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Dr. Mark
Dr. Mark, Neurologist (MD)
Category: Neurology
Satisfied Customers: 11946
Experience:  Neurosurgeon - Brain, spine, and peripheral nerve surgery
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Due to unknown swelling reason in left frontal lobe they

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due to unknown swelling reason in left frontal lobe they would like to preform a biopsy, i assume requires a cranial opening? I prefer to take some medicines for a short period of time to see if it clears up without that?
Submitted: 6 years ago.
Category: Neurology
Expert:  Dr. Mark replied 6 years ago.

If they are going to perform a biopsy, usually this can be done through a small incision and small hole drilled in the skull.

The incision will probably be between 1-2 inches long, over the left front part of the head.

If they see some swelling -- there is generally some issue within the brain causing this swelling. If the MRI shows some kind of "lesion" or "mass" in the area, they will want to get a biopsy so they know how best to treat this.
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Customer: replied 6 years ago.
Since the swelling shown in leftfrontal lobe has been abated, could medicine be tried first to see if thats all it would be require. I am taking Levetitcetam 250 mg 2x a day and Dexamethasone 4 mg 2x a day, I am under the impresion never are good for long term. In your opinion should i try it for a week or so and see if this cures the swelling? I had skin cancer and 37 treatments of radiation onver the same area for skin cancer 4 years ago if this could be a factor. Trying to make the best discision i can. charlie
Expert:  Dr. Mark replied 6 years ago.
Well -- the whole question is what caused the swelling.

The dexamethasone you are taking is what helped with the swelling -- and you can't take that medication forever.

It is certainly plausible to watch and wait -- but I would not watch too long, since if this is something concerning -- such as a potential tumor or cancer -- I would want to get a diagnosis quickly.

Please understand that I have no idea what your scan actually looks like, so it's impossible for me to recommend anything to you, but with a person with swelling of unknown origin on a MRI with a concern for potential tumor -- I would biopsy it relatively quickly.
Customer: replied 5 years ago.

Well Dr. Mark, I did have the cranial opening and biopsy in Mar. 8th. They removed a small amount of begnin dead? tissure and closed it all up. Surgery went well and finished taking the meds for a few weeks.

Things (memory) are better than has been in a few years.

Now I am having a small decline and maybe a little aphasia as i get tired late in the day or under stress. Is that possible? what does it sound like? I have not been back to the Doctor yet.

Expert:  Dr. Mark replied 5 years ago.

Thanks for the update.

It's tough to say what your "new symptoms" are, because you suggest that you seem to feel otherwise normal at other times during the day. If you had a tumor or swelling in the brain -- it would not generally vary like this over the would have constant symptoms. It may simply be that you are tired, or perhaps something medically related like anemia, or other vitamin deficiencies, or any number of a hundred things. If it continues, you might want to stop in with your primary care doctor for a checkup.

Customer: replied 5 years ago.
Hi again, my primary doctor seems to find everything physicallly normal, blood tests etc. I take the vitamins requested and more. I hate to get another MRI so soon, I guess the best corse is to keep close watch and would the next step be a neurologist, ?
Expert:  Dr. Mark replied 5 years ago.
keep a close eye on yourself, and if you and your doctor agree that there is something worsening, then a repeat MRI may be helpful. If that MRI were to show something abnormal, or you continue to get worse despite a normal MRI, then a neurologist would be helpful.

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