Brain Tumors: A Case Study of Severe Complications

The brain tumor has affected the brainstem?

(My mom has diabetes) My mom went to the emergency room at midnight due to a headache.
A CT scan revealed a 7 cm tumor at the front of her brain.
An MRI was performed, and she was admitted to the hospital at 6 PM the same day.
During her one day of hospitalization, she was able to get out of bed and walk to the bathroom, albeit slowly.
She would suddenly talk to herself while sleeping and had a flushed face.
She slept a lot, and when she got up to use the bathroom, she experienced dizziness.
Whenever she was awake, she would complain of a headache, and after eating, she would vomit after a while.
She was still conscious.
The next morning, the nurse mentioned she had a slight fever and needed a urine test.
By around 6 PM, she was unresponsive and had a Glasgow Coma Scale score of 3, leading to intubation.
The doctor stated that she needed emergency surgery as her brainstem was affected.
After the surgery, the doctor reported that the tumor had been removed, her pupils were dilated, and her vital signs were stable.
However, due to high intracranial pressure, her brain was swollen, and they could not replace her skull.
They took her to ice.
The doctor’s outlook was not very optimistic.
After the surgery, she was sent to the intensive care unit.
At that time, I spoke to my mom, and it felt like she could hear me.
I asked her if she could hear us talking, and if so, to move her foot.
She actually moved it and even shed tears.
At that time, her Glasgow Coma Scale score was 6.
However, the next morning around 4 or 5 AM, the doctor informed us that my mom had a slight brain hemorrhage and was experiencing hypoxia, with blood unable to reach the brain.
There was some necrosis from the surgery.
She was at risk of life-threatening complications.
Her blood pressure had dropped, and the nurse administered medication to elevate it.
From 4 or 5 AM to 11 AM, she received two doses of medication to stabilize her blood pressure.
By 8 PM, the nurse mentioned some medication that seemed to show improvement.
I asked if there was progress, and the nurse said it was not considered progress but stability.
Her blood pressure was stable, but her brainstem was already affected, and she was unable to breathe on her own, relying entirely on machines.
With a Glasgow Coma Scale score of 3, have you encountered similar patients? What are the chances of her surviving? If she survives, will she be in a vegetative state, or is there a possibility of recovery? Is there a chance for a miracle?

Xiao Qi, 30~39 year old female. Ask Date: 2018/01/28

Dr. Zhang Junwei reply Neurosurgery

Without seeing the brain CT scan and the actual medical history, I cannot provide you with an accurate answer, but it does not seem optimistic.

Reply Date: 2018/01/28

More Info

I'm sorry to hear about your mother's condition. It sounds like a very challenging and distressing situation for both her and your family. Based on the details you've provided, it seems that your mother has been diagnosed with a significant brain tumor, which has led to severe complications, including increased intracranial pressure, altered consciousness, and neurological deficits.

Understanding Brain Tumors and Their Complications
Brain tumors can be either primary (originating in the brain) or secondary (metastatic, originating from other parts of the body). The size, location, and type of tumor significantly influence the symptoms and complications experienced by the patient. In your mother's case, the tumor's size (7 cm) and its location likely contributed to the severe symptoms she is experiencing, including headaches, nausea, vomiting, and altered mental status.

The fact that your mother has diabetes adds another layer of complexity to her medical management. Diabetes can affect healing and recovery, and it may complicate the management of her blood pressure and blood sugar levels during her hospital stay.

Surgical Intervention
The emergency surgery was necessary due to the high intracranial pressure and the risk of brainstem involvement. The brainstem controls vital functions such as breathing, heart rate, and consciousness. Damage to this area can lead to severe outcomes, including coma or death. The fact that the tumor was removed is a positive step, but the complications following surgery, such as brain swelling and bleeding, can pose significant risks.

Prognosis and Recovery
Regarding your questions about prognosis, it is difficult to provide a specific percentage chance of survival or recovery without knowing more about the tumor type, the extent of any brain damage, and how well your mother responds to treatment. Generally, the prognosis for patients with significant brain injuries or complications post-surgery can vary widely. Some patients may recover significantly, while others may have lasting deficits or may not survive.

The potential for your mother to return to a functional state depends on several factors:
1. Extent of Brain Damage: If there has been significant damage to the brain, particularly in critical areas like the brainstem, this can affect her ability to breathe independently and her overall neurological function.

2. Response to Treatment: Continuous monitoring and treatment in the ICU will be crucial. If her condition stabilizes and she begins to show signs of improvement, there may be hope for recovery.

3. Supportive Care: Rehabilitation and supportive care will play a significant role in her recovery. This may include physical therapy, occupational therapy, and speech therapy, depending on her needs.

4. Miracle Recoveries: While there are cases of unexpected recoveries, they are often the exception rather than the rule. Medical professionals typically rely on evidence-based practices to guide treatment and prognosis.

Conclusion
It's essential to maintain open communication with the medical team caring for your mother. They can provide the most accurate information regarding her condition and prognosis based on her specific situation. While it is natural to hope for a miracle, it is also important to prepare for all possible outcomes. Support from family and friends, as well as professional counseling, can be invaluable during this difficult time.
I hope for the best possible outcome for your mother and encourage you to seek support for yourself and your family as you navigate this challenging situation.

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