Diagnosis
Recurrent brain astrocytoma. Status post-brain tumor surgery. Right-sided hemiparesis.
Patient:
Child, 11 years old, Kazakhstan
Physician:
Prof. Dr. med. Martin Scholz, Head of Neurosurgery Department, Sana Hospital Duisburg
Patient’s Complaints & Clinical History:
Following primary tumor surgery five years ago, my daughter developed right-sided hemiparesis. She remained free of seizures until recently, when focal motor seizures presenting as twitching in her right arm began. She was initially prescribed the anticonvulsant Depakine. Because twitching persisted, Epix (levetiracetam) was added to her regimen. Shortly thereafter, she began experiencing severe headaches accompanied by nausea and vomiting. She is currently hospitalized and feeling very weak due to repeated vomiting, with worsening weakness on her right side, particularly in her right arm. Her headaches have been controlled in the hospital.
Expert Opinion by Prof. Martin Scholz:
The child requires urgent neurosurgical intervention. The imaging confirms a recurrent tumor located in the frontoparietal region, presenting with a solid component in the cortical area. Additionally, a prominent cystic component is exerting significant mass effect and compression on adjacent brain structures.
If her clinical condition deteriorates further prior to transfer, a local cyst aspiration should be performed immediately at her current hospital. Urgent measures must be taken without delay. Furthermore, a repeat histopathological examination of the resected tissue is essential to accurately guide subsequent therapy, which may require adjuvant chemotherapy or radiation treatment.