Wednesday afternoon, April 12, 2006

MRI showing some random tumor-free person's brain:

LV-lateral ventricle

As shown on the other MRI [way down below] that shows a typical craniopharyngioma, all these areas, particularly the hippocampus and the thalamus are affected by this tumor.

Hippocampus : "plays an essential role in the formation of new memories about experienced events" (stolen from Wiki.org)

Thalamus: "forwards signals from auditory, somatic, visceral and visual systems to the cerebral cortex" - also responsible for governing sleep and wake states.

Today is not a great day. Mike's not very alert or awake. He's hard to rouse and his short-term memory isn't working well at all. They have a valve on the catheter in his head that they turn to release fluid and reduce the ICP (Intracranial pressure). This is what they implanted friday morning (4/7). They originally set the rule to drain fluid when Mike's ICP reached 15, then after a couple days of little improvement they reduced the threshold to 10 on Saturday night and he was much better on Sunday. They upped it again to 15 and over the past couple days he hasn't been doing great. This morning they lowered the threshold again so that when it reaches 10 they drain some fluid. They're hoping that will help his cognitive state.

The question of whether or not this is a permanent thing is the huge elephant in the room right now. No one can answer that. The resident was explaining today that the location of the tumor is adjacent to the part of the brain that controls short-term memory. Any swelling or increase in pressure poses a problem. Hopefully, with a permanent shunt and constant maintenance of an appropriate ICP, he'll be ok -- but they just can't say for sure.

The other thing that is crazy is he has NO appetite and NO thirst mechanism. Today he even tried to pretend to take a sip of water when he didn't actually drink anything. So, they've got him on IV fluids again because he just does not drink enough on his own.

Another random detail - many people have suggested to me that they believe radiation will shrink the tumor. Unfortunately radiation is not expected to shrink this tumor. Cancer cells are not stable and respond very well to radiation. Craniopharyngiomas are not cancerous. Craniopharyngioma cells, which are "healthy" cells, do not break down in the face of radiation the same way that cancer cells do. Radiation will be to control the tumor, reduce its rate of growth, or stop it from getting bigger. But, it won't make it disappear.

On a lighter note, today he thought it was Cheryl who had been in to visit earlier today (which was not the case). Maybe he was tired of guessing "Roney" and being wrong.


Peter said...

Interested to see what happens when ICP is maintained down around 10 again.

susan said...

Danna... am posting some research info I found online via NIH. It's in the treatments area. Full details require a subscription to the site-- which I can do if you think it's a good idea.


Cheryl said...

That must mean I'm stored in Mike's long-term memory...Yes!! Hopefully, I'll be over soon!