Cogitive Function Post Surgery

[simonkoch]

I would be interested in understanding more about the possible cognitive effects post surgery (Translab). I am an engineer and would like to continue my occupation for many years to come following surgery to remove my 2.6cm AN.  There doesn't seem to be a large amount of data on cognitive effects after surgery other than that there can be some.
My specific queries are:
- Are concentration issues typical say 3-6 months post surgery and beyond
-what are typical cognitive issues and do they remain
- Are cognitive effects generally less with Radiation option
- Do most people fully recover in this area and continue as normal
- are there any articles on this that discuss this (not from a one off rare case but typical symptoms and issues)
- Are long term effects less the younger you are?

Apologizes for the large list above, i think this is my last area in my mind to close out moving forward,
I appreciate any feedback,
regards,

Simon

[leapyrtwins]

I seem to recall some type of cognitive function questions on past ANA Survey's.  In my AN-time, I've taken at least two such surveys.  I think the survey results may be somewhere on the ANA's website.

My surgery was retrosigmoid approach (aka sub-occipital) rather than translab but I consider myself normal - at least as far as cognitive function goes   

I had a few very small issues post op - mostly my brain thinking one word and my mouth saying another.  For example, if I wanted to ask one of my kids "How was your day?" but I was looking at our cat it might come out as "How was your cat?".  When typing on a keyboard (something I've done for almost 40 years) my brain would be thinking "going" but I'd be typing "doing".  I'd only catch my error when I reread what I'd typed.

These issues only lasted a few months or so in my case and I'll never know if they can be attributed to my brain surgery or to something as simple as being under anesthesia for 7 1/2 hours.

Jan   

[SDTom]

I can probably be of some help but I had a lot of complications. I did some testing with a doctor this summer. What we found (and I suspected) was that my short term memory and quick decision making was negatively affected. The long term memory and if I had time to think about something was ok.
One of the problems is I did not do these tests before surgery so I do not know how I would have scored. I am also very dizzy all the time and I think this affect other areas. If your surgery goes ok the problems most likely will be minimal.
 Tom

[tamim.horizon]

Hi Simon

Think you are in similar situation like me. I am a civil engineer and doing work in Telco infrastructure design in Sydney. I had my AN removal surgery 14 months back and it was 48 mm. I joined to my work just 2 months after the operation. Things were exactly like Jan said at that time and you know no one will understand your condition in your workplace. Those days were worst days of my life. Unfortunately I am still having some cognitive issues. This makes a mess in workplace in many times. But the most challenging part to do office work is my affected eye. It irritates a lot when I concentrate anything both on paper and PC monitor. The cognitive issues just adds some more hurdles Things are so bad that I am thinking to leave the job after this hard 12 months.

But don’t worry things are different for different patients. It may have much less effect on you. Please let us know how are you going.

48mm right AN diagnosis in 11 Aug, 2012
AN removal surgery of 15 hours     08 Oct 2012
Platinum chain implant on right eyelid  29 Dec 2012
Cross facial nerve grafting 5 May 2013
Minor tarsorrhaphy 12 May 2013

Tamim

[tamim.horizon]

Just one thing to add, I am 33 years old.

[simonkoch]

Thanks Tom, Tamim and Jan for you responses.  It is helping me to get a better picture of whether these a possibly long term or short term issues.  I've also gone through the previous forum posts and had a good look at the recent AN surveys which have provided a clearer picture on concentration and memory possible outcomes

I feel a bit like I am throwing myself onto a roulette wheel with anyone's guess as to the post op outcomes.

Tamim, your situation sounds very difficult and I hope it gets better over time.  Its a small world as well, I'm a Brisbane based structural engineer.  It would be good to stay in contact,
regards,

Simon

[leapyrtwins]

I feel a bit like I am throwing myself onto a roulette wheel with anyone's guess as to the post op outcomes.

That's exactly what you're doing.  I've always said treatment outcome is a crap shoot.  You have to weigh the pros and cons, try to figure out what you're comfortable with, and then base your treatment decision on that.  Having the most experienced, educated docs you can find figures into the equation, but even those considered "the best" can't guarantee you anything.  No one really has any idea of exactly what you'll encounter post op or post radiation.

I always tell people, you have to follow your head, your heart, and your gut.  For a lot of us we just "knew" when the decision we made was right for us.

Jan

[Jim Scott]

Simon ~

I don't believe there is a definitive answer to your questions regarding possible effects on cognitive abilities following AN surgery.  As Jan noted, AN surgery is a bit of a gamble in many respects and all one can do is research the options and weigh the probabilities (as you are) with the understanding that the eventual outcome simply cannot be guaranteed but only guessed at using reasonable judgement and what credible information exists.

In 2006, at age 63, I underwent Retrosigmoid approach AN surgery to debulk a large (4.5 cm) acoustic neuroma, then, 90 days later, 26 radiation treatments (FSR) to destroy the ability of the remaining tumor to regrow.  The surgery results were excellent - no complications and a relatively rapid recovery - and the radiation was uneventful but ultimately successful, again with no negative side effects.   

I never noticed any loss of cognitive functions before, during or after my surgery and radiation.  Of course such information is purely anecdotal with no 'scientific' basis and may not be representative of every AN surgical patient.  However, it is my experience and I offer it for whatever value it may have to you.

Jim  

[SDTom]

Hi Simon,
To illustrate Jans point about gambling, Jim and I had similar surgeries. He was a bit older (i was 43) his tumor was bigger (mine was about 3.9 cm). Jim had a relatively good recovery and I am at this point disabled and maybe recovering (I Hope) yet. My advice is to investigate your Dr. and the surgery. Even though this is a benign tumor it still is brain surgery.
Tom

[tamim.horizon]

Simon

It was great to hear that you are in Australia too. This is really a nice and useful website which shows how is everyone with AN going. We don’t have such a beautiful forum here. Good luck for you.

Tamim

[saccadiceye]

I am still experiencing cognitive issues at 9.5 months post-op. The main issues are related to attention, and short term memory (frankly impaired). It's funny how I didn't even need a day planner during my college years pre-operation, but I digress. I also am experiencing some issues with word finding and higher order reasoning, among others. BTW, I actually didn't have an AN, but rather a benign cerebellar tumor (don't tell anyone). 

If you can be patient I think it's best to try to minimize as many symptoms/stressors as possible, while continuing to push yourself everyday.

Luckily, I have noticed improvement in the last few months. For months I struggled to comprehend basic grade school sarcasm. Now I feel much more alert, albeit inconsistently.

 In Jan. 2014 I will be admitted into a rehab hospital for outpatient rehab. I am very grateful the Canadian medical system has this in place for me  (although I am told I should of gotten in much earlier, oh well).

If you are overly concerned about your cognitive status I think you should consider taking a cognitive assessment, conducted by a board certified neuropsychologist.

[leapyrtwins]

BTW, I actually didn't have an AN, but rather a benign cerebellar tumor (don't tell anyone). 

We don't discriminate here, so we won't hold that against you 

Glad you've joined us on the Forum,

Jan

[Tod]

One of the questions you might ask yourself is whether or not you have cognitive deficits now. Most likely you can't answer that question, but I think you might consider it.

I had a largish tumor deep in the skull pressing against the brain stem. I was well-known in my profession but had suffered a bit of decline in recent years prior to diagnosis and surgery. Now there are a number of factors that might have contributed to this or it might be all be in my imagination. What's not imaginary was the level of anger I experienced, but that might also be attributable to other factors, including an undiagnosed case of sever sleep apnea.

Fast-forward through diagnosis and a 32-hour surgery followed by two-weeks in ICU and then 28 sessions of FSR two years later and now almost two years past that, and I can say without question my cognitive functions are better than ever. I know this because I go back through some of the coding projects two years ago and say, "Huh?" a lot. Wondering at some of the choices I made. They weren't wrong, but they could have been so much cleaner and simpler. The same is also true for my policy work.

Coming up on age 52 in a month I am absolutely on top of my game. And occasionally in newsmedia across the nation for my work.

There are no guarantees one way or the other. It seems to me that the great majority of people do okay.

-Tod