Identifying and Treating Signs of a Brain Tumor


The diagnosis of a brain tumor is a life-changing event, but it no longer has to be life ending. Dr. Edie Zusman specializes in awake mapping craniotomy, a unique procedure that allows neurosurgeons to aggressively treat tumors, while monitoring a patient’s language, motor, and sensory functions during surgery to ensure safety for the critical parts of the brain.


How does your practice differ from other physicians?

Pacific Brain and Spine Medical Group is part of a truly collaborative East Bay neuroscience community, where patients are considered part of the team. Our multidisciplinary approach includes a breadth of specialties, including neuroradiologists, neuro-oncologists, neurologists, neurosurgeons and other specialists, providing us with a built-in second opinion when determining the optimal course of treatment for our patients.


How has brain tumor treatment changed in the past decade?

Awake mapping craniotomies are not new; what is new is the vast improvement to functional neural imaging and brain mapping. Neuro-navigation brings the MRI images directly into the OR, giving us a real-time, 3-D view of the brain during surgery. This technology enables precise control over the tips of our surgical instruments—within 1-2mm of accuracy—ensuring the maximum amount of tumor is removed safely for the best possible prognosis.

At the beginning of treatment, our patients undergo brain imaging and a functional MRI scan—among the highest quality in Northern California. This imaging data allows us to design a surgery strategy to aggressively treat a patient’s brain tumor, while preventing long term changes in mobility, cognitive function, speech, etc. It also empowers us to have thoughtful conversations with our patients and their families regarding expectations and outcomes.

We use intraoperative mapping technique for patients under traditional general anesthesia during brain tumor resections in regions near motor and sensory function. With awake mapping craniotomy, we can test the patient’s speech by showing them pictures, stimulating a specific brain location then asking them to name the object. If they’re unable to find the word, we know we’ve located a vital area of brain function. The key is—it’s the brain, and every cell is precious.


What are the typical concerns a patient has?

Patients want to know what to expect during—and after—their operation. How long will the surgery last, and how long their recovery will take? During an awake craniotomy, patients want to know if they will feel anything. Fortunately, the brain has no pain receptors, but we do sedate patients to alleviate anxiety during the procedure.

With any surgery, there are always associated risks. We educate our patients on the procedure, and devise a plan for rehabilitation. Every patient is different; however neurosurgical procedures are much more collaborative, safe, and effective than in the past.


What should someone do if a brain tumor is suspected?

Brain tumor symptoms are often similar to a stroke; however for tumors the symptoms may progress slowly over several days. We ask patients to call their primary physician if they experience progressive headaches, unexplained nausea and vomiting, or balance problems, difficulty with speech or moving one side of their body, new or worsening epileptic seizures, or vision problems. If someone is experiencing these symptoms, seek treatment.


What are some common misconceptions about brain tumors?

The notion that a nonmalignant tumor does not require surgery or other treatment is a myth. Based on location, such as the brainstem, or an inaccessible location, a nonmalignant tumor can be as serious as a malignant one.


Pacific Brain & Spine Medical Group, Inc.
80 Grand Ave., Ste. 300, Oakland, 510-886-3138
20055 Lake Chabot Rd., Ste. 110, Castro Valley, 510-886-3138
1320 El Capitan Dr., Ste. 300, Danville, 925-884-2360

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