Newswise — LOS ANGELES (Nov. 9, 2011) – It must have been nearly 15 years ago that James Babiak’s wife, Beverly, saw neurosurgeon Keith Black, MD, interviewed on the evening news and nonchalantly said, “Boy, if I ever need brain surgery, that’s the man I’m going to.”
She’s fine. No surgery needed. But in the first week of February 2010, doctors detected a colloid cyst deep inside James’ brain, and when the neurologist asked the Lancaster couple if they had a preferred neurosurgeon, they did. They made a Feb. 8 appointment at Cedars-Sinai Medical Center, where, 10 days later, Black surgically removed the growth.
Babiak, who celebrates his 57th birthday on Oct. 27, had gone to an ear, nose and throat specialist because his ears were ringing; the doctor ordered MRIs. The scans gave no clues to the cause of Babiak’s tinnitus – possibly caused by years of working near loud equipment – but, by coincidence, showed a cyst growing in a reservoir holding cerebrospinal fluid that constantly circulates and bathes the brain.
The news that he had a cyst in his brain was shocking to Babiak because he felt fine, and he was still shaken as the couple of 24 years drove the 55 miles to Los Angeles for the initial consultation with Black, who confirmed the diagnosis.
“He showed me the MRI, explained exactly where the cyst was, and said, ‘OK, we have two options. We can watch and wait and see if it grows over the years, or we can remove it.’ So I was thinking, ‘Maybe I’ll just watch and wait and see what happens,’” says Babiak, who begins to chuckle in the retelling. “Then he had to throw in the part that some people who are asymptomatic have been known to just fall over dead. That made my choice for me right then and there. I said, ‘I’d like you to remove that.’”
Colloid cysts almost always occur in the cavity called the third ventricle. Babiak’s cyst was found near small ducts at the base of the ventricle – a location that’s dangerous because if the fluid’s flow is blocked pressure can rapidly build in the brain.
“The most common symptom of a colloid cyst is intermittent, sudden headaches that may change with head position. The headaches may be associated with memory lapses and behavioral issues, but it is very common for patients to have no symptoms at all. The growths are not cancerous but because they can block the flow of cerebrospinal fluid with catastrophic effects, surgical removal is usually recommended,” says Black, chairman of the Department of Neurosurgery at Cedars-Sinai, adding that there are several possible surgical approaches.
“Some neurosurgeons suggest an endoscopic procedure that is considered quicker and less invasive than an open procedure, but it has drawbacks,” he notes. “For one thing, the endoscope offers only a limited view, and the tools provide restricted maneuverability. There’s a risk that in ‘tugging’ on the cyst to remove it, a piece may break off and be difficult to find, so in most cases, we prefer an open procedure, using an operating microscope that gives us the ability to see and do more. The two halves of the brain are connected by a band of white fibers called the corpus callosum. In the front part, the fibers are basically unnecessary, so we go down through this band of fibers and very little normal brain to drop right down on top of the cyst.”
When Babiak arrived for surgery the morning of Feb. 18, he remembers going into pre-op, putting on a hospital gown and lying back in bed – then waking up in the recovery room. In the interim, Black had removed a rectangular window of bone across the top of his skull, slipped surgical instruments down into his brain and taken out the cyst.
“Recovery was fantastic. I was totally astonished,” says Babiak. “I never had any pain, and I believe the relief of the anxiety had a lot to do with my feeling, too. I was feeling super – really, really good that it was over with.”
Again, a laugh creeps into Babiak’s voice as he describes his surprising absence of pain.
“I had requested my medical records and I was checking my pain assessment on them and I saw all the zeros on a scale of zero to 10. Every time they asked me, it was a zero. At one time, there was a one on there, but I distinctly remember the nurse saying, ‘I have to put something down. You’ve got to feel something up there.’ And I said, ‘OK, put down a one.’”
Surgery was on a Thursday, Babiak returned home on Saturday, and he never needed to take anything for pain.
Babiak, who retired as a grocery warehouse manager in 2007, says he has experienced short-term memory loss, which Black had warned might occur, but it is very slight: “It may be like wandering out to the garage to get a tool, and when I get out there, say, ‘What am I looking for?’ I don’t know if I should attribute it to the surgery or to my age and just normal memory loss.”
In retirement, he enjoys tackling household projects that used to be chores.
“I tinker around the yard. Now that I’m retired, I can work on projects and apply myself to them instead of just going out to paint the fence to get it done. I can take my time now on all these little projects that have been piling up through the years,” he says.
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