UB team performs rare, lifesaving surgery on 18-year-old Israeli

BUFFALO, N.Y. – The Oct. 7 attack on Israel dramatically changed everything in that country. But for the Haroush family, living in central Israel, life had begun to change prior to that date but for very different reasons.

For months, Noa Haroush, who recently turned 18, had been complaining of weakness on her left side. At first it didn’t seem severe, but as time went on it got worse. By late summer, says her mother Sharon, Noa was experiencing shakiness in her hand and arm.

“It was scary,” says Noa. “I didn’t know what it was. I thought maybe it could be from stress from school or maybe a medication.”

Clearly, something was very wrong and the family took her to the hospital. After more than a week of tests and imaging, they received a diagnosis: Noa had Moyamoya disease, a rare condition in which the arteries that go to the brain become blocked, putting the patient at high risk for stroke and bleeding in the brain.

The condition can be cured if brain surgery is done in time. Israel has sophisticated medical facilities. But surgery for such a complex, rare condition is best done at a high-volume facility where surgeons have experience operating on such patients – such as Gates Vascular Institute, where University at Buffalo neurosurgeons have done this operation numerous times.

The Buffalo connection stemmed from a lucky coincidence: Elad I. Levy, MD, who chairs the Department of Neurosurgery in the Jacobs School of Medicine and Biomedical Sciences at UB, was born in Israel. His relatives live there and his father and Noa’s grandfather have been best friends for decades. Once they learned of Noa’s diagnosis, it was clear she would go to Buffalo for her surgery.

The family made a quick decision to come to Buffalo once they learned of the Hamas attack. Noa arrived in Buffalo with her parents and three siblings on Oct. 8.

While imaging of her brain had been done in Israel, Levy decided to do another cerebral angiography here. The procedure involves using a catheter to inject contrast dye into the bloodstream. X-ray imaging then reveals how blocked the arteries have become.

The new images told a terrifying story that hadn’t been evident in the original images, providing a much better roadmap for the surgery.

“She had one of the worst cases of Moyamoya we’ve ever seen,” says Levy, SUNY Distinguished Professor, L. Nelson Hopkins Endowed Chair of Neurosurgery at UB, co-director of the Gates Stroke Center and Cerebrovascular Surgery at Kaleida Health, and president of UB Neurosurgery, part of UBMD Physicians’ Group. “It was on both sides of her brain. She was already having symptoms throughout her whole left side.”

Noa needed surgery immediately. Levy teamed up with his longtime surgery partner, Adnan Siddiqui, MD, PhD, CEO and CMO of the Jacobs Institute and vice chair and professor in the Department of Neurosurgery at the Jacobs School.

The surgery felt endless, Sharon recalled. It lasted eight, long hours. “It was very hard to just be in the waiting room, but there was a nurse, Debbie, she was texting me to keep me posted the whole time, with information like now she is asleep, now we are starting the procedure. It really helped.”

The surgery was completely successful but Levy told the family it had been one of the most complicated surgeries his team had ever done. The family’s relief was hard to put into words, especially after they learned that Noa’s condition was so severe she could have been very close to having a stroke.

“I really want to thank Dr. Levy, Dr. Siddiqui and their team and all the nurses,” Sharon says. “Everyone took such good care of us. They did such a wonderful job.”

In addition to state-of-the-art stroke care, complex neurosurgeries for rare conditions are increasingly being done at Gates Vascular Institute, a Kaleida Health facility, by Jacobs School neurosurgeons, making it a top site for complex neurosurgeries. “We’re an international destination for neurovascular surgery,” says Levy. “When people need this kind of care, and they start to research who can deliver it, we are at the top of the list.”