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AJ, 14

Other | Services: Neurosurgery and Traumatic Brain Injury Clinic

Back in the Game

“My nephew died when he was nine from a head injury,” said Tamra Toney, whose son, AJ, fractured his skull after being hit in the head by a baseball in March. “I was worried that my son was going to die.”

Then 13-year-old William “AJ” Roach Jr. had been working out with Buckingham County High School’s junior varsity baseball team since October 2014, hoping to earn a spot on the 2015 team. On March 3, with less than an hour left during tryouts, AJ was on the pitcher’s mound when another player returned the ball and accidentally hit AJ in the forehead directly above his left eye.

“I was numb,” remembered AJ, who suffered a concussion from the hit that crushed his eyebrow and forehead. “I never felt any pain.”

When Tamra, who expected to find a large bump on her son’s head, arrived at the baseball field, she said she was shocked that his forehead was indented. “I fell to my knees,” she recalled.

AJ was immediately transported by ambulance to a local hospital. After a CT scan diagnosed the skull fracture and frontal lobe damage to his brain, AJ was transferred to Children’s Hospital of Richmond at VCU (CHoR) where he met John J. Collins, MD, Professor and Chief, Division of Neurosurgery, CHoR.

Matters of the Head

“When I met AJ, he had an open depressed skull fracture,” said Dr. Collins. “This is a problem because if the bone is pushed in, it’s likely tearing the brain shell, which can cause infection, bruising and bleeding.”

Dr. Collins recommended next-day surgery to carefully repair AJ’s fractured skull and eyebrow bones and clean out the damaged area near his sinus cavity. Because AJ’s bones were so shattered, Dr. Collins reconstructed AJ’s forehead and eyebrow using titanium mesh to prevent infection and restore the bones’ shape.

“Dr. Collins was amazing,” said Tamra. “He used a computer model to show us an image of AJ’s skull and explain what the surgery would involve. He kept us very informed. Anytime I had questions, I’d call and get answers immediately.”

Following surgery, Tamra said she was surprised how quickly AJ was talking and walking around the inpatient unit.

“When AJ woke up from surgery,” she recalled, “his first question was, ‘did you call the coach? Did I make the team?’”

AJ's mom, Tamra, and sister, Emily, have been AJ's biggest fans since he started playing baseball when he was four years old.

The Road to Recovery

Following AJ’s inpatient discharge, he began working with physical therapists at CHoR’s Bon Air Therapy Center to improve his balance. He also began seeing doctors from CHoR’s Traumatic Brain Injury/Concussion Clinic and received homebound academic instruction for 2 ½ months before returning to school in late May. Although he couldn’t practice with his team, he attended every practice and game, riding the team bus as soon as doctors allowed.

“He has never complained about not being able to play,” said Tamra. “His teammates have been very supportive, and he’s received a lot of support from the community.”
Before his accident, AJ was listed as the starting pitcher for Buckingham County High School's junior varsity baseball team.

By the time he was discharged from physical therapy this summer, AJ, who never complained of headaches, pain or dizziness, could balance on one leg, but he continues to suffer cognitive and emotional effects from his concussion.

“AJ had severe post-concussion syndrome,” said Dr. Collins, “but his prognosis is excellent thanks to a lot of teamwork from his doctors and therapists.”

AJ, a fan of the Richmond Flying Squirrels and Washington Nationals, used his time off the field to play baseball video games and improve his culinary skills. (His specialty is pork chops, macaroni and cheese and biscuits.) This fall, he was cleared to return to the ball field but has to be careful about sustaining future concussions. His mom and younger sister, Emily, remain his biggest fans.

“After everything we’ve been through,” Tamra said, “I’m not sure I’m ready for him to get back on the baseball field. He’s ready, but I’m scared to death. But I need to teach him that when you fall, you need to get back up. Dr. Collins is our hero. He saved my child.”

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