A 16-year-old from Warrington, Tilly Phillips, has made medical history as the world's youngest known patient to undergo conscious brain surgery for a specific type of blood vessel abnormality. The complex 12-hour procedure, performed when Tilly was 15 at Alder Hey Children's Hospital in Liverpool, aimed to resolve an arteriovenous malformation (AVM) – an abnormal tangle of blood vessels that can lead to seizures and, in some cases, be fatal.
Tilly's AVM was located near crucial brain regions responsible for speech, movement, and vision. To protect these vital tissues during the delicate removal of the malformation, surgeons briefly roused her for about 30 minutes. During this period, though Tilly cannot recall being conscious, the medical team confirmed she was coherent and able to complete picture-naming tasks. Clinical psychologist Cathy Grant noted that electrical stimulation was used to temporarily halt Tilly's ability to name objects, a technique critical for identifying and preserving essential brain tissue.
Prior to the surgery, Tilly experienced an average of three seizures daily, describing her condition as a "ticking time bomb" that had put her life on hold. Following the successful operation, which she spent approximately a week recovering from in hospital, follow-up scans have confirmed the AVM was effectively treated, and her seizures have significantly reduced. While she experienced some memory difficulties and non-epileptic episodes post-surgery, which she is managing with speech and language therapy, Tilly has since completed her GCSEs and secured a summer job.
This pioneering approach highlights advancements in neurosurgery, particularly in paediatric care. Conscious craniotomy allows surgeons to receive real-time feedback from patients, enabling them to navigate complex brain structures with greater precision and minimise the risk of neurological damage. For conditions like AVMs, which affect approximately 1 in 100,000 people in the UK, this technique can be crucial, especially when the malformation is situated in highly functional areas of the brain.
Tilly expressed immense appreciation for her medical team, emphasising how being involved in her treatment helped her cope. "I was in control of what was happening, which I really appreciated from my surgeons," she stated, adding, "I feel like I was actually listened to." Her mother, Clare, praised the Alder Hey team as "phenomenal," while Tilly herself believes the surgery has profoundly transformed her future, declaring, "I've got my life back."