Neursurgeon #2

We met with:
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Dr. Kim
Neurosurgeon @ Hoag Hospital, Newport Beach, CA
10/13/05

Here's the results of our conversations:
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Episodes were seizures. Probably localized. Brain cells irritable because of lesion. MRI can't prove where it came from, looks like a tumor, but could be non-tumor (i.e. infection) May be two masses there. Possible meningioma, which is a tumor that develops from the surface of brain. It looks like there is one tumor at the surface and possibly one below. Probably not caused by concussion, but unclear what the cause could be at this point. This tumor probably won't go away on its own. Will probably need a biopsy to determine what kind of tumor(s) it is before determining treatment options. Ordered a CT scan to see if there are tumors in chest/abdomen/pelvis. May also get a PET scan. May be helpful to get a careful skin exam to rule out tumor coming from mellanoma. Should probably be treated within 3-4 weeks, don't wait more than 2 months. Avoid caffeine, alcohol, sleep deprivation so as to decrease possibilities of more seizures.

Questions:
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Would the swelled tissue need removed too? no

Should continue baby aspirin? no

What are the signs of a metastatic lesion vs. primary tumor?
- we looked at the lung xray it was clear
- should we be looking elsewhere for tumors? Yes get a ct scan
- is it true that 3/4 of brain tumors are metastatic? Majority are.

Do certain neurosurgeons specialize in certain types of tumors? No. There aren't enough types of brain tumors to specialize.

What is involved in a biopsy?
- limited biopsy with needle, downside is that we may not get a good piece of lesion
- could do a small open procedure to get a piece out It is in dominate sensory area, so there is a risk that you may have difficulty knowing where your hand is in space. 5% risk of that happening

What treatments are available?
Really need to know what kind of tumor first before determining treatment.
Different forms of radiation
Gamma knife, need to know if it is infection, or primary vs metastatic


What's next:
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Mark got a blood test on 10/14/05 to check dilantin levels. (waiting for results)
Mark got a CT scan on 10/14/05. (waiting for results)
We have a 3rd opinion scheduled 10/19/05 with Dr. Keith Black @ Cedar Sinai Hospital

Got questions?
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If you have any questions or other things you want me to ask, please email me.