure neurologists, specific radiologists, and other people of those disciplines that band together not only to treat these patients, but also to study them so that we can improve the outcomes of these patients that come in the future,” Dr. Starke says.

Dr. Starke removed the vascular malformation through a small incision. Fernando is now seizure free and making music with his boys!

“He told me one of the best things I could do for recovery and to increase neuroplasticity is playing my instruments. Big time thank you for giving me my life back, for making my children have their dad back,” says Fernando.


Robert Starke, M.D. is a Tenured Associate Professor of Clinical Neurosurgery and Neuroradiology at UHealth. Visit the website for information on neurosurgical procedures and services.


Video transcript compiled by Janna Ross for ‘Focusing on You: Innovations in Modern Medicine,’ a series of health care-related stories airing regularly on WPLG Local 10.  For more stories like this one, visit UHealth’s YouTube channel.

Tags: awake brain surgery, cavernoma, cavernous angiomas, Dr. Robert Starke, focusing on you, neurosurgeon, vascular malformation

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