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The sky is the limit

The sky is the limit

Teenager triumphs over a rare brain condition

Ryan Logan’s teammates dubbed him “Bullet” for his lightning-quick jukes and his trailblazing speed—the 11-year-old’s athleticism on the football field was unparalleled. With a wit that zipped quicker than his feet, he also excelled in gifted and talented classes and made friends across school. The only thing that reined him in were mysteriously recurring headaches and visual disturbances.

In February 2013, Ryan’s doctors made a startling discovery: A brain scan revealed a grade 4 arteriovenous malformation (AVM), which is a massive tangle of abnormal blood vessels connecting arteries and veins in his brain. His snarled blood vessels were at risk of rupturing, which can cause life-threatening bleeding in the brain.

Researchers estimate brain AVMs occur in less than 1% of the population. There are often no symptoms, and half of people suffer a serious hemorrhage as the first sign.

Although doctors caught Ryan’s brain AVM before further complications struck, they warned that surgical removal would be too dangerous. “Learning our child has a ticking time bomb in his body was devastating,” says Ryan’s father, Mark. “It was an impossible situation. Removing it could debilitate him, but leaving it alone could cause his death.”

To help ensure other families never have to endure this anxiety, the Logans decided to establish the Arteriovenous Malformation Research Foundation. “We had to help find a safer treatment for brain AVMs,” says Mark.

Raising the stakes
Ryan’s brain AVM raised the stakes in September 2014 when the AVM suffered a spontaneous hemorrhage that landed him in the hospital for three days. Because one rupture greatly increases the odds it will happen again, doctors believed surgery was his best shot to avoid a fatal brain bleed.

After consulting renowned specialists across the nation, the Logans met UTHealth neurosurgeon David I. Sandberg, MD. Sandberg’s exceptional care earned the family’s trust, and he devised a plan to remove Ryan’s AVM with neurosurgeons P. Roc Chen, MD, and Arthur L. Day, MD. The surgery would take place in three procedures over six weeks in July 2015.

During the first procedure to block the artery and reduce blood flow into Ryan’s AVM, the AVM began shutting itself down, triggering a deadly hemorrhage. Chen had minutes to save his life.

“Ryan would not be here today if it weren’t for Dr. Chen,” says Ryan’s mother, Sherri. “Dr. Chen’s expertise as both an interventional radiologist and neurosurgeon enabled him to immediately stop the bleeding and relieve the pressure in Ryan’s skull.”

Over the next six weeks, Ryan remained in a medically induced coma while Chen and Day worked to remove about 70% of the brain AVM.

Research to find a safer treatment
When the Logans heard that Chen was interested in starting research on AVMs, they sprang into action to raise support. Although brain AVMs are not hereditary, Chen’s team believes they found a gene mutation that could unlock noninvasive therapies.

“Our family mission is to continue to fight AVM and be there for other families along the way,” says Mark. “We established the AVM Research Foundation to help Dr. Chen discover a safer, noninvasive way to remove AVMs.” Since 2017, the AVM Research Foundation has helped raise $350,000 to support Chen’s research by hosting an annual crawfish boil, an annual golf tournament, and other events.

Setting the pace
After nearly four years of physical, occupational, and speech therapy, Ryan’s family felt there was one thing preventing Ryan from regaining bullet speed—frequent seizure activity that started after his AVM ruptured. The almost constant seizure activity interfered with his cognition and his ability to improve physically and mentally.

In February 2019, leading UTHealth epilepsy surgeon Nitin Tandon, MD, conducted a 16-hour procedure on Ryan—comprising of a functional hemispherectomy to disconnect the right side of Ryan’s brain where seizure activity had taken root, removal of the remaining brain AVM, and a cranial vault reconstruction.

“Ryan’s spirit and love of life are what strike me most,” says Tandon. “As soon as he awoke from surgery, his wit returned, and you could sense a change.”

At 17 years old, Ryan is diving into his senior year of high school— free from seizures and the looming threat of his brain AVM. Despite short-term memory loss and physical impairment, he is striving to regain the skills to live independently. “He’s moving so quickly that we keep forgetting he just had major brain surgery,” says Mark. “The sky is the limit for him.”

With years of recovery behind him, Ryan looks forward to his senior year of high school and spreading his wings after graduation. “The care Ryan received at UTHealth was unbelievable,” says Sherri. “There are so many others living with inoperable brain AVMs, but thanks to research like Dr. Chen’s, those families will one day be able to rest easy.”

The Texas Institute for Restorative Neurotechnologies aims to establish UTHealth as the nation’s leading center for epilepsy care, research, and education. In February 2019, it became a reality behind the expertise of Tandon and two recent faculty recruits: Samden Lhatoo, MD, and GQ Zhang, PhD.

Tandon is at the forefront of leading-edge brain surgery that eliminates seizures with laser precision after pinpointing the source of the epilepsy with fine electrode probes. “Fueled by our groundbreaking work in epilepsy, the Texas Institute for Restorative Neurotechnologies will advance the clinical neurosciences of tomorrow,” he explains. “We will extend our work to explore innovative therapies for functional neurosurgical disorders, brain-machine interfaces, neuroinformatics, Big Data, and precision neurological therapies.”

Lhatoo specializes in the medical and surgical treatment of complex, difficult-to-treat epilepsy. He has a particular expertise in understanding the mechanisms of fatalities in patients with epilepsy and helping prevent them. “We have the right individuals in the right place to investigate critical problems such as sudden unexpected death in epilepsy, to improve the lives of patients in Texas and beyond,” he says.

Zhang brings the power of data analytics to the diagnosis and management of epilepsy by developing innovative tools that enable experts to collect and evaluate vast amounts of data. “Information is power,” he says. “Through leveraging our data, we will be able to broaden our impact to other neurological disorders in addition to epilepsy.”

As co-directors of the Texas Institute for Restorative Neurotechnologies, Tandon, Lhatoo, and Zhang are positioning UTHealth to advance not just the field of epilepsy, but the entire field of brain and behavioral health.

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Ryan Logan with his family
Ryan’s brother Peyton (left); parents, Mark and Sherri (center); and his twin sister, Reese (right), are the pillars of his support team.