Complex Brain Injury Clinic Provides Parker with Expert Coordination of Care, Variety of Resources

The human brain is a mystery to most. But when it comes to brain injuries, especially in children, they are both mysterious and frightening. 

Pediatric neurologists at Cincinnati Children’s understand this. So when talking with families about acquired brain injuries, they bring medical expertise and years of experience to the conversation. 

Among their goals: to answer questions and alleviate concerns, to help families understand treatment options and to provide guidance as they decide what approach to take for their child.

When J. Michael Taylor, MD, first met Brodie and Melissa Cianciolo two weeks after their son, Parker, had suffered a traumatic brain injury (TBI) from an ATV accident, he provided both expert knowledge and years of experience. 

But he also provided hope—at a time when the family needed it the most.   

Finding Hope and Expert Care at Cincinnati Children’s

Shock and disbelief. That was Brodie’s initial reaction after hearing Dr. Taylor’s prognosis for their son, whom doctors in Toledo feared might never be able to walk again or regain mental function. 

“Dr. Taylor met us in the PICU [pediatric intensive care unit] and looked [Parker] over and was like, ‘Oh, he’ll be fine.’ And we were like, ‘Are you crazy?’”

Added Melissa: “No one else had told us everything was gonna be fine. We didn’t have a whole lot of hope before Dr. Taylor and Cincinnati Children’s.” 

At the time of the ATV accident in April 2017, Parker and his family had been visiting relatives near Toledo. Brodie performed supportive breathing for his then 9-year-old son until paramedics arrived. Parker would spend two weeks in a local PICU before being transferred to Cincinnati Children’s. 

Arriving back home in Cincinnati, the family’s spirits were uplifted immediately by Dr. Taylor’s positive outlook. But Brodie and Melissa knew their son still faced a long road to recovery. 

According to Dr. Taylor, his confidence came from knowing that Parker, like other TBI patients before him, would benefit greatly from the many resources at Cincinnati Children’s.

“We have a robust recovery program for children with extensive brain injury,” said Dr. Taylor. “When I saw him in the ICU, I brought the experience and expertise of a whole lot of hard-working team members with me.”

He also caught a glimpse of Parker’s fighting spirit.

“His early signs of recovery and resilience proved to me that he was a fighter and that he had the will to get better,” said Dr. Taylor.

“For Parker’s family, the situation was bleak. But I needed them to stay in the fight. While it is our responsibility as providers to accurately assess the totality of disease, we also must find an intersection that not only allows, but supports hope.”

Multiple Injuries, Additional Surgeries, Parker’s Recovery Continues

In addition to the TBI, Parker suffered a host of injuries from the ATV accident. His pelvis was broken on both sides, and today he still experiences right hip pain related to muscle stiffness. The right side of his body, including his face, still remains partially paralyzed and weaker after suffering a stroke caused by swelling from the brain injury.

While in the emergency room in Toledo, Parker had a craniectomy to remove the crushed bone and to provide room for brain swelling. A few months later, cranioplasty surgery was performed at Cincinnati Children’s to replace the bone flap. 

“They had to make a piece to fit his head because his bone was severely crushed in the accident and was not able to be saved,” said Melissa. 

More surgeries followed in June 2017 and March 2019 to place a gastronomy (G) tube and to prevent Parker’s right eye from turning inwards. 

Parker’s recovery and ongoing treatment continued over the years, including a combination of medication, follow-up imaging (to understand his brain’s recovery) and neurocognitive / neuropsychological testing (to understand how his thought process was recovering after the injury).

“We offer robust inpatient rehabilitation guided by pediatric rehab physicians and the first-in-class outpatient neurorehabilitation team (ONRT),” said Dr. Taylor. 

Parker spent over two months in inpatient rehab from May to July 2017. During the last three weeks in rehab, he started to make significant improvement. 

“It was fast,” said Melissa. “It went from [we feared] Parker [might] never walk again, to Parker walked out of the hospital in three weeks.”  

Parker’s Rehab and Therapy Continue via Games of all Sorts

Parker's rehab continued with physical therapist Michelle Menner, who worked with Parker for over a year, addressing his strength, balance and motor coordination. 

"We spent a lot of time on coordination: working on riding a scooter, bike riding, jumping rope, agility ladder," said Menner. "The family was also great with their home exercise program and finding opportunities for Parker to engage with peers." 

Back home, Parker’s therapy and recovery continue as he pushes himself daily, using small goals (like cleaning his room) to earn rewards (he can have a friend over). 

“I feel like it’s going good,” said Parker, now 15, who is seen regularly in the integrated complex brain injury clinic offered by the Brain Health and Wellness Center.

His parents love the convenience and coordination of care offered in the clinic, where Parker is seen by a neurologist, a behavioral health psychologist, a school specialist and a rehabilitation physician.

“With the clinic and having all that stuff right there and already combined, it’s been absolutely amazing,” said Brodie.

Parker, who used to hold a pencil with his right hand, was forced to learn how to write left-handed following the accident. He’s made great progress, and at school he uses a Microsoft Surface Pro to write on the touchscreen.

“My school work is going good, but sometimes it can be hard for me to write things down in math,” said Parker. Instead, he often solves problems in his head, but he knows teachers like him to show his work.

For fun, Parker enjoys playing a variety of games. He uses both his head and his hands while playing on his iPad, computer and Nintendo. He likes role-playing video games, but the family also has many traditional board games at home, as well.

“We buy a lot of games. And not only video games,” said his mom. “Card games. Dice games. All so he can do therapy, without knowing it.” 

(Published October 2022)