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Experienced Neurosurgeon Removes Challenging Brain Stem Meningioma

Susan Tyra

Susan Tyra had forgotten about the meningioma in her brain. Diagnosed when she was in her early 40s, the pea-sized benign tumor didn’t cause any symptoms for nearly two decades.

But when the Wheaton, IL, resident started experiencing daily headaches and dizzy spells a few years ago, she became concerned and saw her family physician. A CT scan revealed the meningioma had grown to a 5 cm oval. The consensus from family members and friends: go to a major medical center for treatment.

When Tyra and her husband, Rick Snyder, met with University of Chicago Medicine neurosurgeon Bakhtiar Yamini, MD, they were sure they had found the right physician.

Dr. Bakhtiar Yamini Bakhtiar Yamini, MD

“We knew it the minute he walked into the room,” Tyra said. “He ‘got’ that the diagnosis was shocking. He exuded confidence and empathy. He had a lot of training and did this type of surgery all of the time.”

The meningioma was pressing on Tyra’s brain stem, Yamini explained to the couple, and needed to be removed. “The tumor was not yet threatening Susan’s life, but it was likely still growing,” he said. “As it got bigger, symptoms would have progressed to weakness in the arms and legs, headaches and then coma.”

Yamini and his colleagues in the Brain Tumor Center at the University of Chicago Medicine have vast experience in the diagnosis and treatment of brain tumors, including all types of metastatic tumors as well as acoustic neuromas and meningiomas, the most common benign tumors.

“It was just a small price to pay for the miracle of being around for many more years.”

“For benign tumors less than 3 cm in diameter, we often do radiosurgery – a one-time, focused radiation dose to the tumor,” Yamini said. “But for larger ones, such as the meningioma in Susan’s brain, surgical intervention is usually the best option.”

The surgery took place three weeks later. After making an incision behind Tyra’s right ear, Yamini lifted the cerebellum. He meticulously removed the tumor, avoiding critical blood vessels, taking pressure off the brainstem and dissecting the cranial nerves that were wrapped around the lesion. Electrophysiologists monitored Tyra’s motor and sensory function throughout the operation.

During the eight-hour procedure, Yamini determined that a small amount of tumor, deep in the brain and attached to the cranial nerves, was too difficult to remove safely. Because it could be a source for recurrence, Tyra underwent six weeks of targeted radiation therapy to kill the remaining tumor cells.

Susan Tyra's brain scans before and after surgery
Pre-op image (left): A 5 cm oval mass compresses Tyra’s brainstem. Post-op image (right): Tyra’s brain scan after surgery. A small amount of residual tumor was destroyed with targeted radiation therapy.

After the surgery, Tyra experienced some drooping on the right side of her face, double vision and deafness on one side. But six months later, only the hearing loss remained. “Dr. Yamini told me before the operation that I could lose my hearing in the right ear, so I was expecting it,” she said. “It was just a small price to pay for the miracle of being around for many more years.”

Fall 2013 cover of Inspired magazine

This story originally ran in the Fall 2013 issue of Inspired, a quarterly magazine published by the University of Chicago Medicine.
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