Cases of pituitary adenoma recurrence after 5 years.David is my 2004 year old patient, because of decreased visual acuity were found in pitu
Cases of pituitary adenoma recurrence after 5 years.
David is my 2004 year old patient, because of decreased visual acuity were found in pituitary tumor surgery, because of his tumor growth compared with, in order to protect the normal pituitary function, I adopted the selective subtotal resection of lesions after surgery for him, his eyesight has been significantly restored, three months follow-up the remaining tumor did not change.
Now look at the tumor control is still good, but because the location is more diffuse, so the operation can not be completely removed, the remaining part of the more limited, careful, or hit the gamma knife."
"You told me I wasn't clean before the operation, but I didn't want to be a gamma knife. What's the effect?"
"Not in the short term, but the dynamic observation, the best time for three months to do a MRI, if found in the tumor growth, or to consider the gamma knife treatment as soon as possible, I suggest you still have time to consult the relevant treatment."
"I know. I'll think about it."
27 year old boy with a young man's unique casual, not too concerned about their condition, but also a little uneasy. "What can I do for you, please call my office?."
"I know, I'm leaving the director. Goodbye."
Day by day in the ward and outpatient walk, I also used to shuttle between the operation room and office, busy and full, will forget some things should have been remembered.
A year after the day Xiaowei came, "to the director, I review the new film, you help me."
MRI showed that the residue was much larger than a year ago, and the tumors were already involved in the optic chiasm.
Do you see things clearly? Is it a little bit smaller?"
"Let you guessed it, this time the eyes see things as before, so I just wanted to go to do a film review. Director, is my problem serious now?"
"The tumor grew up to be much larger than the last review, I seem to remember that let you do the gamma knife, why didn't you go?"
"I think most of the surgery has been cut, should not be long, but it is said that the gamma knife is a ray, I'm afraid I'll be playing silly, so afraid to."
"To tell you the last time to the gamma knife treatment, why don't you tell me your concerns?"
"I am not ashamed to say, afraid you laugh at me." The young face with a trace of regret, "I am going to do it now, you say I will not be stupid ray?"
"Gamma ray is a kind of treatment, has nothing to do with intelligence, generally does not lead to patients with mental disorders. But your current situation, is not suitable for the gamma knife treatment, because control tumor recurrence has exceeded the diameter of gamma knife. So I suggest you consider surgery again."
"Can't you do it? I'm really scared of surgery..."
"I just said, the gamma knife is a form of therapy, patients generally do not lead to change of intelligence. Surgery is the same, it is a way of treatment, has nothing to do with intelligence."
"Then how come someone who has a brain surgery and who doesn't know?"
"Intelligence changes such as we often say talk rubbish, remember things, not up to people who are familiar with these situations, are generally more common in frontal or temporal lobe lesion; and motor aphasia, so-called sensory aphasia, in cerebral cortex injury; in other words, causes to a series of symptoms is the disease rather than treatment. It can be said that although the treatment can control the further development of the disease, but the damage caused by the disease itself has been irreversible."
"Then I this disease will not silly?"
"You have experienced an operation, is not fancy to listen to me." David reminds me of the naughty boy, lovely people laughing. "If silly, the last operation was silly, but also used until now."
"Hey, I'm a little scared." Hearing this, the young man smiled, "I'll go home and discuss it with my family."
The two time I was still small surgery he chose resection because of residual tumor after surgery too diffuse, so I still advise him to consider the gamma knife treatment.
"This time I will listen to your words," David half lying on the bed, the nose is filled with gauze, smile is bright face, "although your operation is great, but I do not want to do third times."
"I hope this is the last time I saw you on such occasions." I smiled and answered him.
Sunshine in the room.
Note: whether there will be a tumor can lead to changes in patient intelligence? The answer is yes, such as intracranial temporal lobe and hippocampal area of the tumor, because the central occupying brain where our main memory, although some patients receiving surgery before the memory still exists, in order to control the disease development after surgical treatment, lesions and surrounding degeneration of brain tissue to be excised, even for tumor nature is not good and had to take extended resection, leading to postoperative memory changes, or even permanent irreversible loss of memory. There are some of the corresponding language cortex in the brain damage, but also cause the patient to appear corresponding to the damage of speech function, while the majority of irreversible.
What I want to say:
Each patient is asked to come, I also believe that every doctor will give patients the most appropriate treatment recommendations. No matter whether you accept the doctor's advice, you must ask the questions in your heart, do not dare or embarrassed to say, no one will laugh at you, integrity is the link between doctors and patients.
Learn to say what you want to question, not only for the David, because of the delay and make the treatment more complicated.
Last night, David sent the latest online review data, gamma knife after 3 years of residual tumor almost no change.
"I made the gamma knife as you say, now the recovery is good, the civil service exam in the last year, now in the development of a business unit is very good, thank you very much, let me have a good future."
"Well, that's what I want." In my letter, I hope you will always be happy and healthy!"