RIGHT HYPOGLOSSAL NERVE SCHWANNOMA

[GUNASEKAR]

Dear Sir,
My father is 72 years old, one month before he had severe head ache and next day his speech was slurring then we go for neurology doctor. he asked to take MRI Scan the MRI Scan report is here.

Technique:
Multiplaner, multisequence MR imaging brain with contrast done. on 09.06.2009

Findings: T1 ISO intense, T2 slightly hyperintense, Flair ISO intense ( 2.3 x 1.7 x 2.0cm) homogeneously contrast enhancing lesion in the right side od anterior foramen magnum moderately compressing the right side of medulla with small component wideing adjacent the right hypoglossal canal.
- possibility of right hypoglossal nerve schwannoma
cerebral parenchyma : normal, No focal or diffuse lesions.Ventricles are normal.No midline shift. Normal visualization of midline structures.the whitemater signals are within normal limits.the medulla,pons,midbrain,cerebellar folia appear normal, cp angle : normal, Visuvalized para nasal sinuses are normal, CV junction is within normal limits.
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the doctor said surgery only way there is no any other treatment. So we go to neuro surgeon doctor he wanted to take CT Brain with contrast.  29.06.2009
CT Brain Report :
Study protocol: Axial 7.5 mm posterior fossa and 5mm supratentorial cuts were obtained from the base of the skull to the vertex and these were repeated following the intravenous administration of 20 CC lohexol 300.
findings: There is a dumbbell shaped isodense lesion, measuring 2.3x1.7x2.0cm anterolateral to the foramen magnum on the right side causing moderate ipsilateral compression of the medulla. No evidence of calcification / cystic component. The lesion extends into the right hypoglossal canal with resultant widening. There is mild homogeneous contrast enhancement. There is no evidence of erosion/sclerosis of adjacent bony structures.
There are no abnormal focal areas of altered density in the cerebral hemispheres and cerebellium. Appearence and attenuation of the brain parenchyma is normal. Bilateral cerebral sulci and basal cisterns appear mildly prominent consistant with age related mild cerebral volume loss.ventricular system appears normal. there is no obvious evidence of malformations of cortical development. the sella and juxtasellar regions are normal. the internal auditory canals appear normal. the visualized orbits,paranasal sinuses and calvarium appear unremarkable.
Remarks : Mild homogeneously enhancing dumbbell shaped isodense lesion on right side of foramen magnum causing moderate ipsilateral compression of the medulla and expansion of the right hypoglossal canal.
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my father had  no sugar, no bp and also healthy also.
We required immedate surgery for this or wait for some more time? If we wait what is the problem we accured? If we go for surgery any other difficulties we faced so far? Who are the best doctor in India for this surgery?

[rumpled]

If you check his profile, he never posted again. There is also an expert forum where doctors can comment where you can ask about your wife. I wish you the best.

[gregoryk]

How is your father now?
My wife is now in the hospital she has the same case.
Greg

[rumpled]

I am a layman, not a doctor, but here is my take on your father's situation.

The reason for the quick surgery is that the lesion is growing, and it appears to the doctors that it is growing fast hence why his symptoms are happening fast. With this type of tumor, where it is, it can also get larger and can cause more damage up to and including death, so getting it out sooner is better.

Surgical complications are the same for any surgery - they are usually surgeon's skill, infection, and complications from anesthesia.

As for the best doctor in India, I would quickly send his records around to larger hospitals and see who responds as with their experience. Also, look for medical papers written by doctors on this tumor in India and write or call them.