Meet Haley Spitznagel
The Path to UPMC
Five-year-old Haley Spitznagel had been having chronic headaches for several months. Her
neurological exam was normal. Haley’s doctors were fairly confident that her headaches
were due to sinus pressure and treated her for a sinus infection and strep throat.
When she later had her tonsils removed, the headaches went away.
Then on July 4, on the way to watch fireworks, Haley was overcome with head
pain and vomiting.
Her pediatrician referred Haley to a neurologist, who treated her for migraine
headaches, but the headaches and vomiting increased. At that point, Haley was
referred to Children’s Hospital of Pittsburgh of UPMC, where an MRI scan of her
brain showed a large lesion.
Haley had a tumor affecting the pituitary gland at the base of her skull.
UPMC’s team of brain surgeons was contacted immediately.
The MRI showed that Haley’s tumor was a craniopharyngioma close to the
This type of tumor has fluid-filled cysts within it, as well as a solid component.
Haley’s had ballooned up into the third ventricle, preventing her spinal fluid from
draining normally. Her headaches and vomiting were caused by pressure building up
from the blockage.
If the tumor grew just a little bit more, it could completely block the spinal
fluid pathways and make Haley acutely ill.
She was admitted to the hospital immediately and surgery was scheduled.
The traditional approach to lesions of this kind is an open craniotomy,
which requires a large incision across the scalp and skull in order to reach
the tumor. Instead of a craniotomy, Haley’s surgical team recommended minimally
Endonasal Approach (EEA) surgery through the nose and sinuses.
UPMC surgeons have developed the techniques necessary to work with a child’s
smaller anatomy, and have treated more than 100 children with this approach.
Using EEA, UPMC surgeons were able to reach Haley’s tumor directly and remove it.
They decompressed the cyst in the third ventricle and very gently cut it free and
removed it, piece by piece.
With this minimally invasive approach, they removed the lesion entirely without
disrupting Haley’s brain, blood vessels, or critical nerves.
Following surgery at Children’s Hospital, Haley’s MRI showed no tumor.
Her recovery was pain-free, and after six weeks she was “back to herself —
running, dancing, and back in preschool,” says her mother, Jill. “No more headaches.
She’s looking forward to playing soccer, her favorite sport, in the spring.”
Since her surgery, Haley now has another favorite sport — ice hockey.
“The highlight of her hospital stay was meeting Marc-André Fleury, goalie for the
Pittsburgh Penguins,” says Jill.
Fleury gave Haley an autographed jersey when he visited the pediatric intensive care unit.
Now she watches Penguins games on TV with her family, all wearing Fleury jerseys,
and she attended a game with her grandfather.
“When Fleury blocks a goal, Haley thinks it’s the greatest thing in the world,” her
Our patient stories profile a number of patients who have had minimally invasive brain
surgery at UPMC. Although everyone’s care experience is unique, we hope that sharing
these stories will help other prospective patients and their families better understand
these procedures and their potential benefits.
Haley’s treatment and results may not be representative of all similar cases.