Diagnosis

Wednesday, December 7^th I was diagnosed with a tumor in the left lateral ventricle.

The week before Thanksgiving, I started waking up with headaches.  The headaches were not severe, just annoying and went away with a couple aspirins and a couple hours time.  This went on until the first weekend of December, when the headaches took a turn for the worse.  The headaches would simply not go away; no matter how many aspirins I took.  The alarming thing was they got worse when I was lying down.  Finally the night of Tuesday the 6th I didn't sleep at all!  The pain was excruciating, no matter if I stood, set or lay down, nothing helped.  Finally at 5:30 a.m., I decided I needed some help, got dressed and drove myself to the St. Vincent ER.

When I arrived at the ER, I sat in the parking lot for 20 minutes thinking “what am I doing here, I’ve got a headache, I can wait to see my family doctor later”.  But after setting there with my head pounding, I decided this would be the fastest way to get relief.

I was taken to a room, where a nurse took my personal information and a brief of my symptoms.  By now the headache was the worse I had experienced, my entire forehead was throbbing from my eyebrows to my hairline.  Every loud noise felt like a hammer on my temple.  The nurse tried to get me to lie down, but it just made it worse.  I asked her to turn off the TV and lights and could I just set up while I waited.

The Doctor came in about 15 minutes later.  He asked some questions, did an eye exam and some physical exercises.  The Doctor then explained that as a doctor he must present the worst case and tests would conclude if his analysis was correct.  He then suggested that my symptoms were an indication of a brain tumor.  All kinds of thoughts went through my mind as the doctors words played like elevator music in the background.  He asked if I understood, I said yes.   The nurse sets me up with an IV so the CT technicians can inject contrast dye and I’m off to the CT.

With the CT complete, they take me back to my room where I wait for the results.  I asked the nurse if there was anything they can do for the pain, she says not until they have a confirmation of a cause. 

About 20 minutes later, the Doctors returns and says the CT confirmed the presence of a mass and shows me the report.

Findings: Partially intraventricular mass involves the central and left anterior body of the corpus callosum.  It measures approximately 20 x 25mm in representative axial plane.  The mass projects into the left lateral ventricle and abuts the foramen on Monroe, perhaps accounting for exacerbated symptoms in supine position.  The right lateral ventricle appears pushed to the right.  The mass demonstrates precontrast hyperdensity.  There is minimal augmentation of density with contrast.  There is no adjacent vasogenic edema.

IMPRESSION: Mass appears to involve the corpus callosum and left lateral ventricle.  It is somewhat hyperdense.  Consider lymphoma, subependymoma, oligodendroglioma.

My first question is whether the tumor is cancerous.  The Doctor says they can’t be certain, but requests authorization to do an MRI.  The Doctor says the MRI would show more detail and they would know more with the results.  At this point, my emotions are running wild; I get nauseous and need to lie down.  The Nurse comes in and says the Doctor ordered a sedative before the MRI.

With the MRI complete, they return me to my room to await the results.  About 20 minutes later, the Doctor comes in with the results.

Findings: Restricted diffusion is present within the tumor in the left lateral ventricle.  Minimal calcification or hemorrhage is seen within the tumor on images sensitive to susceptibility artifact.  No abnormal areas of signal are present in the brain.  A triangular intraventricular mass is present within the left lateral ventricle.  It measures approximately 2.6 x 1.9 x 1.0 cm.  There is localized dilation of the left lateral ventricle, but the overall size of ventricles is normal.  No abnormal extracerebral fluid collections are present.  The intraventricular mass exhibits minimal enhancement.  Both vertebral arteries and both carotid arteries demonstrate signal voids indicative of rapid flowing blood.  The craniocervical junction is unremarkable.  Tumor in the left lateral ventricle.  The appearance is typical of a central neurocytoma.  A subependymoma would be another consideration.

The Doctor recommends a consultation with a Neurosurgeon and sets up an appointment for Friday the 9^th at 3:45 p.m.  I suggest that the issue of headaches and lack of sleep are my immediate concern and is there anything he can prescribe that would alleviate the symptoms.  He prescribes 5mg Vicodin, 1 or 2 as needed for pain every 6-8 hours.  I am currently taking 2 at bedtime, which provides 3 solid hours of sleep, then back to headaches and light sleep.  It’s still better than no sleep!