Meningioma: Keyhole craniotomy restores memory

October 02, 2014
SuzanneSun

Meet Suzanne Sun

Fox Studios Account Executive

" I've read that there are 100 billion neurons in your brain, and I’m happy to say I believe he put them all back in the right place!"

- Suzanne Sun
Keyhole Craniotomy Patient

Losing Her Way

On the evening of March 25, 2009, Suzanne Sun had a 30-minute lapse in memory. While memory loss isn’t an uncommon occurrence, it was a scary event for this 47-year-old Fox Studios Account Executive. “Physically I felt okay, but I couldn’t make sense of anything,” Sun said. “I was disoriented and essentially lost in my own house.” So a friend of Sun’s drove her to Saint John’s Health Center in Santa Monica where she learned her memory loss was most likely caused by a seizure and that seizure was caused by a calcified mass in her brain.  

The attending neurologists recommended she see Daniel Kelly, MD, the Director of the Brain Tumor Center at the John Wayne Cancer Institute at Saint John’s Health Center. 

Understanding the Options

“Suzanne had a 4 cm intraventricular meningioma and her only real treatment option was surgery,” Dr. Kelly said. “Although benign (not cancerous) this tumor presented quite a challenge to remove safely since it was in the center of her brain in one of the fluid filled chambers called the lateral ventricle. I explained to Suzanne and David there were only a few options to remove the tumor safely and effectively but they all involved traversing normal brain tissue.”  “I didn’t realize the enormity of it until later that day, although I am pretty sure Dr. Kelly could see the fear in my eyes,” Sun said. But Sun felt at ease with Dr. Kelly from the beginning. “He was thorough in detailing all aspects about what to expect with surgery, how they would get to the tumor, how they would shrink it down and remove it, what nerve areas in the brain could possibly be affected and recovery,” Sun said. 

“The care by Dr. Kelly was exceptional.” 

 
Finding a Safe Path 

After their initial meeting, Dr. Kelly ordered two additional studies. “To find the safest path to the tumor, Suzanne had a functional MRI and something called MRI fiber tractography, which allows us to localize key fiber bundles for motor function, sensation, and vision in relation to where the tumor is located. These critical structures were then superimposed on her pre-operative navigation MRI (like GPS for the brain). With this data, it was clear that the best route was to go through the right parietal lobe from the top of the head through almost 5 cm of brain to reach the tumor in the right lateral ventricle.” 

Dr. Kelly performed a small keyhole craniotomy over her right parietal lobe measuring about 2 X 3 cm. The use of intra-operative navigation along with the tractography data and ultrasound helped guide Dr. Kelly safely to the tumor in her ventricle. Although the tumor was extremely firm and rubbery, 99% of the tumor was able to be removed using the surgical microscope and endoscope for visualizing the tumor. Only a tiny cauterized tumor remnant enveloping a large important blood vessel was left behind. Since the tumor is benign and very slow growing. Sun likely will not have to worry about it for the next decade, if ever. Her recent MRI more than 4 years after surgery shows no visible tumor.  

She'll Never Forget Dr. Kelly

Overall, Sun was extremely happy with the care she received from Dr. Kelly and Saint John’s. “Not having been a patient at Saint John’s prior to my initial seizure, the entire staff at Saint John’s treated me with the utmost professional and personal care,” Sun said. “My husband, who was involved with many of the decisions and interactions, was very, very impressed with the hospital staff, the environment and the professionalism.” Despite having some minor sight problems post-surgery, Sun is now back to normal and is feeling good both physically and cognitively. She was even able to go back to work at Fox Studios a few days earlier than she intended.  

Now, more than 4 years after, her surgery is only a memory but not one she will easily forget. “The strong and respectful relationships between Dr. Kelly and the other doctors involved was very helpful to my success; the staff at Saint John’s believes in Dr. Kelly, and that showed through out our time there,” Sun said. “When you have to deal with this for the first time, there are such a myriad of thoughts and emotions that you experience, and having confidence in a place like Saint John’s and a doctor like Dan is critical. "I’ve read that there are 100 billion neurons in your brain, and I’m happy to say I believe he put them all back in the right place!” 

The condition and treatment of this patient may not be representative of all such cases as each situation and patient is unique.