Teen from Angola undergoes life-changing surgeries at NYC’s Mount Sinai on tumor the size of an orange

A social media miracle brought a seriously-ill teen from Angola to New York for two life-altering surgeries.

Abel David Bachalhau Santos, 14, was halfway across the world when an Instagram account run by a member of the staff at Mount Sinai Hospital caught the eye of his neurosurgeon in Africa, where the teen was battling several benign brain tumors — one the size of an orange — leading to his trip to New York for a once-unlikely pair of complicated operations in as many days.

“In 2017 he was playing soccer with his friend and he started to have seizures,” said Julieta Bachalhau, the patient’s mother, in Portuguese. “After that he started with a lot of headaches.”

Bachalhau took David, as he’s known, to a local hospital where he stayed for two weeks, with doctors unable to figure out what was wrong. It was initially thought that David had malaria, a common affliction in Angola, said neurologist Dr. Emanuel Silva, who met the teen last year in his home province of Huila.

David ended up going to four more hospitals and finding no answers as his condition worsened, said his mother. The soccer-loving teen was forced to stop his studies in the sixth grade and could no longer play with his friends.

“In 2020 he starts with weakness on the left side of the body,” said Silva. The teen’s brain became so compressed by the largest tumor, said doctors, that he lost mobility and began to use a wheelchair.

A CT and MRI showed that David had five tumors. He underwent surgery in Angola to remove the largest one, but several blood vessels redirected from the brain caused too much bleeding to complete the procedure, and Silva said conditions at his hospital made a safe surgery impossible.

The same year David began having seizures, a physician assistant working alongside the chairman of neurosurgery at Mount Sinai started posting about her work as @BrainyLeslie on Instagram.

“It’s turned out to be this awesome little community of neurosurgery all over the world,” said Dr. Leslie Schlachter of her account, which has more than 27,000 followers.

In August, Silva sent Schlachter images of David’s brain, and she soon went to work securing the surgeries necessary to remove the largest tumor, with the work performed pro bono by Mount Sinai doctors at its E. 99th St. and Madison Ave. location.

“So fast they answer us,” said Silva. “She said bring him to New York, we can do that.”

The first day of surgery last Wednesday consisted of an endovascular process—a minimally invasive method that used David’s femoral artery to deliver an agent that would cut off the blood supplies to the largest tumor.

As a black fluid called Onyx 18 was injected into the brain the mood in the operating and control rooms was hopeful.

“Not bad, eh? Look at the difference,” said Dr. Alejandro Berenstein, co-director of the Pediatric Cerebrovascular Program, as multiple screens showed the agent making its way along the blood vessels, where it immediately stemmed blood flow to the mass.

The following day’s surgery required more preparation, including the removal of a portion of David’s skull.

Before the second surgery began David lay unconscious on a bed in an operating theater, machines beeping as he was prepared, an array of monitors showing images of his brain.

“It’s using so much blood that it has actually attracted blood vessels that would’ve fed the brain to grow into the tumor,” said Dr. Joshua Bederson, chair of neurosurgery at Mount Sinai and one of two surgeons who would soon be removing the tumor.

“It’s as large as a tumor can get before someone can’t survive.”

The nine-person surgery team communicated clearly and moved quickly, each member and machine serving a specific purpose. A monitor showed an image of David’s brain that had been mapped from MRIs and acted as an overlay to guide the process, almost like a stencil.

“The midline’s way over here,” said Bederson, seated on a stool in front of David’s head. The surgeon’s forearms were placed on an armrest as he used an electric cauterizing instrument to prevent bleeding and began the painstaking work of cutting the tumor out.

The first piece was removed and set aside, and sensors were placed into the brain to measure motor activity while the rest of it was being cut away. The surgery lasted eight hours.

On Friday, David was beginning his long road to recovery. The tumor had been entirely removed. There had been a risk of the procedure causing permanent damage to his left side, but instead, within 30 minutes of waking up after surgery, David was able to squeeze using his left hand, and moved two fingers that had been immobile since 2018.

“You wonder sometimes if it’s wise to take on such an endeavor and make a family travel around the world, to allow them to have hope,” said Bederson. “Going into it yesterday I wasn’t sure. Today I’m really delighted we were able to do it.”

“I feel better, very grateful to the hospital. I’m so happy because I’m going to play again,” said David, referring to soccer.

Mount Sinai doctors were confident none of the largest tumor will return, but David still has four others that will be removed once he returns to Angola.

He’s expected to stay in Mount Sinai’s pediatric ICU for two more weeks, where he will begin physical therapy that will be continued back home.

“I’m not sure anyone knows the real David, his brain has been compressed for so long,” said Schlachter. “He’s going to be a different person three months from now. That’s how long it takes for the brain to go back to its normal position.”

As David lay in bed in the pediatric ICU Friday and demonstrated for visitors how he was able to kick his left leg, his mother was beaming.

“I’ve recovered my hope,” she said in Portuguese.