Tag: Brain Surgery

One More Test!?!

Darren Long1 Comment

Finally got ahold of the lady at the hospital that I need to talk to about getting the appointments set up with the doctors/surgeon to have a meeting next week about my surgery in September. She told me that “yes” the doctors/surgeon had talked about me this week and decided that they wanted one more test. The Wada Test. This is the test that I was told is a “dangerous” type test, and would only be done as a last resort. (Guess I got that far)

Wada Wada Wada…  Let me find a good description on the web to copy over…

The neuroradiologist inserts a catheter (a long, narrow tube) into an artery, usually in the leg (groin). The catheter is directed to the right or left internal carotid artery in the neck, which supplies the brain with blood. Once the catheter is in place, a dye is injected. Some patients report a warm sensation when this happens. The dye can be seen on a special x-ray machine. This machine takes pictures of the dye as it flows through the blood vessels of the brain. Once the angiogram is done, the catheter will stay in place for the Wada.

During a Wada, the neuroradiologist puts one side of your brain to sleep for a few minutes. This is done by injecting sodium amobarbital (also called sodium amytal) into the right or left internal carotid artery. If the right carotid artery is injected, the right side of the brain goes to sleep and can’t communicate with the left side. Once the physicians are sure that one side of your brain is asleep, the neuropsychologist shows you objects and pictures. The awake side of the brain tries to recognize and remember what it sees.

After just a few minutes, the sodium amobarbital wears off. The side that was asleep starts to wake up. Once both sides of your brain are fully awake, the neuropsychologist will ask you what was shown. If you don’t remember what you saw, items are shown one at a time, and you are asked whether you saw each one before. Your responses will be recorded word-for-word.

After a delay, the other side of the brain is put to sleep. To do this, the catheter is withdrawn part of the way and threaded into the internal carotid artery on the other side. A new angiogram is done for that side of the brain. Different objects and pictures are shown, and the awake side (which was asleep before) tries to recognize and remember what it sees. Once both sides are awake again, you will be asked what was shown the second time. Then you are shown items one at a time and asked whether you just saw each item.

I’m reading some more things on this web page about safety and so forth. I’ll just keep that info to myself….

Told on the phone this takes two hours. NEXT WEEK is when I’m doing this and NEXT WEEK is when I’m meeting with the doctors. Just have to figure out what day/time.

Called the doc…

Darren LongLeave a comment

Called to doctor’s office and they called back a bit later. This is what I found out…

#1… I am the next on the “list” to be be talked about and my head worked on.

#2… The Neurologists and doctors and surgeon will be meeting early next week to discuss all my tests together. 

I want to set up an appointment with all these guys to ask some questions. If I don’t hear anything back by Wednesday, I need to call them myself.

Now, it’s either the main Neurologist or surgeon (one or the other) has the entire month of  August off, so this surgery won’t be happening till September.

Temporal Lobe Resection

Darren Long1 Comment

I think today that I’m going to come across and explain this operation the best I can. The Temporal Lobe Resection is the removal of a portion of the temporal lobe, or temporal lobectomy. These brain structures play an important role in the generation or propagation of the majority of temporal lobe seizures. In most cases, a modest portion of the brain measuring about 2 inches long is removed. The temporal lobes are important in memory, emotion and language comprehension. However, the extensive tests that I have been doing ensure that removal of the area causing seizures will hopefully not disrupt any of these critical functions.

Risks? Permanent complications associated with temporal lobe resection surgery are very low. Mortality is less than 0.1% and permanent unexpected morbidity less then 1%. In dominant hemisphere resections, temporary language difficulties are seen in 10% of the cases although these usually resolve. An upper quadrantanopsia (partial upper peripheral vision loss) is expected in large temporal resections, but seen in less than 25% of the patients. Memory impairment rarely occurs from temporal lobectomies because of extensive preoperative testing of language and memory functions.

Success Rates? Seizure control in temporal lobectomy varies:

  • 60%-70% of patients are free of seizures that impair consciousness or cause abnormal movements, but some still experience auras
  • 20%-25% of patients have some seizures but are significantly improved (greater than 85% reduction of complex partial and tonic-clonic seizures)
  • 10%-15% of patients have no worthwhile improvement

Therefore, over 85% of patients enjoy a marked improvement in seizure control. Most of them need less medication after surgery. Approximately 25% of those who are seizure-free eventually can discontinue antiepileptic drugs.

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What does all this mean? It’s scary. Do I feel confident and want to go through with it? Yes.

But, it’s still not a sure thing as to if I qualify. The damage would be best (or I should say “safest”?) if the bruise on the brain is completely on the left side. But from what the tests have shown so far, there might be slightly on the right. I don’t exactly know what that means, but I guess it’s not a good thing as far as a surgery goes.