– POST-SURGERY COMPLICATIONS -
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Dear friends,
my name is Carla, I'm brazilian as my best friend Jane.
The story is about her:
My best friend Jane, had a benign tumor known as acoustic neuroma considered big in size (1.38in) that was partially removed in 2001 due the risk to loose de facial nerve function. However she lost her hearing on left ear.
The surgery was performed in Brazil, in the state of Rio Grande do Sul.
In the 6 years after the surgery the tumor grew slowly, always monitored by the doctors with MRI exams. In the last exam (June 2007) they noticed that there had been an obstruction to the passage of cerebrospinal fluid (CSF), the 4h ventricle swelled causing hydrocephalus.
The tumor had grown big again (1 - 1.2in) and after 8 hours of surgery, through MRI, the doctors noticed that a small remaining part of the tumor near the trigeminal nerve had not been removed.
With the consent of family members the doctors decided to perform a new surgery within 7 days to remove the remaining tumor, taking into consideration that the patient was in hospital, conscious and feeling well.
An external drain was placed to drain the fluid whose passage to the ventricle had been blocked. In the first few days after placing the drain the 400ml produced daily were being totally expelled externally.
The second surgery had occurred normally, the patient woke up in the recovery room and was conscious when suddenly, still in the recovery room, suffered 4 convulsions in a period of 3 hours resulting from a strong intracranial pressure (ICP). She fell into a coma and was transferred to the Intensive Care Unit where she almost passed away. She remained in coma for 15 days.
According to the doctors, this ICP is not normal and there is no logical explanation for this. Still in the ICU, the external drain was replaced by a Shunt valve under the suspicion of infection in the external drain because of a persistent fever.
The placement of this new valve did not work. It broke or wasn’t the right size,, we don’t know exactly what happened, but we know that the fluid leaked all over the brains and ended up in an acute hydrocephalus that almost brought the patient to her death for the 2nd time. The valve was replaced very urgently and placed on the other side of the skull where it is today.
All together, my friend has been in hospital for 60 days.
Now in February 2008 it has already been 8 months since her surgery and she still has the following consequences:
- Lost recent memory (approximately the last 10 years);
- Mental confusion around 90%;
- Recognizes only people close to her, but does not connect them with the reality;
- Demonstrates signs of dementia when speaks;
- Doesn’t remember things seen and done after 5 minutes, the day before or the week before;
- Speaks very little, without emotion even with the loved ones;
- Watches TV but doesn’t understand what is watching;
- Is unable to make a cell phone call;
- Lack of satiety. Will take food without limit, until it is removed from her;
- Uses the toilet but not unattended;
- Walks but does not perceive steps;
- Sleeps between 12 and 15 hours a day and has difficulty waking up – needs to be awakened insistently;
- Speaks as if still going to school and to work, things that used to do in the past;
- Speaks with certainty about things that never happened;
- Speaks about relatives that have passed away years ago as if still alive.
We are all suffering to see Jane in such condition. The neurosurgeons here say that there’s nothing more to be done but wait. No medication has been prescribed after Jane left the hospital.
We desperately need your opinion. I visited your website and noticed that here probally I'll find other people with the same experience. Please help us with your advice. We suspect but don’t want to believe that Jane’s lesions are permanent. We would appreciate having your opinion on the following:
- If possible at all, how long can it take until Jane shows any improvement?
- Can “neural plasticity� work in her case?
- Is there any medicine that could help her to regain memory?
- Why did this happen to her, considering that it does not happen to the majority of patients with acoustic neuroma?
- Increasing the contact and interaction with her closest friends and relatives and memory exercises can help or have no influence? Is it only a problem of cerebral lesion?
- Why did she have convulsions after a normal 2nd surgery? Aren’t convulsions unusual in this kind of operation?
- Is there any kind of exam like MRI (Magnetic Ressonance Image), electroencephalogram or tomography that can show the affected area of the brains?
I’ll be looking forward to your reply. Please help us.
Sincerely,
Carla Schmitt – RS – Brazil
