FOR IMMEDIATE RELEASE
SAN FRANCISCO - Ariel Nelsen’s 4th birthday is one her parents will never forget. Just one day after her birthday on October 16, 2005, Ariel underwent brain surgery. For about six months, she had been experiencing headaches which became progressively worse. Her mom Sheila recounts, "Ariel had always been a picky eater, so when her headaches were accompanied by some vomiting and nausea, we thought she was on a "sugar low" caused by under eating. We encouraged her to eat healthy snacks and meals, which seemed to help."
A trip to her pediatrician in Portland, Ore. on October 11, however, led to testing the next day. An MRI of the brain was done to help determine the underlying cause. Ariel’s pediatric neurosurgeon, Monica Wehby, MD, diagnosed a brain tumor called a craniopharyngioma, about four centimeters in diameter.
Ariel’s story is one of the three winning entries in the Neurosurgical Patient Stories Contest, being featured during Neurosurgery Awareness Week (NAW). NAW kicks off this year from April 22-27 during the 74th Annual Meeting of the American Association of Neurological Surgeons (AANS) in San Francisco. "The goal of NAW is to help educate people about a wide range of neurosurgical conditions and diseases," stated Alex B. Valadka, MD, FACS, AANS spokesperson. "One of the most compelling ways to do this is to share real life stories of people who have experienced neurosurgical conditions firsthand," added Dr. Valadka.
Craniopharyngiomas are treacherous tumors to remove because of their location near critical structures deep in the brain. Surgical mortality ranges from 5-10 percent, and five-year survival is approximately 55-85 percent. These tumors typically arise from a portion of the pituitary gland (the structure that regulates many hormones in the body), so nearly all patients will require some hormone replacement therapy.
Craniopharyngiomas are slightly more prevalent in children than adults. According to the Central Brain Tumor Registry of the United States, an estimated 3,410 new cases of childhood primary brain and central nervous system tumors were expected to be diagnosed in 2005, both benign and malignant. Of those, an estimated 3 percent were craniopharyngiomas in children age 14 and younger. Other sources estimate the incidence of pediatric craniopharyngiomas at 3 to 5 percent.
Craniopharyngiomas can cause symptoms by:
- Increasing the pressure on the brain (intracranial pressure), which may cause headaches, nausea, vomiting (especially in the morning), and difficulty with balance
- Disrupting the function of the pituitary gland
- Damaging the optic nerves, which may cause vision loss
- Blocking spinal fluid flow, which may cause hydrocephalus
Just five days after her diagnosis, Dr. Wehby performed a craniotomy on Ariel and successfully removed the entire tumor. A craniotomy is a surgical procedure in which a neurosurgeon opens a portion of the skull to operate on the affected portion of the brain. Ariel spent two days in the pediatric ICU at Emanuel Children's Hospital, and was discharged from the hospital six days postsurgery.
"Ariel's surgery went very well. We were pleased that we were able to safely remove the tumor completely. Nothing is more rewarding than having parents entrust you with their child, and then being able to return that child to them intact and unharmed " minus the tumor," commented Dr. Wehby. "Although the pituitary stalk and gland were left intact, it is the nature of these tumors that patients require some degree of hormone replacement. Ariel is closely monitored by an endocrinologist, who has prescribed medication to address these issues. I see her regularly for follow-up visits and MRI scans to watch for any sign of recurrence. The good news is that Ariel did not have to undergo radiation because the tumor was completely removed. That should equate to an excellent prognosis."
According to Sheila, less than one month postsurgery, Ariel was at home doing all the energetic activities expected from a child her age. "Considering all that she has been through, Ariel’s resilience has been amazing. She has emerged from this experience seemingly unscathed both in body and spirit. We’ve gained an immeasurable amount of respect and appreciation for Dr. Wehby and the other dedicated healthcare professionals who cared for her. Were it not for the knowledge, expertise and practiced skills of her doctors, Ariel’s story might not have such a promising ending," remarked Sheila.
Detailed information is available on brain tumors and other neurological conditions at: http://www.neurosurgerytoday.org/what/, under Conditions & Treatments. To locate a qualified neurosurgeon in your area, visit: http://www.neurosurgerytoday.org/findaneuro/.
Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 6,800 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada, or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain, and peripheral nerves.
