For most graduating seniors, the transition to college includes a summer spent purchasing dorm room supplies and hanging out with friends.
For 18-year-old Ashley Witzke, that transition lasted only a weekend and came less than one year after undergoing extensive brain surgery.
She completed her studies at Catonsville High School Friday, Jan. 25, and began her collegiate career Monday Jan. 28, at the Catonsville campus of Community College of Baltimore County.
As she prepares to complete her first semester of college and take final exams on May 11, said she has been reflecting on the lengthy journey that brought her to this point.
She had just transferred to Mount de Sales Academy from Catonsville High School to begin her junior year when she began having debilitating headaches in October of 2011.
"I had just started and everyone thought it was stress," Ashley Witzke said.
"I knew right away, no, it's not stress. I've had stress before," she said.
"She's a very outgoing, very active, very involved person," her father, Craig Witzke, said.
"And every day she'd go to school and she was there for an hour, maybe half a day and we'd have to go pick her up," he said.
After many hospital visits, misleading diagnoses and weeks of absence from her new school, in December 2011 an MRI and an appointment with Dr. George Jallo, professor of pediatrics and neurosurgery at Johns Hopkins Children Center, revealed a brain condition called Chiari Malformation.
Jallo explained that the malformation results when a portion of the brain called the cerebellar tonsils do not fit properly inside the skull.
"They slide down and they slide out of the skull cavity and they're putting pressure on the brain stem and the spinal cord," Jallo said.
She tried a variety of medications to treat her symptoms, but after nothing helped, Ashley Witzke made the decision to undergo risky brain surgery on Feb. 10, 2012.
Jallo said that although 80 to 90 percent of patients see improvements after surgery, only about 15 percent are completely rid of their symptoms.
After making a small incision at the base of her neck, Jallo said he removed a piece of Ashley Witzke's skull.
"We would drill out some bone that measures about an inch and a half by an inch and a half," Jallo said.
"At that point, once we decompress it (the brain), we open up the covering of the brain, the dura, and sew in a graft," he said.
That graft allows the dura to grow back at a size that allows the cerebellar tonsils to be protected.
Looking back, she said she could not be happier with her decision to proceed.
"I took the risk and I've never had a headache since," she said.