Homestead Woman Breaks Leg, Learns She Has a Brain Tumor

Over the past year, Ketty Ledan of Homestead has gotten to know some of Baptist Health’s top neurosurgeons—all because of a broken leg. Last summer, after more than a year of suffering weakness in her right leg, Ms. Ledan, 74, fractured her right leg when she fell getting out of the shower.

“Oh, it was very painful,” recalls Ms. Ledan, now retired after a decades-long career with the Miami-Dade County Health Department. The mother of three adult sons needed help from her husband Patrick and her next-door neighbor to get down the stairs and into the car.

They drove her to an urgent care clinic near them but the facility didn’t have a wheelchair to take her from the car, nor did they have an x-ray, so they were sent to a nearby hospital. “It was almost 4pm on July 3^rd and I knew the emergency room there would be crowded,” Ms. Ledan continues. “We decided to go to Baptist Health Homestead Hospital instead.”

(Watch now: Over the past year, Ketty Ledan has gotten to know some of Baptist Health’s top neurosurgeons—all because of a broken leg. See how doctors at Miami Neuroscience Institute were able to remove an undiagnosed brain tumor and help get Ms. Ledan back on her feet again. Video by Alcyene de Almeida Rodrigues and Dylan Kyle.)

That turned out to be a good decision. Because of Ms. Ledan’s age, a nurse decided that in addition to an X-ray of her leg, she should also have a scan of her head to rule out any neurologic issues that may have possibly caused her to fall while getting out of the shower, such as fainting.

“During her evaluation in the emergency room, Ms. Ledan had imaging of her head done that showed she had a left-side brain tumor that was causing pressure on her brain,” says neurosurgeon Robert Wicks, M.D., co-director of cerebrovascular surgery and director of the neurosurgical anatomy laboratory at Baptist Health Miami Neuroscience Institute. “When I first saw her, she had weakness of her right leg and a little bit of weakness of her right arm.”

Complicating her brain tumor diagnosis

Neurosurgeon Robert Wicks, M.D., co-director of cerebrovascular surgery and director of the neurosurgical anatomy laboratory at Baptist Health Miami Neuroscience Institute

The tumor turned out to be a meningioma, which the National Cancer Institute (NCI) says is one of the most common types of brain tumors. Typically found in the dura, or the lining of the brain, these tumors originate in the meninges, the outer three layers of tissue between the skull and the brain that cover and protect the brain just under the skull.

While meningiomas are most often benign, they can continue to grow if left untreated. In Ms. Ledan’s case, her tumor was quite large – about two inches in diameter or roughly the size of a lemon – and it was pressing down on her brain. That pressure was what had caused the weakness in her leg, forcing her to curtail the daily walks she had always enjoyed.

Complicating her diagnosis was the location of her tumor, directly next to one of the main veins inside the brain. “One of the unique aspects of Ms. Ledan’s tumor was its location and the possibility of it spreading into the superior sagittal sinus, the main vein that travels down the middle of the brain,” Dr. Wicks says. “Not only is it more difficult to remove portions of the tumor in that area, but there are also greater risks of causing major bleeding with that type of tumor.”

Two different views of the tumor on the left side of Ketty Ledan's brain

In addition, Ms. Ledan’s tumor was pressing on the main parts of the brain that control the function to her right leg. “This meant there was a greater risk of potentially causing paralysis or loss of function of both the arm and the leg,” Dr. Wicks says.

Treating meningiomas takes a team

There are different options for treating meningiomas, according to Dr. Wicks. “Sometimes we monitor them, other times we can recommend very targeted radiation treatment to shrink the tumor.” Once the tumor gets to the size of Ms. Ledan’s, however, radiation therapy is not as effective so another option is surgically removing the tumor, he says, noting that “surgery offers the best chance of recovery.”

Dr. Wicks’ first step was to call in his colleague, Guilherme Dabus, M.D., co-director of interventional neuroradiology at Miami Neuroscience Institute, who specializes in interventional neuroradiology and neuro-endovascular surgery. Dr. Dabus did an angiogram to get an accurate look at the blood vessels in Ms. Ledan’s brain, followed by a procedure called an embolization to close off some of the blood vessels supplying the tumor.

Neurologist Guilherme Dabus, M.D., co-director of interventional neuroradiology at Baptist Health Miami Neuroscience Institute

“We performed a tumor embolization, a minimally invasive catheter-based procedure where we insert a tiny catheter either through the groin or through the wrist and we get very close to where the tumor is,” explains Dr. Dabus. “Embolization not only blocks the vessels feeding the  tumor, but it also facilitates the eventual surgical removal of the tumor by making it softer.”

According to Dr. Wicks, blood loss during the surgery was also a concern. “These surgeries can take many hours. Because of the size of Ms. Ledan’s tumor and the risk of blood loss during surgery, it was important that we minimize the amount of time she was in surgery,” he says. 

To expedite the surgery, Dr. Wicks performed the surgery along with his colleague, neurosurgeon Michael McDermott, M.D., chief medical executive of Miami Neuroscience Institute. Working together, the two neurosurgeons were able to complete Ms. Ledan’s extremely delicate surgery in under three hours, taking great care to preserve the blood flow through the main vein next to her tumor.

Neurosurgeon Michael McDermott, M.D., chief medical executive of Baptist Health Miami Neuroscience Institute

Recovering from brain surgery

The day after her surgery, Ms. Ledan says she was recovering in her room at Baptist Health Baptist Hospital when her youngest son screamed and said, “Look! Look! You’re moving your toes. You’re moving your leg.”

“I just started crying and said, ‘Thank God.’ I don’t think even Dr. Wicks himself realized the miracle that had just happened. The day after the surgery, I was moving. Before that, I couldn’t do anything,” says Ms. Ledan, who was transferred to the Baptist Health Rehabilitation Hospital at Homestead Hospital for two weeks of rehabilitation before returning home.

Today, now that she can walk again, Ms. Ledan is now able to resume her daily walks and is looking forward to visiting her son and his family in Baltimore soon. She hopes to do more traveling with her husband and going out with friends.

“I almost couldn’t believe that my recovery was so fast, and that my eyes, my ears, my speech, nothing was really affected,” Ms. Ledan says. “I call Dr. Wicks my angel. He was extraordinary and he has such composure. Given the gravity of my situation, he made me feel so comfortable. I would give him five stars.”