Dr. Leslie D. Cahan, MD

This is not a common side effect of that sort of surgery. I think it would be wise to call the surgeon and discuss with the surgeon directly

After brain surgery, there is certainly a risk of neurologic deficits occurring. While they not be common, they certainly happen. It depends on where in the brain the surgery was being done, the type of surgery, and in some cases complications (for example bleeding) that can occur hours after surgery. Speech impairment is one of the problems that can happen

The effects of anesthesia only last several hours after surgery usually. If there is persistent speech trouble after brain surgery, it is more likely due to the type of surgery and the location in the brain where the surgery was done.

Depression, anxiety and headaches can persist long after head injuries and can be difficult to treat. A neurologist or psychiatrist might be very helpful to you. Also consider the importance of sleep, exercise and friends and family support.

It's hard to answer for sure without knowing all the details, but a short answer would be it is likely that headaches, double vision are indeed related to the tumor and that surgery has a good chance of helping.

This is a complicated question and you really should speak at length with the doctors caring for your sister. It is easy to confuse coma with the term "brain dead." Coma means unresponsive to pain and other stimuli, but the patient still has some reflex activities, may breathe, and may react to pain (even though non purposeful). Brain dead, on the other hand, means no brain or brain stem activity--the pupils do not react to light, there is no response to a variety of stimuli. An EEG will show some residual electrical activity in a comatose patient, but in brain death, there is no electrical activity. Similarly, in brain death, tests show no circulation of blood to the brain. In the US, brain death is recognized as the equivalent of cardiac cessation death. Coma, on the other hand, is not the same. It sounds like what the doctors are proposing is that they stop supportive care (respirator, perhaps feeding, perhaps intravenous fluids, antibiotics and so on). This kind of discussion requires you understand what your sister's medical situation is. It is often helpful for some families if you include advisors, religious leaders or others whose opinions you value in making these decisions.

An MRI scan has no radiation. The other commonly done scan (a CT scan) does have radiation. Depending on the clinical reasons for the scan, doctors prefer MR scans for children precisely because they do not expose the child to radiation. On the other hand, because an MR scan can take a long time, children may need to be sedated to hold still for the MR scan

This can be a complicated subject because you haven't described a lot of detail about the tumor surgery. The short explanation is that there may be seizures developing because of the residual scarring/injury left by the tumor or because there is still tumor residual. Seizures after surgery can often be treated by medications -- in cases where medications fail, further surgery at an epilepsy center may be helpful, too.

This is a complicated topic. In general the first line treatment for recurrent seizures is medications. There are a large number of medications available and depending on patient's age, type of seizures and other considerations, a pediatric neurologist can help select which medication or medications will be appropriate. For some patients, however, seizures recur in spite of optimal medication. For some of these patients, surgery may be appropriate--again there are different types of surgery for epilepsy. The best advice would be to be seen by a pediatric neurologist with special interest in epilepsy and that center can more fully advise you.

As a general answer, most benign brain tumors are not treated with medications. However, there are exceptions--for example one type of pituitary tumor may be treated with medications. It really depends on type of tumor, location, etc. Besides surgery, some benign tumors are readily treated with a special form of radiation called radiosurgery. This is a non invasive treatment which does not require open surgery.

The answer to this question depends very much on the type of tumor, your brother's age and general health, and other factors. Not all tumors require surgery. Some can be treated, for example, with radio surgery (a kind of radiation treatment). Others can be observed and followed depending on many factors.

Your question is difficult to answer without actually seeing the study which showed the aneurysm. Your question doesn't say what study (MRI, angiogram, CT scan) was used and what it found. The best answer to give you is to have a meeting with the neurologist/neurosurgeon who obtained the test and to review what it found. This may be a completely innocuous finding, or it may be indicative of a more serious vascular malformation for which treatment might be recommended. It's not possible to give a complete answer without reviewing your history, physical exam and the imaging studies which showed the finding.

I'm assuming that what you mean by "back injury" is an injury to the lumbar (lower back) spine. In general, a lumbar spine injury could not cause neurologic problems with the hands or arms. It is possible for lumbar spine injuries to cause weakness, numbness in the legs and trouble walking. Such injuries may also cause trouble controlling bowel/bladder function.

The best way to proceed here would be first to see your doctor to obtain a full history and neurologic exam. If neurologic deficits are found (weakness, sensory loss, etc.), then imaging studies (CT/MR scans) might be appropriate.

But the simple answer to your question is a lumbar spine injury would not cause problems with the hands.

It is difficult to give a complete answer to the question, because I don't have details about the head measurement and so on. Often babies have large heads and this is not of any clinical significance--often large heads, for example run in families.
Sometimes, however, abnormally large heads can be indicative of serious problems such has hydrocephalus or other problems inside the skull. Since most pregnancies nowadays include fetal ultrasounds, I'm assuming that the doctors knew that the ultrasounds did not show any problems such as hydrocephalus inside the skull.

Signs that would be worrisome are: 1. If the head growth after birth is abnormally rapid (pediatricians routinely measure head size on well baby visits and chart them comparing to normal sizes. 2. If the fontanelle (soft spot on the top of the babies head) is bulging or tense. 3. If there are other neurologic signs such as excessive irritability, delayed development of normal milestones, seizures, crossed eyes.

Bottom line: It is likely that the head size is not of serious consequences, but a full discussion with your pediatrician is appropriate because of the concerns that sometimes a large head size (especially if the head growth is abnormally rapid) can indicate a serious problem which needs prompt attention.

No some brain tumors are benign and some are malignant (cancerous). Even benign brain tumors, however, may require treatment because they might continue to grow.
Often, the appearance on the MRI scan is highly suggestive of whether or not a tumor is benign or malignant, but in some cases, it is necessary to obtain a biopsy to be sure.

For some tumors, the appropriate next step is surgery to biopsy and remove it. For other cases, it may be appropriate to biopsy only. For other patients, radiosurgery (a form of radiation therapy) may be appropriate without surgery. Finally, in some patients, doctors recommend no treatment, but merely follow up scans from time to time.

All these decisions depend on details of what was found on the MRI scan and what the other medical issues are with the patient.

It is very difficult to answer this question because you gave so little information. Is the visual loss in one eye or both? How long has it been since the injury? In general, there are many reasons why vision may be impaired or lost after trauma--sometimes it's because of injury to the eye itself, sometimes injury to the optic nerve and sometimes because of brain injury. The prognosis (how likely it is to recover) depends on what was injured, the severity of the injury and how long a time has passed since the injury.

The answer to this question depends on many factors. A simple answer is that a disk herniation in the lumbar region in and of itself does NOT always require surgery. In some patients, the disk herniation is so large that nerves are compressed in such a way that the patient has significant weakness, sensory loss or even incontinence (trouble controlling bowel or bladder function) -- in these cases surgery is required on an urgent basis.

However, in most patients, the herniated disk may cause only pain (especially in the leg) -- if there is no weakness, or bowel/bladder incontinence, surgery can often be avoided and the pain treated with analgesics, exercise, weight loss and time.

Recovery from a serious head injury and craniotomy can take a long time. Trouble concentrating, trouble with temper, trouble learning are all quite common after a serious head injury whether or not surgery is done.

Chronic back pain is a very common problem. In the vast majority of cases, it does not lead to neurologic problems such as paralysis, sensory loss or loss of control of bowel/bladder functions. However, there are cases where back pain is a symptom of a problem which can lead to neurologic problems. While rare, they do happen. Often in cases of persistent back pain doctors pay special attention to so called "red flag" symptoms. These include things like fever, weight loss, numbness, weakness, trouble controlling bowel/bladder or changes in reflexes. When these symptoms are present, often an MR scan is done to be sure that there is not a problem which could lead to paralysis.
So short answer: unlikely that back pain alone causes paralysis, but things which cause back pain (like tumors/infections of the spine) can lead to neurologic problems. In terms of percentages, the vast majority of chronic back pain does not lead to paralysis, but on rare occasions neurologic damage can occur.

A coma is a prolonged state of unconsciousness. There are a number of causes of coma: head injury, drug or alcohol intoxications, stroke, tumors, infections and others. A patient in a coma does not respond to painful stimuli or light or sound and lacks a normal sleep-wake cycle.