| 02/27/2010: |
Q: Hello, I had a fusion L4-S1 done in March of 09. Since Dec. of 09 I have been getting pain down the same laeg as I had prior to the surgery. Just had a new MRI done.
What does Postlaminectomy changes seen at L4-L5?
Also what does this mean?: Demonstrates an unremarkable appearance at L1-L2.
Also what is a Grade one anterolisthesis of L5 on S1?
Thank you for your time. |
| Michele, Limerick, PA |
| Neurosurgeon Response: |
A: although i cant tell you exactly what the radiologist intended with his comments, some genera definitions of terms used are as follows:
postlaminectomy changes: the spinous processes and lamina were removed at surgery and this is seen on the imaging study.
"unrmearkable appearance" generally means either normal , or without significant pathology
"anterolisthesis, grade 1" is when the vertebral body is pushed forward on the one beneath it less than 25% of the width of the body. |
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| 02/27/2010: |
| Q: extra blood vessel in brain discovered through MRI. What does this indicate? |
| carolyn, new jersey |
| Neurosurgeon Response: |
| A: I would need more information to answer. |
| |
| 12/06/2009: |
| Q: My husband was recently diagnosed with AVM. In your opinion, where is the best team of Interventional Neuroradiologists and Neurosurgeons on the east coast of the U.S. for AVM treatment? |
| Susan Freund, Arlington, VA |
| Neurosurgeon Response: |
| A: I am very pleased with the team that I have here on long island and believe that it is as good as any comprehensive AVM team. If you have a more specific geographic location, I can direct you better. Otherwise, I'd be happy to consult. |
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| 12/06/2009: |
| Q: I am six months post op double jaw reconstruct... I have nerve damage from stretch injury.. I have seen a microsurgeon in dallas.. He has told me that my condtiion is permenant... I wanted to ask, is it considered permenant after six months, and how can you know if the nerve is getting better? Does the nerve the longer it takes to heal the less likely it will heal correct? also When I drink or eat cold foods I feel cold all on the outside of my face, why is that? any info would be apperciated ty :) |
| natalie, kansas |
| Neurosurgeon Response: |
| A: I will respond with general concepts as I can't comment on your specific situation without formally evaluating you. I do believe that the longer a nerve is injured and not responding, the less likely it will. That said, nerve injury can recover after extended periods, usually on the order of months at the tops.I am not sure why the abnormal sensations reach the outside of your face, but suspect it is related to the path of the nerve and/or nerve regrowth that is sometime different from its original course (called aberrant regeneration). |
| |
| 10/11/2009: |
Q: Dx'd with ddd, cervical stenosis, radiculopathy, moderate myelopathy C3-7. Waited 5 years after Dx to have surgery due to how many levels have myelopathy.
11-09: acdf of 5-6, 6-7 with plating, screws, infuse bmp
Told that we need to watch 3-4, 4-5 . Have been doing great, much more stable, active without too many myelopathy symptoms. 2 weeks ago had severe allergy reaction to mold, with violent sneezing episodes. Notice return of some symptoms that have been absent since surgery ie: disequalibruim, feeling off balance, symetrical sensory burning down arms, sensory tingling in shins, feel a thickness when swallowing and feel like I'm half there when rotating neck side to side. Last F/U visit 6-09 showed good fusion and hardware placement normal. Could this be just an inflammatory reaction, loose hard ware, or the other levels above fusion (3-4, 4-5) that could need addressing now? Just scared. Feel very strange when I have that internal "off balance" feeling. Called my neurosurgeon's office and was just forwarded to 2 different people, given an appt. in 3 weeks, and not given any instructions on what to do in the meantime. Any suggestions?
Thanks so much! |
| Christine, St. Charles, IL |
| Neurosurgeon Response: |
| A: Unfortunately, this website is not intended to give medical advice. If you would like a referral to a neurosurgeon in your area i would be happy to do so. |
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| 10/11/2009: |
| Q: MRI results state: C6-C7 disk osteophyte complex produces moderate central effacement of the thecal sac without definite cord or nerve root impingment. Mild changes of degenerative spondylosis. Could you explain? |
| Gail, Tulsa, OK |
| Neurosurgeon Response: |
| A: this reports describes an entity known as spinal degenerative disease or spinal arthritis. I would reccomend you be seen in consultation by a neurosurgeon, preferably one that specializes in spinal disease |
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| 10/11/2009: |
Q: My daughter at age 2 was diagnosed and successfully treated at St. Jude in Memphis for a sacrococygeal terratoma (pathology report =a malignant tumor, yoke sac). Her coccyx was removed and she had chemotherapy. When she was undergoing treatment one Neurosurgeon noted that she had weird/twisted nerves, but didn't indicate that it was a problem. She did have back pain for two years after her surgery, but that is no longer a problem.
She is in good health and is physically active.
Now, five years later, after a series of back x-rays she has been diagnosed (by the internal medicine clinician in the aftercare clinic at St. Jude) with a minor form of scoliosis (8 degrees). I was told by her aftercare clinician and her pediatrician that there is no need for her to see a neurologist. She no longer has a relationship nor ha she met with a neurologist since she was two years old.
Given her history, I am not comfortable with this recommendation, and would like to re-establish a relationship with a neurologist and have her thoroughly checked. But will a neurologist want to check- her or would he/she not want to be bothered with a minor problem like this.
Do you feel that she should see a neurologist or should I wait and see the pediatrician once per year. |
| Martha B, Mobile, Alabama |
| Neurosurgeon Response: |
| A: I would reccomend that you take her to be seen by either a pediatric neurologist or a pediatric neurosurgeon |
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| 10/11/2009: |
Q: In a cervical spine injury in which there is compression at every level except 7, which level would cause the skin to become lax over the body, even causing the face to look "fat?"
Also, have you ever heard of severe compression causing the intestine to paralyze painlessly, and the esophagus to rupture painlessly in the abdominal cavity? Please consider these questions---they have happened to a relative... what can be done? |
| SEF, Massachusetts |
| Neurosurgeon Response: |
| A: unfortunately your questions are very general. The best thing would be for you or the person involved to see a physician for a consultation. A neurosurgeon who specializes in spinal disease would be a good person. |
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| 10/11/2009: |
Q: I am 21 years old and suffer from Spinal Stenosis, Degenerative Disc Disease, and two bulging discs in my l4 l5. I have been facing this battle for 4 years now, first signs occured when I was 17 years old. I have seen two physical therapist, one whom said id be better off seeing a neurosurgeon. I have also been to two different chiropractors. I am currently taking Hydrocodone for my pain but have tried many anti-immflamitorys, muscle relaxers etc.
For the last two months my eyes have been burning and I have had some trouble with my breathing. My mother suggested it could be an issue with my back. With the problems I have listed with my back, is it possible it could relate to my breathind and sensitive eyes? I would also like to know the procedure most likley to occur on me if surgery is the next step.
Thank you for your time,
Sean Hanson |
| Sean Hanson, Klamath Falls, Oregon |
| Neurosurgeon Response: |
| A: I am sorry to hear you are not feeling well. Best thing is to see a neurosurgeon at this point for him/her to review your situation in person after interveiweing you, examining you and reveiwing your imaging studies |
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| 10/11/2009: |
| Q: I was diagnosed with hydrocephalus. All ventricles in my brain are enlarged. After a cisternogram my surgeon decided not to do the shunt surgery. I'm a 47 year old female. I have all the symptoms of the hyrdrocephalus. He really wont tell me anything else. What is going on? Do I just live with this suffering? |
| Cheryl Schnell, Columbus Ohio |
| Neurosurgeon Response: |
| A: If you are not satisfied with your surgeon's explanation, it is best to obtain a second or even third opinion. I'd be happy to refer you to someone else should you wish. |
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| 10/11/2009: |
| Q: Im scheduled for an ACDF surgery in 2 weeks including C3/4, C4/5 and C5/6. I'm 32 years old. Is it common to have 3 discs fused? I've been reading up online and have heard of 1, maybe 2 but not 3. Will this create more complications during or after surgery? |
| Sherrie, Texas |
| Neurosurgeon Response: |
| A: generally, 1 or 2 discs is much more common than 3, but depending on the patient and situation, 3 discs are on occassion necessary |
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| 10/11/2009: |
| Q: hello there!i wld like to ask if normal pressure hydrocepahalus(NPH)can be diagnosed on MRI? cuz my neurosurgeon says it can not be diagnosed on the scan.and plz let me know if i can post or send my MRI scans with a brief history on the website or somewhere for some one to look for the evidence of NPH and possibility of getting a VP shunt? |
| dr. junaid, lahore |
| Neurosurgeon Response: |
A: i would be willing to have you send films and your information if you were interested in having your surgery in long island, NY..where i operate. Otherwise, I would be happy to refer you to a neurosurgeon in your area.
NPH refers to increased fluid in the ventricle sacs of the brain but with normal pressure. the symptoms, which ususally are found in older individuals include trouble walking, dementia and urinary incontinence...the MRI is just one part of making the diagnosis. the patient's story in addition to whether or not the patient has a beneficial effect on the symptoms after a spinal tap are the usual ways the diagnosis is clinched |
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| 10/11/2009: |
Q: I recently had an MRI donw of the C spine. I have a small syrinx 3mm since 2006 with no new signs of progression. Also, the DR found mildly desiccated subtle disc bulges at C3/C4 through C6/C7 levels. There was no disc herniation, central canal or neural foraminal stensis at any level.
I have had severe neck and left shoulder pain since 2006. It seems to be getting worse. What is your suggestion? I have had joint facet injections (8) of them with no pain relieve. What would be my next steps? Thank you . Heidi Fields |
| Heidi Fields, Kingsland, GA |
| Neurosurgeon Response: |
| A: I would reccomend seeing a neurosurgeon. If you wish for me to refer you to a good one in your area, I would be happy to do so. Syrinx or degenerative spine disease can both give pain in the neck and/or arm. Second or even third opinions are good to help guide patients. but ultimately i cannot make a suggestion regarding care online. the dr who has interviewed you and examined you and reviewed your films would be the best to do so. |
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| 10/11/2009: |
Q: Doctor,
I had previously asked a question regarding my mom being diagnosed with low grade glioma. But now the situation has deteriorated. Infact she has been diagnosed with gliomatosis cerebri and has undergone 27 days of radiation. The prognosis from the doctors here are not encouraging. Is there any treatment that you can recommend. |
| Adil Fiaz, India |
| Neurosurgeon Response: |
| A: I am not a specialist in gliomatosis cerebri and would not offer any reccomendations online. Such reccomendations should come from neurologists, neurosurgeons or neurooncologists who have evaluated your mother and reviewed her clinical situation |
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| 06/18/2009: |
Q: Unfortunately my physiatrist has the bed side manner of a cold fish and has no patience for explaining anything. I really would like to understand these findings and the exact severity of each thing if not treated. Please put this in laymen terms before I go nuts. My back just hurts so bad and I want to know why exactly. I am just so sad and in pain because I don't believe in pain medication. Are there any other treatments for this injury besides physical therapy. Could physical therapy make this worse? I don't want any surgery at all so this is not an option unless I won't be able to move. How could this have happened to my back. Could I have had some of these things for years? Is this the cause of some kind of disease process?
History:
Back Pain persisting for more than one month despite conservative treatment - Radiculopathy (such as pain, numbness, abnormal reflexes) persisting for more than one month despite conservative treatment.
Report:
Technique:
MRI of the lumbar spine was performed without injected contrast using standard department protocols.
Findings:
The alignment is normal.
Bone marrow is diffusely low in signal, a finding that may relate to anemia. There is no evidence of fracture or marrow replacing lesion.
The conus is normal in appearance and terminates at L1-L2. Images of the lower lumbar spine are partially degraded by motion artifact. This lessens the sensitivity of this examination for the detection of smal lesions. Vertabral body heights are maintained.
L1-2: unremarkable
L2-3: unremarkable
L3-4: There is mild loss of T2 signal within the disk in association with mild posterior extrusions of the nucleus pulposus. This causes no significant effacement of the ventral thecal sac. There is minimal left uncovertebral joint squaring which results in very mild left neural foraminal stenosis.
L4-5: There is mild loss of T2 signal within the disk, also with a small posterior disk extrusion. This minimally indents the ventral CSF space. There is no significant neuroforaminal narrowing. There is superior and inferior endplate irregularity.
L5-S1: unremarkable
Impression:
Annular tears with small posterior disc extrusions at L3-L4 and L4-L5 causing minimal indentation of the ventral CSF space as above.
No sites of significant central canal stenosis or of marked neuroforaminal narrowing. |
| Angie Baker, Boston,MA |
| Neurosurgeon Response: |
A: Back pain is extremely common, unfortunately. Although there are many many benign causes of backpain, such as muscle spasm, or ligamentous injury from agrressive excercise etc...there are often more serious conditions that cause this, such as tumors, herniated discs etc. The best thing is for you to be seen by a neurologist/neurosurgeon/pain management specialist or other capable doctor to evaluate you appropriately.
Often, particularly in the case of "benign" conditions of the spine, pain medication and physical therapy are all that is reccomended/indicated. Surgery is reserved for more serious conditions causing pain, weakness, numbness or other neurologic deficit or if a tumor or other lesion is found that a surgeon feels should be biopsied or removed. Pain medication/physical therapy is often very helpful. Again, i'd reccomend you consult with a physician to review your individual situation. |
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| 10/11/2009: |
Q: Hi Doctor. I recently underwent an MRI and afterwards my Neurologist and the Neuro Surgeon both concurred that i need an ACDF operation. If I quote from the MRI report can you tell me if you agree w/their diagnosis?
Findings:
"At C2-3 through C5-6 shallow herniations indent the sac.
At C6-7, a moderate-size broad-based herniation indents the sac. A superimposed moderate-sized focal right-sized lateral recess herniation causes moderate right-sided ventrolateral cord impingment. The herniation extends the behind the inferior endplate of C6 and superior endplate of C7, without associated spurring. Very slight increased cord signal is detected at the site of the herniation (sagittal image no. 6, series6). There is slight marrow edema involving the C6 and C7 vertabral bodies."
"No other herniations are detected. There is loss of lordosis. No spondylolisthesis is present. The craniovertebral junction is unremarkable."
Thanks in advance for any advice you can give. John |
| John, Brooklyn, NY |
| Neurosurgeon Response: |
| A: thanks for your question. Unfortunately the purpose of this website is not to offer consultations online. If you wish to arrange for either a personal consultation with one of the surgeons in my group or a referral to a surgeon near you, please resend a question as such.thanks. |
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| 05/17/2009: |
| Q: I had a neuroschwannoma removed from my brain stem. It has been almost 10 months. I still have double vision, my left eat still has wind blowing sounds and my left cheek and inside of my mouth is still somewhat numb. i am now experiencing my forehead twitching on the opposite side. The doctor I had thought my double vision would be past months ago. I still have some head pain and get a little dizzy. I also developed chronic fatigue. Can you tell me what to think about my present symptoms. |
| Gary Ealy, Memphis, TN |
| Neurosurgeon Response: |
| A: Unfortuantely i dont have enough information from what you've given to make any comments on a major operation like this. And wouldnt anyway without seeing you and your films and examining you. Generally speaking, however, major brain surgery such as this can often result in lingering patient complaints, some of which may hopefully get better with time. Or at least patient's get accustomed to them and are not as bothered. I'd reccomend you work closely with physicians in your area. Don't be afraid to get second opinions or to see additional types of specialists as you never know who may have some techniques that could make you feel better. |
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| 05/17/2009: |
Q: Can having anterior cervical discectomy with fusion (plating/screws) affect thyroid function? I had C5-6/6-7 surgery 6 months ago and my TSH is 6.0. Never had any thyroid issues in past and last TSH a yr. ago was 1.8. I'm just wondering if all the edema and trauma from surgery could have that impact.
Thanks! |
| Christine V, Illinois |
| Neurosurgeon Response: |
| A: your question is a good one and i do not know the answer. I have not heard of this before, but certainly the surgery is in the vicinity of the thyroid. I looked it up online briefly and could not find a correlation and suspect that it is unrelated. |
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| 05/17/2009: |
| Q: I am 42 yr old. The doctor look at my mri find I may have a split spinal cord at c6-c7. the mri reported development remnant of the central spinal canal. at c6-c7. from c2 to c6 the disks are mildly desiccated and minimal disk bulging. I had a bike accident in 1991 with close head injury and reinjuried neck last month with neck and back pain. What is split spinal cord and remant of the central spinal canal. |
| tim, virginia |
| Neurosurgeon Response: |
| A: It is sometimes difficult to answer questions like this as the actual name that patients remember sometimes isn't quite the same name that a doctor recognizes. I am not familiar with the term "remnant of the central canal," but do recognize the term "split spinal cord." Split spinal cord refers to an abnormality in which someone's spinal cord is literally split into two pieces. This may be the result of something that happens in utero. It can often be asymptomatic, but sometimes it causes trouble and needs to be treated. Regarding the rest of your situation, it sounds like you should be in touch with a good neurologist/neurosurgeon. |
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| 04/09/2009: |
| Q: My dad has heart problems and required a defibrillator. Unfortunately it went off and he hit is head. He was on plavix was in hospital and they did not pick it up at first that he was bleeding. He had abrupt cofusion but then was cleared by neurologist went home and confusion did get better after about two days. He ended up in hospital a month later with bliateral subdural hematomas had emergency brain surgery and started to do better then worse and they went in a second time. Discovering that he was put back on plavix after first surgery. This second time they told us he could never be anticoagulated and was in hospital a few days then down to a rehab facility. During medicine review the nurse revealed he was on aspirin and we were very upset and called our regular doctor and he said that the neurosurgeon put him on it. He is also put on kepra and they started it IV in the hospital and now orally at rehab. He was very lethargic then started to be more alert now he is in a sleep state again. They just did his cat scan again a determined he is not bleeding and the brain did not shift. What could be causing him to be in this almost comatose state throughout the day? |
| Jennie, Pennsylvania |
| Neurosurgeon Response: |
| A: Thank you for your question. The evaluation of "consciousness" is a very complex thing that I cannot comment on without examining your father and review his medical records and imaging. I would suggest you speak with your father's neurologist and neurosurgeon and ask them this important questions. Some things that can make a person comatose such as medications or blood clots on the brain are potentially revesible, whereas others such as certain strokes, may not be. |
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| 03/26/2009: |
| Q: what are your thoughts about nerve transfer surgery for treatment of foot drop caused by damage to the axonal left L5 nerve root a complication from L4-5 fusion? What are your impressions of Dr Nath in Texas? Thank you for your time! |
| pl, pa |
| Neurosurgeon Response: |
| A: Unfortunately, i don't know of Dr. Nath. I would reccomend, however, that you obtain at least two separate opinions from different institutions. |
| |
| 03/26/2009: |
| Q: what are your thoughts about nerve transfer surgery for treatment of foot drop caused by damage to the axonal left L5 nerve root a complication from L4-5 fusion? |
| pl, pa |
| Neurosurgeon Response: |
| A: Nerve transfers are an advanced topic in the field of peripheral nerve surgery/evaluation. I would reccomend that you see an expert in peripheral nerves. If you such a referral, I'd be happy to refer you. |
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| 03/26/2009: |
Q: On Jan 27, 2009 I had a small tumor removed from L-3 , I had a laminectomy. When I got to recovery, they told me I had a small CSF leak, and had to stay reclined for 24 hours and then gradually elevate to 60 degrees to see if I got a headache. I did not. The wound was healing very well, no other symptoms. I of course was put on Oxycodone which gave me severe constipation. Nobody told me of the risk of CSF leakage, nor the importance of stool softners etc. and so I tried very hard to have a bowel movement when I got home (with no instructions from the hospital). Within a week I developed a large (3" X 5" X 1") bulge below and around the wound. I was seen and told at first by the doctor's nurse to put heat on it. Three weeks after surgery, I saw a resident who told me it was probably a hematoma and that I should come back in 2 more weeks. Yesterday, I finally saw the surgeon (6 weeks post op). It is still the same size although I have virtually no other symptoms (no headaches or leakage from the wound). He drew out some fluid with a needle and it was definitely CSF. He told me that either it would go away by itself in 90 days, or I could do nothing, or have surgery to repair/glue it. I asked him if there was any risk to doing nothing, he said only that I would have the negative cosmetic bulge.
Just does not sound right to me. |
| Steve L, Cleveland, OH USA |
| Neurosurgeon Response: |
| A: Thanks for the note. Spinal fluid collections as you are describing are a known potential complication of lumbar spine surgery. |
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| 03/26/2009: |
| Q: My name is Mary. I am 22 years old, was diagnosed with advanced scoliosis at age 11 and underwent the standard posterior spinal fusion (T1 - L1) with harrington rods. Surgery was done in 1998. I had moderate pain for years following the surgery, but assumed that it was something I would just have to live with, seeing as this was a pretty invasive surgery. Well, as if this wasn't bad enough, I was involved in a really bad MVA in 2005, in which I pulled into oncoming traffic in the path of a fully-loaded 13-ton dump truck travelling at around 35+ mph. The truck struck my vehicle on my side and resulted in a fractured L2 and L3. Now...my question is this. Bear with me as it gets slightly convoluted. When I was hospitalized for my car wreck, a CT scan was performed and it was noted in my records that, in addition to the fractures, that there was a "right-sided laminar hook at the T1 level protruding into the spinal canal and causing decompression of the posterolateral cord." ER doctors never mentioned this to me, I only know this now, 4 years after the MVA, basically because I requested a copy of my records and read them out of boredom and curiosity. And this is the approximate area where 95% of my pain seems to originate. Is this just a coincidence? My orthopedic surgeon has never ordered me a CT scan, only does the regular standing lateral and AP x-rays. Last time I saw him, 2 years ago, it was because my pain has been increasing in severity and frequency ever since the MVA (now it is constant), and it is to the point now that I just can't stand it anymore. He diagnosed me as having whiplash and wrote me for PT. However, I have spoken with other doctors who all seem to think that this hook protruding into the spinal canal could potentially be the source of most of my pain. I am getting a 2nd opinion from a local neurosurgeon March 6th. Is this something that would potentially require surgical intervention to fix? Am I crazy for thinking that this is a problem and it is not supposed to be this way, and that I potentially have found the source of my pain? And most pressing to me...should I be concerned that this was never brought to my attention, only put in my med records for me to read about YEARS later, and no treatment was ever recommended? I guess I would just like to know whether or not I can expect to live with this level of pain for the rest of my life, and if there is any amount of real relief to be found besides relying on narcotic pain relievers. And one more question. My back problems have severely limited my ability to work...an office type job where I sit at a desk is the ONLY thing I am somewhat physically capable of doing, and even then I still have trouble. I can't stand for more than 15 mins at a time, bending, stooping, lifting more than about 20 lbs, any repetitive motions, anything require much movement is totally beyond my pain tolerance. I have a pretty high tolerance for pain. Should I be filing for disability, or would I be wasting my time at my age (22)??? Help!!!! I need some advice. |
| Mary, Rifle City, KY |
| Neurosurgeon Response: |
| A: Thanks for your question. Unfortunately your situation is quite complex and the answers would best come from doctors who have examined you and reviewed your medical situation in a formal situation.. i.e. beyond the scope of this website column. I would encourage you to see specialists as it sounds that you are. |
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| 02/12/2009: |
Q: Dear Doc,
My mom (45 years) has been diagnosed with low stage glioma in the left side of the brain (speech area). While one doctor suggested that the best method is to go for intra operative navigation surgery another doc asked us to wait until we see the tumor grow more aggressive. Kindly advice me on the best possible method to get rid of it.
Sincerely,
Adil Fiaz |
| Adil Fiaz, India |
| Neurosurgeon Response: |
| A: Unfortunately, this situation is too complex to handle via email without seeing the patient or the MRI. Both the treatment approaches you described have been used for this disease with varying success. I would defer to the physician's in your area that you trust and have confidence in to help you make this important decision. |
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| 02/27/2010: |
Q: Diagnosed grade 1 anterolisthesis of L4 on L5. Multilevel disc space narrowing throughout the lumbar spine with facet joint arthritic change.
I have NO back pain but I was experiencing sudden severe pain in my left foot. Pain would come spontaneously and was relieved by relieving weight on the foot.
One neurosurgeon wants to do a rather simple laminectomy. A second opinion states I have a spinal instability and therefore if I have a laminectomy, I will also need a L4-L5 fusion.
I don't know if we are on the same page because I was under the impression a fusion was for elimination of back pain which I have none. |
| Carl W., Knoxville, TN |
| Neurosurgeon Response: |
| A: this website is not intended to answer specific questions regarding a specific problem for an individual. Spinal surgery often can relieve back and/or leg pain. My reccomendation is to use neurosurgeon who specializes in complex spine surgery and to obtain at least two if not three separate opinions. |
| |
| 01/19/2009: |
| Q: My 84 year old mother has been very healthy all of her life. When she was 73, she was diagnosed with Lymphoma which she beat quickly after less than a year of therapy. As of last June, she was still cancer free, and as mentally sharp as ever. Early December she was given a routine cognitive test by her doctor and passed with flying colors. Just before Christmas, she was crossing a parking lot and was hit by a car. She suffered a massive concussion, with multiple stiches in the back of her head. The back of her head and neck were grossly swollen and bruised, but that faded within a week. However, all through the holidays she was vomiting and sleeping all the time, and returned to the hospital twice. By New Year's day, she was still too sleepy, confused and nauseous, and complained that the back of her head still hurt terribly. We took her to a neurologist, who conducted another cognitive test which she failed miserably. He referred her for a CAT scan. It showed swelling in the front of the head near the frontal lobe, but was inconclusive, so an MRI was done. The second MRI showed a swelling in the front temporal lobe, and the doctor believes she may have a possible Astrocytoma tumor, but again it is inconclusive. We now have to take her to a neurosurgeon for further tests and possible exploratory surgery. It's devastating how quickly my mother is deteriorating since she was hit, and I am finding it hard to believe an astrocytoma can show up so suddenly. Is it too much of a coincidence that she would begin showing symptoms of a tumor right after having a severe concussion? Could this be a recurrence of her cancer so quickly? Could the concussion be causing this kind of sudden brain swelling that looks like a tumor? What else, if anything, should we be asking or looking for? Thank you so much for any time you can give answering this. |
| M. Rouse, Germantown, MD |
| Neurosurgeon Response: |
| A: Lot of great questions here. Often, we do uncover diseases that have been smoldering only when someone has some kind of accident or other unrelated reason to have imaging performed.Sometimes the accident can exacerbate subtle symptoms a patient may have been having even before the accident. It is true that contusions (brain bruises) can mimic tumors on imaging studies...without seeing the films, I cannot comment. My only other thoughts are that i reccomend 2-3 opinions prior to undergoing surgery. |
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| 01/19/2009: |
Q: I have recently had an episode of SAH. It is very likely that this episode has been "benign" perimesencephalic haemorrhage. However, during the CT scan (with angiography) performed at the beginning of the event, a small (4 mm) aneurysm at the right a.cerebri media was found.
The only option offered by my neurosurgeons was a conventional operation (position makes coiling impossible).
I was wondering if any other less invasive option (e.g.gammaknife) could be performed on this type of aneurysms.
Thanks for help |
| Suzana R., London |
| Neurosurgeon Response: |
| A: Thanks for the questions. "Coiling" is the newer technology "less invasive" approach to brain aneurysm treatment. Without seeing the films myself, it is hard for me to say whether or not I agree that 1. the aneursym is unrelated to the bleed or 2. that the aneurysm is not amenable to coiling. Aneurysm in almost all blood vessels of the brain have been coiled. To my knowledge, gamma knife radiosurgery has not been applied to cerebral aneurysms. |
| |
| 07/31/2008: |
| Q: Are the symptoms of stroke for women different from the symptoms for men like they may be for heart attack? |
| Mary S., Melville, NY |
| Neurosurgeon Response: |
| A: I am not aware of any evidence that the manifestations of stroke in women and men is different. |
| |
| 06/27/2008: |
Q: I am a graduate student and have recently done research on the topic of the neurological, psychological, and physiological effects of spanking on children.
I have designed an educational brochure on this topic and am interested in speaking with a neurologist about this subject.
Would it be possible to put me in touch with a neurologist who could shed light on this topic?
Thank you,
Valerie W. |
| Valerie W., Forestville, NY |
| Neurosurgeon Response: |
A: There are many good neurologists and you can contact them by simply asking your local hospitals whether they have pediatric neurologist that they can refer you to. I do not know the pediatric neurologists in your area. An internet search in which you plug in "Forestville NY" and "pediatric neurologist" may also prove helpful. That said, you may find that this topic is more relevant to a pediatric psychiatrist or psychologist.
Thanks for the question.
Jonathan Brisman
Neurosurgeon |
