Cory Smith Rises to the Challenge

In May 2012, Cory Smith, a straight-A student and star basketball player at Clear Springs High School in Houston, suffered a severe intracranial empyema, an infection that arises most commonly as a complication of sinusitis or otitis, particularly in males in later childhood, adolescence or early adulthood. Today, thanks to the skill of specialists at Memorial Hermann-Texas Medical Center and the multidisciplinary team of TIRR Memorial Hermann’s Challenge Program, he’s back in the game.

Smith developed a severe headache on a Saturday in mid-May; a week later when his parents tried to awaken him for school, he was comatose. A CT scan and MRI at a community hospital revealed fluid in his brain, and he was transported by Memorial Hermann Life Flight® to the Mischer Neuroscience Institute at Memorial Hermann-Texas Medical Center, where neurosurgeons performed a craniotomy, evacuated the empyema and performed a hemicraniectomy to remove the infected bone and relieve pressure caused by swelling of the brain.

After a stay in the intensive care unit, Smith was transferred to the acute care hospital’s inpatient rehabilitation unit, where physiatrist Meilani Mapa, MD, attending physician in the Brain Injury Program at TIRR Memorial Hermann, oversaw his care.

“Thanks to his youth and athleticism, Cory made significant gains in his functional mobility during inpatient rehabilitation,” says Dr. Mapa, a clinical assistant professor in the department of Physical Medicine and Rehabilitation at McGovern Medical School at UTHealth. “We thought he would benefit from participation in the Challenge Program. Two-thirds of children returning to school after a brain injury report difficulties with schoolwork, and nearly 50% report problems with attention and memory. The Challenge Program provides a comprehensive return-to-school program that addresses the physical and emotional challenges children like Cory face.”

At TIRR Memorial Hermann Pediatric Outpatient Rehabilitation, specialized services focus on community reentry skills critical for the transition to independent living, school, work, or volunteer activities. Joyce Leverenz, CRC, clinical coordinator of the Challenge Program, was Smith’s primary therapist.

“Cory is a very smart kid – one of those students who didn’t have to work hard to keep his grades high before his brain injury,” Leverenz says. “In therapy we worked on organizational skills and improving planning and time management. He had good brain functionality to begin with and was a very hard worker.”

Smith’s outpatient rehabilitation was interrupted in June 2012 when an MRI revealed that a second empyema had developed on the opposite side of his brain. He returned to Memorial Hermann-TMC for neurosurgical evacuation of the infection and a third surgery in which otorhinolaryngologists cleared the infection from his sinuses. In October of that year, he underwent a final surgery to repair the hemicraniectomy with synthetic bone.

Smith spent the remainder of 2012 in the Challenge Program and also worked with tutors. Throughout his surgical treatment and rehabilitation, he maintained a 4.3 grade point average. He returned to school full time in January 2013 and was back on the basketball court a few weeks later. He began his senior year last fall as captain of the team, and has applied to premed programs at four Texas universities.

Smith says returning to basketball was one of his biggest motivators during rehabilitation. “My desire to get back on the court – that was big for me,” he says. “But the thing that really got me through was my faith and the support of my family and friends, my coach and teammates, the therapists in the Challenge Program, everyone. I just loved working with Joyce and the therapists. They pushed me harder and harder and helped me get back to where I wanted to be – the same person I was before the surgeries.”