Ari, 3, Treated with Gamma Knife at Karolinska University Hospital
In January 2023, 3-year-old Ari Hetrakul from Bangkok experienced a severe brain hemorrhage. Initially crying inconsolably, he became unresponsive, prompting his parents to rush him to Bumrungrad Hospital. A CT scan revealed a five-centimeter hemorrhage in his brain. Emergency surgery, led by neurosurgeon Yot Navalitloha, successfully drained the bleeding. Post-surgery, Ari faced significant challenges—he couldn’t walk, talk, or eat without assistance. Daily therapy sessions gradually improved his condition, allowing him to walk again by April 2023.
A follow-up MRI in June revealed an arteriovenous malformation (AVM), a congenital vascular abnormality that had caused the hemorrhage. Open surgery was too risky, and other methods, such as endovascular treatment, were later deemed unsuitable. Seeking specialized care, Ari’s parents consulted hospitals worldwide, including Cedars-Sinai in Los Angeles and Mount Elizabeth in Singapore. Ultimately, they chose Karolinska University Hospital in Sweden for its expertise with gamma knife treatment and its affordability compared to U.S. options.
In March 2024, Ari’s case was presented at Karolinska’s multidisciplinary neurovascular conference. Given the AVM’s critical location in the brain and the high risk of another hemorrhage, the team recommended gamma knife treatment. Ari’s parents engaged in detailed discussions with Karolinska’s specialists and appreciated the thorough, individualized approach.
"The doctors and nurses truly understood how children behave and how to talk to them. The atmosphere at the hospital was very child-friendly. Another thing that impressed us was that we were allowed to keep the room for a couple of days after Ari was discharged, in case he developed any symptoms. It was very generous. Fortunately, we didn’t have to return," says Lalitta Prachakit.
In June 2024, Ari underwent a successful gamma knife procedure at Karolinska. Neurosurgeons and physicists collaborated to map the AVM with sub-millimeter precision using advanced imaging, delivering targeted radiation to treat the malformation. The procedure went smoothly, and Ari recovered well, leaving the hospital after a short stay.
His parents praised Karolinska’s child-friendly care and the seamless coordination by the International Patient Office. They ensured Ari enjoyed the trip by exploring Stockholm, making it a positive memory rather than a purely medical one.
Now back home in Bangkok, Ari attends an international school that accommodates his needs. Though he still faces challenges, such as limited use of his right hand, he enjoys an active life, including taekwondo and piano lessons. His parents remain hopeful yet vigilant as they monitor his recovery, grateful for the exceptional care that gave their son a brighter future.
"The worry for Ari is always there, and I take nothing for granted. At the same time, we are incredibly grateful for the life we have and for each new day. I believe Ari's own strength has helped us a lot. He is happy, talkative, and thriving in school. We are so proud of every step forward he takes," says Lalitta Prachakit.