Media Contact: Sandra VanE-mail: [email protected]Telephone: 1-800-396-1002
Because 6-year-old Isabella Gutierrez had been sick, mom Deanna Fuller was not too concerned when her daughter complained of occasional headaches or vomited some mornings last December.
But when the symptoms became more frequent instead of less, Deanna took Isabella to the pediatrician. Not wanting to jump to more serious conclusions right away, the doctor's first suspects were migraine headaches and the prescription for Isabella's glasses.
Isabella spent Christmas weekend with her father, Sebastian Gutierrez, who is divorced from Deanna. "He reported back to me that she was still having the headaches and they were getting to the point where she was just lying in bed," says Deanna. "She couldn't move, and she would wake up in the middle of the night and vomit."
On Christmas morning, Isabella woke up, vomited, looked at her presents, and went back to bed.
Deanna placed an emergency call to Isabella's ophthalmologist, who was in Hawaii. When they made contact and the ophthalmologist heard Isabella's symptoms, she said, "Get her to a neurologist right away. It's not her glasses."
Because Deanna didn't know of a neurologist, she called the pediatrician, who said diagnostic images would be the first step in any case, and she scheduled Isabella for an MRI on Dec. 27. The first test led to more, and the technicians suggested Deanna take a break while they continued.
She went home and called Sebastian to keep him updated. "About an hour later, I got a call from the pediatrician, saying, 'Your daughter has a cancerous brain tumor, and I'm going to give you some numbers to call.' I burst into tears. In my generation, a brain tumor means 'you're dead,'" Deanna recalls.
After Deanna and a friend made a flurry of calls to find the best neurosurgeons, they contacted Cedars-Sinai's Maxine Dunitz Neurosurgical Institute and were connected to the office of Moise Danielpour, M.D. Although Dr. Danielpour, director of pediatric neurosurgery at the Institute, was scheduled to leave for vacation in two days, an evaluation was scheduled for the next day.
When Dr. Danielpour met the family the following morning, he noted Isabella's rapid decline. She had quickly gone from occasional vomiting to being unable to walk. Although he did not want to alarm her parents unnecessarily, he was concerned that the tumor -- located at the back of the brain, on top of the brain stem -- might be an aggressive type. If it were to wrap around the spinal cord, complete surgical removal would be nearly impossible and the prognosis would be dismal.
"We had to agree to let her go and be operated on by a man we had just met," recalls Deanna. "It's a very strange sort of thing: 'Hi, nice to meet you. Here's our daughter. We hope you can save her life.' This was all within less than a 24-hour period. We found out Wednesday afternoon that she had a brain tumor; Thursday morning, she was in surgery. They rushed her into surgery, and we sat for seven hours praying that she would come out alive."
Dr. Danielpour and the surgical team found a pilocytic astrocytoma, a low-grade tumor that can occur in adults but is much more common in children. When completely resected, they rarely come back.
When Dr. Danielpour returned to the waiting room after the operation, the first thing Deanna noticed was his facial expression. "His face was beaming," she remembers. "He said, 'The tumor was a lot bigger than I expected, and I think I got it all.' We were elated."
Isabella stayed in pediatric intensive care for two days. A follow-up MRI confirmed that the tumor had been completely removed. Still, Isabella will continue to have an MRI performed once every six months for the next 20 years, and she underwent occupational therapy and physical therapy to regain her coordination and physical skills.
With a brother, Gabriel, who is a year-and-a-half older, Isabella has always been an active child -- until the tumor started growing in her brain. "She couldn't stand up on her own. She couldn't throw a ball. All of a sudden she had the capacity of maybe a 1-year-old," says her mom. "I was heartbroken, thinking maybe she'll never be able to fully walk again or do things that a normal child does."
Isabella's recovery was nearly as quick as the onset of symptoms, according to Deanna. "After the first week of physical therapy, I saw how rapidly she was progressing. I knew that she would be completely fine."
Because she had recently been laid-off from her job as a copywriter, Deanna was able to spend all of her time caring for Isabella. Now that her daughter has returned to school and resumed the hectic life of a 6-year-old, she'll go back to work and gladly put this episode behind her.
"It was very dramatic every step of the way. Will she be able to breathe? Then the issue became the brain swelling. Then, will she be able to walk again?" remembers Deanna, who says the roller-coaster experience was made easier by the attentiveness of Dr. Danielpour. "He actually postponed his vacation to do this."
According to Dr. Danielpour, the outcome was well worth the delay. "Isabella is a very cute, delightful child. She now walks normally, her double vision has gone away, and she has no more headaches and no more vomiting," he says. "Naturally, the family was in tears when we took her into surgery, but it was wonderful to be able to tell them that we got all of the tumor out with the operation we did, and chances are it's not going to return."
Neurosurgeon Keith L. Black, M.D., founded Cedars-Sinai's Maxine Dunitz Neurosurgical Institute in 1997, assembling a multidisciplinary surgical, research and clinical team to treat virtually all problems that can occur within the brain. Paul Zeltzer, M.D., provides expertise in pediatric medical oncology, and Dr. Danielpour joined the Institute in 2000 to expand the pediatric neurosurgery program.
Under Dr. Black's direction, Institute researchers have a particular interest in discovering the biologic mechanism that allow tumors to grow and proliferate -- with the goal of creating new approaches to treatment and prevention of brain tumors. For several years, for instance, the Institute has studied a dendritic cell "vaccine" that shows promise in helping to prevent the recurrence of highly aggressive tumors. Dr. Black, Dr. Danielpour and their colleagues are currently developing a protocol that will allow them to extend the study to select pediatric patients.
SIDEBAR:
IF THESE SYMPTOMS LINGER, TAKE THEM SERIOUSLY -- AND TAKE YOUR CHILD TO A DOCTOR
Depending on their location, brain tumors can cause any number of signs and symptoms -- many of which can result from a variety of other illnesses. Nausea and vomiting, for example, are much more likely to be caused by a virus your child picked up at day care, but symptoms that persist should not be ignored. Here are some of the more common signs and symptoms caused by brain tumors:
1. Headaches with nausea and vomiting, especially if they occur in the middle of the night.
2. Blurred or double vision.
3. New difficulty with walking.
4. Regression of developmental milestones. A baby who was able to sit up loses this ability, or a toddler who was able to stand only sits up, for example.
5. A larger head than expected for the baby's body size.
6. Abnormal eye movements.
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For media information and interviews, please contact Sandra Van via e-mail at [email protected] or by calling 1-800-396-1002. Thank you.
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