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Suggest Treatment For Brain Tumor
Dear doctor, Three years ago (2006) , My daughter had been diagnosed with brain tumor called (DNET) in the right temporal lobe size (33x22x19 mm) . The MRI scan was done after having a car accident as a normal check up. Doctors recommended not to expose her to an operation to remove the tumor since she was only two years old and did not complain from any health problems. Recently ,my 6 years old daughter started to complain from headache episodes nearly every day. I started to notice that her eyes directions are not parallel as usual and within two days she has crossed eyes. The doctor discovered that she has a compressed optic nerve due to increased pressure in the skull ( hydrocephalus) and ordered an urgent operation called(shunt )to drain the accumulated fluid . A tube was inserted in her skull to drain fluids in to her abdomen . Her eyes returned back to its normal direction and every thing is ok now. However, doctors recommended that the tumor should be removed within one year maximum otherwise she will suffer from serious complications. An MRI scan was done after the shunt surgery shows an increased size of the tumor ( 39 X 53 mm) .Kindly, I want your recommendations based on the attached MRI scans and the best surgery methods to follow with minimum complications. 1. What are the most common post-operative complications ? 2. What is your evaluation in general? 3. How long we can wait until she get fully recovered from the hydrocephalous operation that was done one month ago in order to do the surgery required ? Please Note: In this letter I will attach the following: - MRI scan that was done 3 years ago (2006) with the report . - MRI scan done in 2008 with report. - MRI scan done in 2010 after shunt surgery with report. If you could not receive the attached files please send me another e-mail so I can send them back to you. Your fast response will be appreciated. Best regards; Hope KUWAIT
Mon, 23 Nov 2015
Hello. Thanks for asking from HCM.
I can understand you concern.
1. Replying your first question, most common complications of tumor surgery are mild like post-operative headache, ugly looking scar and tingling sensation, collection of blood and fluid below scalp. They improve with time. Other important complications are intra-operative like bleeding, injury of major vein or artery like middle cerebral artery if tumor is reaching unto it. Due to anaesthesia drugs, patient may awaken late or may need ventilatory support, fluid overload, sodium imbalance. In post-operative period, patient may develop seizures, brain swelling and herniation which may need decompressive surgery, sodium imbalance, memory impairment. Long term complication includes recurrence of tumor if partial removal only and seizures. These major complications are less than 10-15%.
2. According to the MRI report, tumor is located in right temporal lobe which is a bad location. Tumor size is 39 X 53mm which is significant. This much size tumor in temporal lobe can cause tentorial herniation which is dangerous for life. So your daughter needs surgical decompression of tumor.
Good news is DNET. It is a grade I tumor. Complete removal means 100% tumor free life in future. Chances of brain edema due to tumor is very less as compared to other brain tumors.
3. Hydrocephalus surgery is not an contraindication for surgery. After suture removal, you can get surgery done.
I did not get your MRI film or report. If you are still having doubts, you can ask premium question and send MRI reports. HCM will forward your reports.
Thanks. Hope it will help you. Take care.
I can understand you concern.
1. Replying your first question, most common complications of tumor surgery are mild like post-operative headache, ugly looking scar and tingling sensation, collection of blood and fluid below scalp. They improve with time. Other important complications are intra-operative like bleeding, injury of major vein or artery like middle cerebral artery if tumor is reaching unto it. Due to anaesthesia drugs, patient may awaken late or may need ventilatory support, fluid overload, sodium imbalance. In post-operative period, patient may develop seizures, brain swelling and herniation which may need decompressive surgery, sodium imbalance, memory impairment. Long term complication includes recurrence of tumor if partial removal only and seizures. These major complications are less than 10-15%.
2. According to the MRI report, tumor is located in right temporal lobe which is a bad location. Tumor size is 39 X 53mm which is significant. This much size tumor in temporal lobe can cause tentorial herniation which is dangerous for life. So your daughter needs surgical decompression of tumor.
Good news is DNET. It is a grade I tumor. Complete removal means 100% tumor free life in future. Chances of brain edema due to tumor is very less as compared to other brain tumors.
3. Hydrocephalus surgery is not an contraindication for surgery. After suture removal, you can get surgery done.
I did not get your MRI film or report. If you are still having doubts, you can ask premium question and send MRI reports. HCM will forward your reports.
Thanks. Hope it will help you. Take care.
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