Recovery from mild brain injury is a process

My dear readers,
This may help you and your loved ones to cope with any post treatment effects of brain surgery or brain radiation. I copied and adapted it from the websites I listed below


As a person recovers from their meningioma treatment, the brain cells re-establish the precise balance needed to ensure effective information processing, but this may mean some compensations or adjustments to the neural cell’s original alignments. Neural cells must compensate or adjust to the prior tumor compression, decompression or treatment injury. Some times after large brain tumor removal any task may take longer and memory may not be as complete until all the neural networks realign themselves with time, practice, patience and constant repetition. Mild aphasia or "word finding" problems is common too.

For example, when a person sprains or fractures an ankle, professionals recommend cold/heat treatments, rest and supports (i.e., cast, brace) and specific exercises to help the ankle adjust to the injury and recover maximal function. Depending on the severity of the ankle injury (i.e., sprain, fracture) and what is required after recovery (i.e., long distance running, ballet), the injury to the ankle can disrupt a person’s life.

Obviously, a human brain is much more complicated than an ankle. Yet, similarly, rest, supports (i.e., compensations, modifications) and “exercises” (i.e., cognitive therapies, educational tools) for the brain may be recommended to rehabilitate and restore useful function and memory. Depending on the severity of the injury and what the person needs to do and wants to do (i.e., care for a family, return to work or school, manage a large company), a mild brain injury can disrupt a person’s lifestyle for a short period of time or even longer.

Diagnosis of Mild Brain Injury

Due to the diffuse and subtle nature of mild brain injury, it is common for typical neuroimaging (CT scan or MRI’s) to show no evidence of injury. The damage to the brain is a real injury. The limitation of these brain imaging technologies is they often cannot detect mild brain injury. Mild brain injury can often damage the "white matter" of the brain. "White matter" consists of the axons of neurons (connections) in the brain. This is much harder to capture or visualize using common types of brain imaging.

There are newer, more sophisticated imaging technologies that show promise in more effectively capturing the damage that occurs in a mild brain injury. However these imaging technologies are currently much more expensive, and are not as readily available. Some of the newer imaging techniques include:

Positron Emission Tomography (PET)
Single Photon Emission Computerized Tomography (SPECT)
Functional Magnetic Resonance Imaging (fMRI)
Diffuse Tensor Imaging (DTI)



Neuropsychological assessment is typically used to assess the functional impact of a mild brain injury or brain tumor. It may also be done while the meningioma patient is on "watch and wait" as part of an active surveilance monitoring plan . This assessment is normally done when some type of brain dysfunction is suspected. A mild brain injury is often initially diagnosed by evaluation of the symptoms a person reports after sustaining a brain injury or after treatment.

The assessment is comprised of a wide range of tests that objectively measure specific brain functions. Testing includes a variety of different methods for evaluating areas like attention span, orientation, memory, concentration, language (receptive and expressive), new learning, mathematical reasoning, spatial perception, abstract and organizational thinking, problem solving, social judgment, motor abilities, sensory awareness and emotional characteristics and general psychological adjustment. The neuropsychological evaluation can be used as a starting point for a plan of rehabilitation. It can assist brain injury professionals in identifying specific cognitive areas that have been damaged, as well as those areas still intact. You can read more about neuropsychological evaluations and brain injury from the American Psychological Association.

What can I do if I have a mild brain injury?

Understanding the changes that have occurred from a brain injury is an important part of the recovery process. This makes education and awareness crucial for both the person with a brain injury as well as family and friends. The person with an injury and others need to understand that a “mild” brain injury can result in changes in thinking and memory that can affect a person’s ability to return to their former life. While a person can “look fine,” brain injury is an invisible injury.

Research has shown that education and information about the possible consequences can be helpful to the person with an injury and their family members. Some basic symptoms for family and friends to be aware of include:

Early Symptoms:
•Headache
•Dizziness or vertigo
•Lack of awareness of surroundings
•Nausea with or without memory dysfunction
•Vomiting

Later Symptoms:
•Persistent low grade headache
•Lightheadedness
•Poor attention and concentration
•Excessiveness or easy fatigue
•Intolerance of bright light or difficulty focusing vision
•Intolerance of loud noises
•Ringing in the ears
•Anxiety and depressed mood
•Irrability and low frustration tolerance

If you suspect you have a mild brain injury, contact a brain injury professional to help with the diagnosis and treatment of a brain injury. Also contact the Brain Injury Association in your state. State Brain Injury Associations and brain tumor organizations will have information to share and can connect you with support groups, programs and professionals who understand the injury.

Mild Brain Injury Issues

Some important information to share, from families and people who have sustained a mild brain injury:

The recovery from a mild injury is not always quick.
For mild brain injury, the issues are the same as moderate to severe brain injury. While there are general guidelines for recovery, there can be wide individual variations in the timeframe for recovery. It can take several weeks, or several months for symptoms to fully resolve.

Recovery is often uneven.
There will be “good days” and “bad days.” This is normal in recovering from a brain injury. An important thing to keep in mind: on the “good days”, people want to get as much done as they can. Often, this can lead to overdoing it, which can bring back symptoms that were previously gone. Even on the good days, it is important to give yourself more time to complete tasks, and to listen to your body. You cannot “tough out” a brain injury.

Create the best possible environment for recovery.
Substances like caffeine, alcohol and nicotine can affect a person with a brain injury much more than it did before the injury. Be aware of the possible consequences of alcohol on recovery post injury. It is recommended to abstain from alcohol consumption during the recovery period. You can read more about alcohol use and recovery from a brain injury at the Ohio Valley Center for Brain Injury Prevention and Rehabilitation.

Give yourself more time to complete things.
Issues like fatigue, attention and memory issues can cause delays in completing tasks that were easily done before the injury. Allowing additional time to do things like laundry, menu planning, shopping, bill paying can help. Thinking out the steps needed to complete tasks and writing them down can be helpful too. Better planning can decrease stress and anxiety.

Professional help is important.
It is important to understand the effects of a brain injury. The injury itself can impair the ability of a person to accurately assess their abilities. And once problems are identified, often a person with a mild brain injury struggles with figuring out effective strategies to compensate for problem areas. Working with a trained brain injury professional can help identify specific problem areas, and can help implement effective strategies. You do not need to figure out brain injury all on your own. There are useful books and many resources available.

Support groups can be helpful.
Brain injury or an illness like a brain tumor can be isolating. People say things like “you look fine,” with the implication that you should be fine. It is an invisible injury. Sometimes talking with others who have experienced similar experiences can help a person with a brain injury understand they are not the only one dealing with these issues. Contact the Brain Injury Association in your state and brain tumor organizations to find out about support groups or other resources that may be useful to you.

Mild Brain Injury and Concussion

It is important to understand that a concussion is a physical injury to the brain that causes a disruption of normal functioning just like any other physical injury disrupts your normal functioning. For example, some ankle injuries (i.e., sprains and fractures) are more disruptive than others, just as some brain injuries are more disruptive than others. The better we understand any injury, the better our chances are for a speedier and healthier recovery.

There is some confusion as to the definition of a concussion and the definition of a mild traumatic brain injury (mTBI). Brain injury can be viewed along a continuum that incorporates concussion, mild brain injury, moderate brain injury and severe brain injury. Each type of brain injury varies depending upon: (1) whether the person was unconscious; (2) how long he/she was unconscious; (3) the length of their amnesia; (4) the resulting cognitive, behavioral and physical problems; and (5) the recovery process.

The definition for a concussion and a mTBI tend to overlap and brain surgery and brain radiation therapy can have mild and/or serious long term effects.

To further clarify, a concussion is defined as a trauma (i.e., a blow to the head or a serious whiplash) that induces an alteration in mental status (physical or cognitive abilities) that may or may not involve a loss of consciousness. Concussion as detailed by guidelines developed by the American Academy of Neurology (AAN) and the Brain Injury Association (BIA), commonly is divided into three different types.

Grade 1 Concussion
•Person is confused but remains conscious
•SIGNS: Temporarily confused, dazed, unable to think clearly, has trouble following directions
•TIME: Symptoms clear within 15 minutes

Grade 2 Concussion
•Person remains conscious, but develops amnesia
•SIGNS: Similar to Grade 1
•TIME: Symptoms last more than 15 minutes

Grade 3 Concussion
•Person loses consciousness
•SIGNS: Noticeable disruption of brain function exhibited in physical, cognitive and behavioral ways.
•TIME: Unconsciousness for seconds or minutes

If concussion and mTBI are seen as part of the brain injury continuum, with Grade 3 concussion and mTBI overlapping, one can get a better understanding of how these definitions compliment each other and enhance our understanding. The Brain Injury Association estimates that approximately 75% of all brain injuries fall in the “concussion-mTBI continuum.”

For the majority of people who sustain a concussion or have brain surgery, a full recovery is possible with appropriate diagnosis and management.

The CDC has information available about concussion management and safe return to play guidelines. Additionally, the Brain Injury Association supports legislation like "Zach’s Law," enacted in Washington State, that requires any school athlete to obtain medical clearance to safely return to play following a concussion. Information about this legislation is available from your state Brain Injury Association.

Additional Resources

CDC Concussion Booklet
Road to Rehabilitation Series Part 3 - Concussion and Memory
Road to Rehabilitation Series Part 8 - Concussion and Mild Brain Injury
TBI Guide, an online book about brain injury and recovery written by a neuropsychologist.

There are several books available in the Brain Injury Association Marketplace:

Brain Injury Survival Kit
In Search of Wings
Remind Me Why I'm Here
Brainlash: Maximize Your Recovery from Mild Brain Injury
Brain on a String
Shaken but not Stirred

My Sources:

Road to Rehabilitation Series, Part 8 - Concussion and Mild Brain Injury, Brain Injury Association of America, 2006.
Brain Injury Medicine: Principles and Practice, Nathan D. Zasler, MD, Editor, Douglas I Katz, MD, Editor, Ross D. Zafonte, DO, Editor, 2007, Demos Medical Publishing.
Mild Traumatic Brain Injury: A Therapy and Resource Manual Green, B, Singular Publishing, 1997
Textbook of Traumatic Brain Injury Jonathan M. Silver (Editor), Stuart C. Yudofsky (Editor), Thomas W. McAllister (Editor), 2004 American Psychiatric Press
Horn, L.J. & Zasler, N. (1996). Medical Rehabilitation of Traumatic Brain Injury. Hanley & Belfus, Inc: Philadelphia, PA.
Kay, T. Brain Injury Association of America. Mild traumatic brain injury, 1999.


GBYAY Anne McGinnis Breen
See my ponytail bouncing and my smiley face winking at you? &;>)
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Keep your faith, cherish your reason, treasure your mind and hold to your own good purpose...be not afraid!

Proptosis- bulging eyeball symptom of meningioma, etc in Grand Rounds presentation 2010

My Dear Meningimates around the world,

Meningiomas are an international medical issue, not limited to the United States, many of my blog readers are from other countries. I wish I could help get our world leaders more focused on providing better medical health care options for everyone with brain tumors.

I came across this link last month and I was completely fascinated by meningioma case details of this woman and other possible causes and diagnoses on page 61 explained by this ENT (eye/nose/throat) doctor in his grand rounds presentation on proptosis. Learning more from the MRI pictures and the wealth of English/Latin mix of vocabulary medical terms using "google search" might be an interesting computer brain retraining exercise. Its so important to keep learning something brand new to stimulate our brain and sharpen our mental abilities. I had to start by taking a typing course and a computer course in order to go back to work.

A small remainder of my lower left temporal lobe sphenoid wing meningioma regrew after two major craniotomies eventually causing the gradual protrusion of my left eye and pinched optic nerve in the bony optic nerve canal about 10 years ago. Over the past twenty-seven years (1st sx 1986 and 2nd sx 2000) I had a large ovid mass 5 cm of soft fibrous spindle cell tissue completely removed, during second look surgery some bony involvement (hyperostosis) was scraped away from the bony canal around the optic nerve and some thin sheeting of en plaque meningioma was removed from behind my left eye socket. I have taken Mifepristone for a combined total of 11 years to successfully block meningioma regrowth. It is commonly available in China for this purpose as you can read in this report, but sadly not yet in the USA. I was not surprised to read his expert opinion about radiation risks for meningioma tumor progression after further radiation exposure either. One of my dear friends has the pseudotumor diagnosis, and there are many other types of eye proptosis from cranial trauma and developmental facial deformities described in this report. The Tan Tock Seng Hospital centrally located in Singapore where Dr David Law presented this in 2010 is well known for accident and emergency medical care in China.


Please feel free to pass the medical presentation link below on to others online who may want to learn more. 79 pages might be more than you ever want to know, so print a few of the more important or interesting pages ( like the proptosis chart on page 61) or pass the entire link below to your current ENT doctor or NS doctors. Promoting international medical cooperation among doctors in other countries can help all people. Health care options ought to be a global and national security priority in every country.



http://www.teigrandround.com.sg/images/gallery/1273824062_20100415%20DavidLaw%20OCULO.pdf



GBYAY Anne McGinnis Breen

Limit and Count the lifetime number of your CAT scans and dental xrays

My dear Meningimates and our beloved significant others,

YOU may remember my frequently shared anecdotal personal medical history about having multiple full mouth dental xrays by three different dentists as a child before I was 19 for regular pediatric dental care, for three years of braces and two broken front teeth in high school and for removal of all my wisdom teeth. Twenty years later in 1986 I was diagnosed with a large lower wing of the left temporal lobe 5 cm grade 2 meningioma primary brain tumor.


I believe am still alive, adjusted to my "new normal" and doing well because I frequently decided to postpone additional highly recommended brain radiation therapy early in my brain tumor journey several times in 1992, 2000, and 2004 and participated in a 1992 NCI SWOG 9005 clinical trial of a safe effective investigational study of an old generic drug Mifepristone instead . Please take this informative report to your medical doctor and limit your future cumulative radiation exposures from Cat scans by asking your doctor to please use MRI scans whenever possible.


Finally forty years later in 2012 you can believe what I suspected and told anyone who would listen to a brain tumor lady since 1992. LOL


Now please believe this recent report by Dr. Elizabeth Claus and a team of well known respected meningioma researchers.


http://thegazette.com/2012/04/05/study-frequent-dental-x-rays-linked-to-most-common-brain-tumor/

Today I believe a major risk factor for cancer is multiple Cat scans, please be careful to limit the life time number of CAT scans, especially for your children or if someone has epilepsy or serious head injury or any condition that is monitored by cat scans. Please see if you can switch to MRIs.
http://www.huffingtonpost.com/leo-galland-md/radiation-risks_b_843282.html


GBYAY Anne McGinnis Breen
See my ponytail bouncing and my smiley face winking at you? &;>)

Please scroll all the way down to my first two blog entries for my list of 28 questions to ask your medical team about brain tumor treatments originally composed in 1997 plus my personal meningioma alternative drug therapy RU486 Mifepristone and my blog comments about the obsolete 1990s EPA radiation risk calculations for women and children are found at http://gbyay.blogspot.com
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Keep you faith, cherish your reason, treasure your mind and hold to your own good purpose...be not afraid!

Towards a Global Ethic in 1993 :an Initial Declaration by Dr Hans Kung and others

Towards a Global Ethic: An Initial Declaration is an interfaith community declaration, drafted initially by Dr. Hans Küng, in cooperation with the Council for a Parliament of the World's Religions staff and Trustees and experts. Drawing on many of the world's religious and spiritual traditions, the community declaration identifies four essential human affirmations as shared principles essential to a fair global ethic.

Commitment to a culture of non-violence and respect for life
Commitment to a culture of solidarity and a just economic order
Commitment to a culture of tolerance and a life of truthfulness
Commitment to a culture of equal rights and partnership between men and women
This Declaration was signed at the Parliament of the World's Religions gathering in 1993 by more than 200 leaders from 40+ different faith traditions and spiritual communities. Since 1993 it has been signed by thousands more leaders and individuals around the world. As such, it offers common ground for people to agree and to cooperate for the good of all humankind and the sustainability of our planet.
Because of unequal geographic population growth and international economic inequalities I would add another commitment to a civic priority to serve and respect the human rights of the most vulnerable populations living among us around the globe. Especially financial aid and community support for refugees and survivors of natural disasters, to provide clean water, eliminate extreme poverty, educate the poor, care for the sick, and protect people marginalized and/or discriminated against by established societies and megacorporate international interests. I thought we were making real progress until the problems with human rights violations started after 9/11 because our economic priorties shifted. The pre emptive military strikes loudly condemned by both Catholic Popes and practically ignored by our American Bishops were carried out by American leaders bombing in 4 soverign countries. They have wasted our tax money on massive death and destruction, human rights violations and environmental damage to our fragile planet's sustainabilty than at any other time since the Vietnam war. We want more affordable health care, not more warfare or destruction of our earth's natural resources and raw materials.

Welcome to my blog I'm trying to update again, by learning how to use google chrome as my new dashboard

I'm so glad you found my blog, welcome to all, especially our dear new readers and my old bt friends, both caregivers and patients. (Anyone with a newly diagnosed or recurrent brain tumor after a radiologist doctor has read MRI or CT scans of the head is probably in shock right now) Sorry to be so blunt with you dear new bt readers... but we are all blown away at first and I became very depressed for a while when they told me it had returned in the same place six years later after a successful total resection the first time. Second look surgery is becoming more common especially for young people. GK (Gamma Knife)Cyberknife, Trilogy or any linac brain radiation therapy is not a real non-invasive option or cure in the usual sense of the word, except in the medical business marketing departments of a new GK unit for profit facilities before they treat you. Radiation therapy is basically pallative care for terminal conditions and some very aggressive brain tumors can come right back after either surgery or radiation. The smaller medical facilities that have recently invested in GK do want you to be their customer or patient client IMMEDIATELY, but they will not be able to help you if it comes back more aggressively in the unknown future.


Please get second opinions from a neurosurgeon, an endocrinologist and a skilled neuro oncology doctor before you are treated by anyone for a primary brain tumor. There is a new FDA approved drug therapy Korlym available now for primary brain tumors centrally located inside your brain, on or near the pituitary master gland and they are often called pituitary adenomas and can cause Cushings syndrome. Brain surgery to remove the tumor is generally the best method of care, then they can find out exactly which of 120 brain tumor types you have or do a needle biopsy and a neuropathology report of your original tumor tissue to design an individualized treatment plan for you to receive specific personalized medications instead of an established old standard of care for your follow up plan.

The exact size/type and tumor grade you have can not be reliably determined by MRI or CT Scans alone (they get it right about 80% of the time) and after brain radiation the original tumor type may never be recognized or known because of DNA changes after radiation treatment. Radiation destroys the original tumor histology. I think that's a fancy marketing way not to say radiation therapy can cause cancer later on in life. I do not say I have brain cancer out loud or even to myself... Based on my belief that where there is a will there is a way, I trust God's will to provide for my future safety, I'm sort of a bit more childlike and more emotional than normal sometimes... God knows and he must have planned it that way for some reason. Its not going be my way or the highway so much as God's will expressed in his own way. And I am certainly not in control or in charge of anything much beyond my own behavior anymore. Nor am I the first person to use mind over matter to help my brain heal itself.

Neurogenesis, the birth of new adult brain cells is a proven fact now. Its not just an overly optimistic neuroscientific theory anymore, like it was twenty years ago. Many adults can grow tiny brand new brain cells with appropriate cognitive retraining and structured motivational guidance to avoid depression or apathy in about 4 to 6 weeks developing good habit patterns using holistic cognitive, social and physical techniques. The human mind/body/spirit biochemical interconnections for self improvement and self control are also known biomedical facts now. Encouraging daily habitual practices and frequent mental and physical repetition, like walking exercise and music therapy are essential ingredients most bt patients need to add to their own persistence and determination to finish a task without becoming totally frustrated. Therapists and loved ones can encourage new learning by cueing and prompts starting with individual baby steps, breaking tasks down into smaller individual goals just like a toddler beginning to walk.

You may want and need to go to a major regional city medical center or excellent university hospital for brain tumor care. Some meningioma brain tumors which are usually low grade tumors are caused by cummulative radiation injury after short or long latency periods of many years. I hope I didn't really scare you when I sent the neuroscientists research report about longterm brain injury from prior radiation exposure. If it is very small, less than 1 or 2 cm or if they say it is inoperable they may recommend having GK radiation without having any needle biopsy or operating right away or watching it by MRI for three to six months or a year to see if it grows at all.

I advise active monitoring by MRI "watching and waiting" especially if you do not have any serious symptoms yet. Some people may have other serious health conditions which make surgery impossible, or it maybe located deep in the brain near the pituitary gland in a location that is too difficult for some cautious local neurosurgeon who mostly does back and spine surgery. To have the tumor removed completely you want to find the best facility that has a neurosurgery speciality team of doctors and trained staff specifically to remove brain tumors and intensive care post op. Not a nice popular local back and spine surgeon. Please check to find out if he removes at least fifty brain tumors totally each year so he has plenty of practice. A needle biopsy can be sure it is not a small more aggressive type of brain tumor that probably will reoccur in less than a year or two after either surgery or brain radiation anyway. However there is no way to be sure what type of tumor it was by pathology after radiation treatment scrambles the DNA if it comes back again in 5 to 10 years and you might need more surgery anyway. There maybe other longterm side effects from radiation necrosis or swelling called brain edema, and other drugs you may need for the rest of your life, if the master pituitary gland receives any scattered radiation injury from exposure to radiation hot spots, if it hits bone or is deflected by small bony surfaces inside the brain.

GK may seem like a sure quick fix right now, and you may still be fine in a few years, but the longterm survival results are not guaranteed to be any better than actual brain surgery, we have had meningioma patients online here before who have had recurrence or other new mulitple tumors discovered either after GK therapy or after surgery, I do hope some of them who are still online here with more than 5 or 10 years since their GK treatment or surgery will write back to you I do not mean to scare you, but I do suggest you get other independent second and/or third medical opinions from major brain tumor centers where the doctors treat hundreds of brain tumor patients each year of all types and grades with surgery first, so they know exactly what it is before they radiate your precious remaining brain cells, because any radation therapy has to go through healthy brain tissue to get to the tumor area. And some brain tumor patients need anti seizure drugs for the rest of their life or hormone supplements if their pituitary gland is damaged by radiation.

Please read my list of 28 questions to ask your medical team and discuss with your significant others, with each second opinion doctor visit you will learn more about your specific condition and possible drug treatment options for some without surgery or radiation therapy. Currently mifepristone is being made in other countries for birth control, like China and India where it is very popular and very cheap, here in the US the brand names Mifeprex, Corlux and now Korlyn, are very expensive and generally used for oral contraception and Cushing's disease after testing it for safety for more than ten years.

Please send for educational handbooks of brain tumor treatment from the major not-for-profit bt support organizations in Boston, NYC, Chicago and San Francisco, it only takes a few minutes to google, call or email all of them for free literature and then you and your family will have well organized printed material to plan together at your own pace and determine the best way for you to proceed in the beginning or if you have any recurrence like I did. I was able to get my own FDA approved investigational clinical trial after I volunteered for a NCI clinical trial meningioma drug therapy instead of either invasive standard method of care for a safe personalized anti-growth hormone drug therapy plan. I'm still fully alive, fully human and dancing and singing, reading and writing, walking and talking 27 years after my first surgical removal and I have postponed the standard tumor board recommended brain radiation therapy for twenty years and I had my gradual slow growing reccurence safely debulked 12 years ago. I have been on the drug Mifepristone for a total of ten years with no noticeable permanent side effects from the safe non toxic drug.

GBYAY Anne McGinnis Breen, a 26 year survivor of a grade 2 meningioma which has regrown a bit each time after two surgeries couldn't get every single bad tumor cell from behind my left eyeball, but it has not progressed to a higher grade tumor as some other patients tumors do, especially after any brain radiation therapy. See my ponytail bouncing and my smiley face winking at you? &;>)

Hope is a free gift I want everyone to have at each step of their journey in life.
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"Hope has two daughters--anger and courage: anger at the way things are and the courage to work to make things other than they are." -- Saint Augustine
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Keep your faith, cherish your reason, treasure your mind and hold to your own good purpose...be not afraid!

My old blogger profile I just saved before it was deleted

Anne McGinnis Breen My new primary care family doctor found a 5 cm in diameter, left temporal lobe tumor dx and sx 1986 at age 39, after I had been having sudden sharp sinus headaches, occasional fainting spells, TIA'S were moments of profound muscle weakness and I had very heavy asnd exhausting menstrual periods. I was working full time one year post op and continued to raise our three young children. Then upon documented tumor recurrence in 1992 after a total hysterectomy for uterine fibroids and endometriosis I chose a 1992 NCI SWOG 9005 Phase 3 clinical trial of Mifepristone for meningioma with Dr Steven Grunberg 1995-1999 (my tumor was stable for three years on the real drug after I flunked the placebo the first year) instead of the SW Tumor board recommended immediate second surgery and six weeks of IMRT brain radiation in 1992. I continued to teach and raise our 3 kids for eight more years until they were grown and then I finally agreed to my second craniotomy in 2000 at Barrows Neurological Institute in Phoenix, by Dr Robert Spetzler and his fine team where they safely debulked it. Since Feb 2005 I am on 200mg daily Mifepristone, brand name Mifeprex, again in my own FDA clinical trial to current and my July 2005 MRI compares well and my condition appears stable and unchanged to my most recent MRI in Nov 2011. Its hard to find a doctor to prescribe MIFEPREX Mifepristone for meningiomas, another brand name is Corlux and now a new brand name Korlym for Cushing’s disease symptoms has been FDA approved. BTW Dr. Harvey Cushing was the great neurosurgeon who named meningiomas for many tumors found anywhere around the brain in the three layers of meninges lining the brain and many of these low grade primary brain tumor types like acooustic neuromas and vestibular schwannoma seem to have a much higher incidence in female than male patients. Women have a 50% higher risk of abnormal cells or tumors from the same life time total low dose man made radiation exposures as REFERENCE MAN, but the EPA doesn't mention it much. My favorite links for new readers to brain tumor info and clinical trial information are Al Musella's site www.virtualtrials.com and www.abta.org

FDA approves Mifepristone for some Cushing's disease symptoms(new brand name Korlym)

Here is the link to http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm292462.htm Korlym, the new Corcept Inc brand name for Corlux and the old generic Mifepristone might also help anyone with diabetes suffering from a pituitary adenoma brain tumor or a primary brain tumor pressing on the pituitary gland which is the master gland. The FDA News report mentions the word en·dog·e·nous ( n-d j -n s). adj. 1. Produced or growing from within. 2. Originating or produced within an organism, tissue, or cell: Mifepristone or Korlym is now FDA approved for endogenous Cushing's disease. I highly recommend that my new dear meningimates (my own affectionate term for patients and caregivers) check out their own symptoms if they are badly overweight, frequently tired and out of breath and have high blood sugar levels compared to a list of Cushing's disease syndromes and get a doctors referral for a second opinion from an endocrinologist before they have either surgery or radiation therapy if possible, and if their brain tumor is or was centrally located near and/or causing internal pressure on their pituitary gland. Remember, I'm not a doctor or a nurse, just an experienced and informed brain tumor survivor. In fact, neuroendocrinology is a tough course of study, its an advanced medical specialty with these two major fields of medicine overlapping, so highly skilled neuro-endocrinologists who can dispense drug therapies are few and far between in the US today.