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- Question: My 12-year-old son began complaining of odd headaches; electric pulse/shocks of pain that varied in number of pulses, severity of pain, and sometimes accompanied by dizziness and vision effects (things looked elongated and appeared to be farther away than they actually were). All resolved on their own though sometimes after taking ibuprofen or acetaminophen. An MRI showed a lesion in the anterior region of the medial right temporal lobe. Our neurosurgeon stated that, from the scan, it looks like a low grade, slow growing tumor. She also expressed doubt that it is tied to his headaches and classified those as migraines. He has no other apparent symptoms according to neurological exams. No seizure activity per video EEG results. We are weighing option of surgery now before things can change and symptoms may start. Dr. stated that tumor is in very accesible location and follow-up treatments after surgery (radiation, chemo, etc.) would likely be unnecessary. Dr. is obtaining second opinion from brain tumor center. We are also speaking to another doctor in the same practice who sits on the tumor board with first neurosurgeon mentioned. First neurosurgeon seems fairly proactive and falls on side of surgery now given his age and location of tumor. However, she is upfront with possibility of risks from surgery being the very things we would be trying to practively avoid with surgery now (possible memory and cognition impairment as well as possible seizures) given it's proximity to the amygdala and hippocampus. I believe the other doc from the tumor board we are seeing next week tends to fall on the side of monitoring my son's tumor. She is trying to locate someone local to conduct neuropsych testing as another source of information on the effects of the tumor. Surgery can be done without those results. My first question is: can the headaches/migraines be tied to the tumor? My next question is what advantages might there be in doing surgery now, despite the risks rather than waiting for tumor effects and then doing surgery? Also, should we ask for a biopsy before any possible resection (the tumor is approximately 12-15mm).
Before doing anything, you need to be evaluated at a major brain tumor center which operates on 500 or more brain tumors per year. See
www.survivingbraincancer.com or other sources for the nearest center near
you. That comes first before any of the other questions can be answered.
Paul M. Zeltzer MD
Co-Director WholeChildLA Pain Program
Clinical Professor in Neurosurgery
David Geffen School of Medicine at UCLA