A for Athlete


Westmoreland to have brain surgery[]

Source: Gordon Edes covers the Red Sox for ESPNBoston.com. ESPNBoston.com's Joe McDonald contributed to this story.

Ryan Westmoreland, a 19-year-old outfielder and Rhode Island native widely considered to be the best position prospect in the Red Sox system, is scheduled to undergo brain surgery in March 2010 for an unusual congenital condition that carries significant risk of neurological damage and is potentially life-threatening. Westmoreland will undergo surgery to remove a "cavernous malformation of the brain."

Ryan Westmoreland hit .296 with seven home runs and 35 RBIs in 60 games for the Class A Lowell Spinners in 2009.

The condition was discovered, according to a team source, after Westmoreland began experiencing headaches and exhibiting other neurological symptoms, including numbness. He left the team's minor league camp on March 4, according to a statement released by the team, and was diagnosed the next day at Massachusetts General Hospital. After the Red Sox flew him around the country for consultations with three specialists, the decision was made to have surgery, which is to be performed by Dr. Robert Spetzler of the Barrow Neurological Institute in Phoenix, Ariz.

The malformation is located on the brain stem, according to multiple sources, and there has been an episode of bleeding in the brain. Typically, any further bleeding could cause severe neurological damage, according to Dr. Joseph Maroon, the vice chairman of the Department of Neurosurgery at the University of Pittsburgh Medical Center and team neurosurgeon for the Pittsburgh Steelers.

A cavernous malformation, Maroon said, "is a congenital abnormality of small abnormal capillaries [tiny blood vessels] that are connecting vessels between the arteries and veins.

"These capillaries have very thin, weak walls and are susceptible to bleeding because of their thin walls. And the cortex, or brain stem, is an extremely sensitive area from which to remove [the malformation]. It's very unusual to find these abnormalities in the brain stem."

Neurological damage resulting from a cavernous malformation could affect movement and eye function, depending on where the malformation is located, Maroon said.

The malformation is typically embedded in normal tissue. "The tissue of the brain stem is extremely sensitive to disruption, he said, "and thus requires meticulous dissection."

Spetzler, who is both a friend and associate, Maroon said, "has as much experience with this as anybody in the world. His results with this overall are very good.

"He is who I would go to," Maroon said, "if I needed this surgery."

Westmoreland, a resident of Portsmouth, R.I., and the state's Schoolboy Athlete of the Year as a high school junior in 2007, was the team's fifth-round draft choice in 2008 and accepted a higher-than-slot $2 million bonus to sign with the team rather than accept a scholarship with Vanderbilt University.

"It's unfortunate," said Tampa Bay Rays special assistant Rocco Baldelli, also a Rhode Island native. "It's sad. More than anything, it's upsetting. Ryan is a great person and a great baseball player. I hope everyone respects the family's privacy. It's a sad situation, something I wish he didn't have to deal with. Knowing Ryan and his family the way I do, they're going to take care of it in the best way possible. My thoughts and prayers are with him and his family, and I'll be watching him very closely. He's probably worried about getting healthy and not about playing baseball."

His brief time with the Red Sox, even though marred by injuries, was sufficient to create tremendous excitement within the organization about his potential. Jason McLeod, who this past winter left the Sox as scouting director to go to the San Diego Padres, said that Westmoreland had more upside than any other player in his five years of running the team's amateur drafts.

Baseball America, the esteemed trade publication, ranked Westmoreland as the No. 1 prospect in the Red Sox system, even though he has played just one season in short-season Class A ball, and was projected to start in lower Class A this season.

"He's a potential 30-30 player [30 home runs, 30 stolen bases] who one day could bat third in the Boston lineup," Baseball America wrote in its evaluation.

Westmoreland is also ranked as the Red Sox's No. 2 prospect by ESPN.com's Keith Law. He's also 32nd overall in Law's top 100 prospects.

Westmoreland underwent surgery to repair a torn labrum to his throwing shoulder, a pre-existing condition, in November, 2008, which limited him to mostly serving as DH at short-season Lowell last season. He then fractured his collarbone running into an outfield wall near the end of the season and had surgery in September, but was able to follow his full off-season conditioning program.

"The entire Red Sox organization stands in support of Ryan as he courageously deals with this issue," Red Sox general manager Theo Epstein said in the statement released by the team Saturday night.

"Ryan is a remarkable kid and a talented player, and we understand that many will be concerned about his health. He is getting the best medical attention the world has to offer, and we will have more information soon. Until then -- out of respect for Ryan's privacy and at the request of the Westmoreland family -- we will not have any further comment."

Maroon, who has performed the procedure himself but, he said, not in some time, said the operation typically can take several hours. Dr. Spetzler is expected to use advanced neuro-navigational techniques -- "like a sophisticated GPS system to localize it in the brain" -- and then employ microsurgical techniques and minimally invasive surgical procedures to remove the malformation.

"It is potentially life-threatening, as is any brain surgery," Maroon said, "but the mortality is low."

The prognosis for surgery? "It depends if there are any neurological deficits or not," Maroon said, stressing that he has not examined Westmoreland or seen his records. "And how well he tolerates it."

When, or whether, he resumes playing baseball again is almost irrelevant at the moment, one member of the Sox organization said, , asking that his name be withheld because of the sensitivity of the issue. "Sure, he is a great prospect," the Sox official said. "But he's a fantastic kid. Very professional, very intelligent, well-spoken, a good worker -- everything you'd want in a kid."