What an early day once again. Dad stayed home while I made the drive to the
neurologist to talk about the results from Dad’s spinal tap. I met with Dr Kenneth Reichert a neurosurgeon on the same team as the neurosurgeon who performed Mom's brain operation last November.
The results are in and he is positive for
hydrocephalus. Here is the official report for those of us who like to read medical bumbo-jumbo:
But what does this mean? Yes, there’s excessive spinal fluid on the brain and it is possible it is affecting his short term memory. Here is the breakdown form the doctor.
TECHNIQUE: 0.69 mCi of of indium 111 DTPA was intrathecally injected
followed by 30 minute imaging of the thoracolumbar spinal canal.
Subsequently, 4, 24, 48 and 72 hour anterior, posterior and lateral planar
imaging of the brain was performed.
FINDINGS: Initial 30 minute post
lumbar puncture images of the spinal canal
do not demonstrate any the
leak/extravasation of tracer. Four hour images
demonstrate physiological
tracer uptake within the basal cisterns, sylvian
and interhemispheric CSF
spaces; there is also prominent lateral ventricle
activity. 24 hour images
also demonstrate prominent lateral ventricle
activity, minimally decreased
from 4hrs. There is some physiological tracer
uptake tracking along the
cerebral convexities. 48 hour images demonstrate
further migration of CSF
along the cerebral convexities however there is
decreasing but persistent
tracer uptake within the lateral ventricles. 72
hour images do demonstrate
near resolution of activity within the lateral
ventricles with additional
tracer migration along the cerebral convexities.
However, there is no
significant sagittal sinus activity even at this time.
This delayed CSF
migration pattern with tracer reflux into the lateral
ventricles is
suspicious for communicating hydrocephalus.
IMPRESSION: There is delayed
CSF migration pattern with persistent tracer
reflux into the lateral
ventricles up to 48 hours, suspicious for
communicating hydrocephalus.
Day of spinal injection; typical; you see the dye in the brain and down the spinal cord. Nothing significant - as expected |
Four days later, should not being seeing signs of dye; still showing about 6.29 inches down the spinal cord and in the brain. |
But what does this mean? Yes, there’s excessive spinal fluid on the brain and it is possible it is affecting his short term memory. Here is the breakdown form the doctor.
Dr Kenneth Reichert Neurosurgeon |
Dad’s a candidate for surgery whereby they would place a
shunt in his brain. The procedure would
mean he would probably be between the hospital and rehab/nursing care for up to
two months while he recovers. Then he will require assistance at home for an
unspecified amount of time.
The surgery has a 70% chance of improving dad’s walking –
which isn’t really a concern right now.
The surgery has a 60% chance of correcting incontinence –
which Dad isn’t experiencing right now.
The surgery has a 40% chance of correcting short term memory
loss – of which Dad has a significant loss.
If we do nothing, Dad will decline and eventually require
nursing care.
If we do surgery there’s a 40% chance that he’ll be able to
eventually get back on his own. However,
he will require assisted living and other protocols in place to always monitor
how he’s doing. Dad will always be a
fall risk, too. With surgery, there’s a
60% chance he’ll require nursing care starting immediately and for the rest of
his life.
The odds are not exactly in his favor.
This Friday I will meet with the neuro-psychologist and find
out their take on Dad’s condition.
I spoke to Dad today about it for about an hour or so. The first thing he said was, “well tell the
Doctor I don’t hear any sloshing around and I’ll let him know when I do!” That’s my Dad – always quick to shrug things
off with a joke. But he realizes the
serious nature of this issue. He is
prepared for his life to change drastically IF he chooses the surgery. I told him we will make the decision as a
team. He told me he wouldn’t want it any
other way.
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