Suddenly Young slumped in his chair and crumpled, unconscious, to the concrete patio. His wife and workmen at the house came to his rescue as his worried granddaughter watched the emergency unfold.
Young remembers nothing of the ambulance ride to the Eisenhower Tennity Emergency Department, but he says now, “I was fortunate this is where they brought me.”
Called in to consult, Alfred Shen, MD, Board Certified in Neurological Surgery, spotted a dense area of tissue on Young’s CT scan and ordered a closer look with magnetic resonance imaging (MRI). Dr. Shen also scheduled a toxicology test to rule out any metabolic issues.
The MRI revealed the origin of Young’s seizure: a brain tumor — specifically, a parafalcine meningioma.
Meningiomas arise from one of the three layers of membranes, called meninges that provide a protective cover for the brain and spinal cord. As the most common central nervous system tumor, meningiomas make up about 37 percent of primary brain tumors. Most are benign — less than two percent turn malignant. While they tend to grow slowly, meningiomas can cause serious problems, including compression of the brain and spinal cord. The incidence of meningiomas increases with age and is more common in females.
Symptoms can vary and many patients are asymptomatic. Overtime as the tumor grows, symptoms can initially be subtle. Young’s seizure had been a helpful alarm bell. “It brought his tumor to our attention,” says Dr. Shen.
A Challenging Tumor Site
Dr. Shen took special note of the location of Young’s meningioma. The large tumor originated along the meninges adjacent to the sagital sinus near the middle of the skull. The sagital sinus is a large vein that drains a significant amount of blood from the brain. Damage to this structure can lead to substantial bleeding, resulting in death or stroke. “That brought more complexity to any potential surgery,” says Dr. Shen.
The news took Young off guard. “When someone first says ‘brain tumor’ to you,” he says, “it sounds like a death sentence.”
He listened carefully as Dr. Shen outlined the options: one, monitor his tumor with MRI scans every few months, or two, perform surgery. The second option carried certain risks, including weakness or partial paralysis. Young was 78 and he had hypertension and a rapid heart rate controlled by a pacemaker.
Young wanted the surgery as soon as possible. “I had confidence in my health and my doctor,” he says.
Young is, by nature, decisive. Born in Colorado, Young moved often as a child, attending 26 schools before law school because his father was a mining engineer. The travels had given Young resilience and resourcefulness. So did his career choice.
After graduating from the Gould School of Law at the University of Southern California, Young began working as a Deputy District Attorney in Los Angeles County. He remained in the District Attorney’s office for 30 years, with a brief stint to sample private practice, before returning to public service. When he retired, the Youngs moved to Klamath Falls, Oregon. Missing the sunshine state, they adopted the snowbird life, first in Port Hueneme, then Sun City, Palm Desert.
Prior to brain surgery, Young saw a cardiologist to assess his heart health. Once approved for the procedure, he checked into Eisenhower Health on May 17, ready to go.
Management options for meningiomas include observation or radiographic monitoring, radiation therapy or surgery. Surgery remains the go-to treatment for most meningiomas, though some respond well to radiation.
“Our team in the Eisenhower Neuroscience Institute works closely with our colleagues in radiology, as well as medical and radiation oncology, to provide a multidisciplinary approach to make sure each patient gets the best, most appropriate care,” says Dr. Shen. “Soon after surgery, we bring our rehabilitation team to assist the patient in their physical recovery.”
The Successful Surgery
A sophisticated computer navigational system — a kind of GPS for the body — enabled Dr. Shen to view Young’s brain in 3D and avoid the large venous drainage system. The tumor was irregular in shape, requiring microdissection techniques and exacting movements, but in under five hours, the surgery was done. When he woke, Young got the good news: his tumor was definitely benign and a gross total resection had been achieved.
Initially, Young had a few speech problems, but those quickly cleared up. He worried he might lose the Spanish vocabulary he had learned, but that was still there, “along with the Latin lessons I had in high school,” he reports. On day three post-surgery, Young went home. He feels great. He hasn’t had any seizures and needs no follow-up except for checkups every six months.
He was impressed with the care from the entire medical team. “Everyone was so patient and kind,” Young says. “It’s the nicest hospital I’ve ever been in.”
Or as Judy Young tells her husband about Eisenhower Health, “We were meant to be here in the desert when you got sick, so we could come here.”
“I was pleased to have been a part of Thad’s surgical team during this period of his life,” says Dr. Shen. “I wish him and his wife many more years of enjoyment and meaningful time with their friends and family. Benediximus vobis salutem — I wish you good health.”
To contact Eisenhower Neuroscience Institute, call 760.837.2020, or visit EisenhowerHealth.org/Neuro.