Case study: Low-grade brainstem glioma

Technology improves ability to remove brainstem tumors, preserve brain function

160112-101Seventeen-year-old Courtney Coit of Riverton, Ill., was at school when she suddenly felt disoriented and dizzy. Her dad, Daniel, left work immediately to pick her up. He took her to a local hospital, where an MRI revealed a tumor nestled in her brainstem.

As the Coit family waited for results from the biopsy, fluid began to build in Courtney’s brain, affecting her ability to eat and speak. At one point, she even had a seizure.

“They told us it was non-malignant, but because it was in her brainstem, it was serious. The brainstem controls everything. Only Dr. (Frederick) Boop in Memphis could remove her tumor, doctors told us,” said Daniel.

The Coits were referred to Le Bonheur Children’s Hospital, where Pediatric Neurosurgeon Boop and his colleagues have developed a precise surgical approach to treating low-grade brainstem gliomas – a type of tumor notoriously difficult to remove.

“Many of these kids are not offered a resection at other institutions and either get put on chemo or radiation
or undergo multiple unnecessary surgeries,” said Paul Klimo, MD, chief of Pediatric Neurosurgery at Le Bonheur.

A combination of intraoperative monitoring with a 3-Tesla iMRI and tractography, which uses MR imaging to construct a three dimensional map of the brain’s white matter, allows Le Bonheur neurosurgeons to target the tumor’s precise location in the brain and map out a surgical resection that preserves vital brain function.

Courtney underwent surgery on June 1, and Boop, co-director of Le Bonheur’s Neuroscience Institute and chairman of the Department of Neurosurgery, was able to remove all of her tumor. She spent one week recovering at Le Bonheur before she was able to return home.

“She has partial paralysis on the right side of her face, and her vision is a little blurry, but with time and therapy, she should recover,” said Daniel. “Dr. Boop is an answered prayer. I’m so thankful there was someone who could do this operation.”