Good morning. Baby Maryam’s seizures were not stopping, until a drastic brain procedure gave her a fighting chance to survive. More on her story below, plus wildfires in Western Canada and new proposal for a ceasefire in Gaza. But first:
Today’s headlines
- A U.S. federal appeals court reinstated President Donald Trump’s tariffs as the legal battle reframes global trade war
- Halting an active CSIS operation in 2022 put a team at risk, the watchdog says
- The first player takes the stand in his own defence at the Hockey Canada trial
- The federal Justice department invokes national security in the case of an elite soldier’s assault of spouse
Maryam Fatima, 15 months old, during a neurology appointment at the Hospital for Sick Children in Toronto. March 28, 2025Melissa Tait/The Globe and Mail
Health
The drastic procedure that gave baby Maryam a fighting chance
Hi, I’m Jennifer Yang, a health science reporter with The Globe.
In February, I was wrapping up a meeting with media contacts from Toronto’s Hospital for Sick Children when I decided to throw in a question that I often like to ask: What’s something you’re excited about right now?
I could immediately tell from their faces that they were sitting on something special. And that’s when I learned about Maryam Fatima, the remarkable little girl at the heart of my latest story.
Maryam was born in December, 2023, with a rare condition called hemimegalencephaly, where her left brain hemisphere was abnormally large. This caused frequent seizures – sometimes hundreds per day.
Babies like Maryam are often treated with a surgery called functional hemispherectomy, where the faulty brain hemisphere is “disconnected” from the healthy side. But Maryam was too small to safely undergo open brain surgery.
Shahban Beg sits behind his daughter Maryam for a picnic in Toronto on Mother’s Day 2025.Melissa Tait/The Globe and Mail
She was running out of time so her medical team decided to try something that had never been done before in Canada – a procedure where they inserted catheters into her brain through her blood vessels and intentionally caused a series of strokes, thus killing the brain territories responsible for Maryam’s seizures.
This “endovascular embolic hemispherectomy” was pioneered by a medical team at Children’s National Hospital in Washington, D.C. I spoke with neurointerventionist Monica Pearl about the backstory behind this astonishing procedure.
Tell me the story of how this idea was sparked?
It was more than 10 years ago. My colleague, the doctor Taeun Chang, who has since died – it was her. She was a neonatal epileptologist who treated and managed neonates [newborns] and young infants with seizures.
Those with hemimegalencephaly are a really unique group of patients. They’ve got the worst extent of the disease that causes the seizures.
In 2013, we had a neonate who had intractable epilepsy, was only a few days old, and really had no surgical options. So Dr. Chang had come to me and asked me, ‘Well, what do you think about embolizing [deliberately blocking blood flow in a particular blood vessel] or stroking out the brain territory to stop the seizures? Perhaps we can control them so that the baby can grow to an age at which surgical hemispherectomy would be an acceptable treatment option.’
We did a few cases and noticed that the seizures started stopping after the embolizations. Then 2018 was when we thought, well, maybe we could consider if embolization alone could provide that seizure freedom.
From 2018 to now, we have had a total of 13 patients treated.
Dr. Chang was such a revolutionary thinker and cared deeply about her patients. She was relentless in trying to find every way to help her patients.
Dr. Prakash Muthusami the pediatric neurointerventionist who performed the procedure on Maryam, explains the location of coils in her brain imaging on May 15.Melissa Tait/The Globe and Mail
Were there people who said we shouldn’t do this? Did you get a lot of pushback?
Yes. A lot of pushback on social media, from the Facebook family groups. And rightly so. They are protective, specifically for the pediatric population, and they didn’t want this to be some sort of experiment.
Insurance companies denied us many times. We’ve had several cases where our team had to make the appeals with the insurance companies, go to court hearings to advocate for the families.
The angiography suite at the Hospital for Sick Children prepared as a demonstration for endovascular neurosurgery procedure, with Maryam Fatima’s angiogram images onscreen.Melissa Tait/The Globe and Mail
Are we at a pivot point now, where we might be looking at endovascular hemispherectomy as a first-line treatment for these patients?
We certainly need more data. But I think we’re at the point where we can say with confidence that endovascular hemispherectomy is an option. And then, whether or not it can serve as a standalone therapy, or functions as an adjunct to additional surgical hemispherectomies – that will play out in the future.
Bella was our first child [to undergo the procedure as a standalone therapy]. She’ll be, I think, six or seven in the fall.
Is she still seizure free?
Yes! And they’re wondering if she should go to a regular school, or still her special school. She’s on par with her peers and she does ballet...
Hemimegalencephaly – if you read the literature, it’s very devastating, with poor prognostic indicators for seizure freedom outcome. But she provides hope.
This interview has been edited and condensed for length and clarity.
The map
‘It looks like it is going to further deteriorate.’
Saskatchewan declared a state of emergency as wildfires force evacuations in Western Canada, just one day after neighbouring Manitoba also declared a state of emergency. Three First Nations in Saskatchewan had already declared a localized state of emergency by late Wednesday.
The Wrap
What else we’re following
At home: PEI is the only province openly following Health Canada guidelines for toxic ‘forever chemicals.’
Abroad: Israel accepts a U.S. proposal for a temporary Gaza ceasefire and Hamas gives a cool response.
Undergrad: Harvard grads cheer commencement speakers who urge the school to stand strong against the Trump administration.
Masters: Joga Kaler has the perfect scone down to a science. Meet the pastry chef known as the Scone Master.
Note: In yesterday’s newsletter, a statement of exasperation about U.S. President Donald Trump was attributed to Minister of Agriculture Heath MacDonald; however, the Parliamentary Press Gallery issued a correction after publication to attribute the statement to Liberal MP Darren Fisher.