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Neurology (Expert Forum)
Surgery too risky?
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
Surgery too risky?
by greendog, Aug 19, 2006 12:00AM
Two years ago I was diagnosed with a small cavernous haemangioma in the substance of my spinal cord,around the level of T12, which currently gives me constant pain, that has only slightly eased by taking carbamazepine and amitriptyline tablets daily.I would like to be rid of pain and my consultant says surgery is the only answer. However he says that there is a high risk of being left paralysed following the op., approximately 1 in 3, and he suggests to only proceed as a last resort,if i can't stand it anymore.Maybe techniques are more advanced in the USA. Could you tell me what you feel the risk situation is, in your hands, and if favourable, what the operation would cost if i travelled to your hospital for treatment. Many thanks
Doctor's Answer
by CCF-Neuro-M.D.-SH, Aug 20, 2006 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes. Cavernous hemangiomas are rare vascular malformations that can occur at any place in the nervous system including the spinal cord. They occur intra and extra dural (inside and outside the lining of the spinal cord), and more rarely intramedullary (inside the cord). These lesions are most commonly located in the thoracic cord (middle segment) with the cervical cord being next most common. Patients generally present with pain, which can then follow a progressive course of weakness and/or numbness if the lesion expands (bleeds). Treatment consist of complete surgical excision using microsurgical techniques, and these surgeries do have a good outcome when done in major hospitals (although your exact risk is largely dependent on your lesion, which I am not able to examine). The cost of such a procedure is dependent on many variables, and I would suggest that you speak with a financial counselor (available at all major hospitals). A 30% risks of paralysis does seem unreasonable, and I would a least seek a second opinion. I would recommend that you see a neurosugeon and bring your MRI scans for him/her to examine. Until then, there are a number of neuropathic pain medications that may be helpful that include Lyrica, Neurontin, Cymbalta, Maprotiline, Desipriamine, etc. (discuss these with your neurologist).
I hope this has been helpful.
I hope this has been helpful.
