Alex's story
 Alex's story

    Brain cyst

Surgery removes mass from Alex's brain, restores his quality of life

Alex had experienced the fatigue for several months. He was so tired that he even started taking naps at work. His headaches continued to get more intense. He didn't know what caused the symptoms, but they were starting to overwhelm his daily life.

"One day I called home and asked my wife Melissa, 'Do I have a meeting today?'" he recalled. "She was saying, 'Alex, that meeting was yesterday. Come home now. We're going to the ER.'"

At the hospital, doctors soon discovered a large mass near the center of Alex's brain. They referred him to Dr. Yair Gozal, a Mayfield Brain & Spine neurosurgeon and a brain tumor specialist. More tests revealed the lesion was partially filled with fat and fluid, and it was affecting structures including the pituitary gland, brainstem and optic nerve. It also was restricting the normal flow of spinal fluid inside the brain, a condition called hydrocephalus.

Photo: Alex with his wife MelissaAlex with Melissa

Dr. Gozal said large masses like the one Alex developed often press against parts of the brain that govern functions like vision, balance and self-control. He said the mass showed some similarity to a craniopharyngioma or a Rathke cleft cyst, tumors that often develop near the pituitary gland.

"Alex's symptoms were severe and getting worse," Dr. Gozal said. "Advanced imaging confirmed that the large mass inside his brain was putting significant pressure on the brainstem and the frontal lobe. The region where the tumor was located is complex because it is surrounded by really important neurological and vascular structures. Removing the tumor and allowing those areas to heal and function normally can be a challenge when our goal is to restore Alex's quality of life."

MRIAn MRI showing the cyst putting pressure on Alex's brainstem and frontal lobe.

Only two weeks after that call to his wife, Alex underwent surgery to remove the lesion. Working with an ear, nose and throat (ENT) surgeon, Dr. Gozal removed the mass endoscopically, through Alex's nostrils, then repaired the damage in the surrounding regions. Thankfully, the mass turned out to be a fluid-filled cyst, meaning that it was not malignant.

After a week in the hospital and about a month recuperating at home, Alex has eased back into a full work schedule. He doesn't remember the first time when Dr. Gozal showed him the scan with the mass still inside his brain, but he saw it again after the surgery.

"It's pretty jarring," said Alex, still only in his mid-30s. "It's crazy to think something that size was in my brain."

Dr. Gozal said when he talked to Alex after the surgery, he could already see improvement in some of the symptoms related to the mass and hydrocephalus.

"He just looked like he was there again," Dr. Gozal said. "Alex's young age, amazing support from his family and determination to advocate for his own recovery are positive factors. We were able to remove the entire cyst and ease the pressure on the pituitary gland, optic nerves, brainstem and other vital systems inside the brain."

Alex remembers Dr. Gozal visiting his hospital room close to midnight and spending nearly an hour with the family.

"I'm confident he was always looking out for my best interests," Alex said. "He just made me feel very confident about the procedure."

Alex's symptoms had taken an emotional toll as well. Since the operation, he wants to re-establish the confidence of those around him after the turmoil of the last several months.

"I wasn't being myself," he recalled. "I was less patient with myself and my family. My wife was just saying, 'Alex, that's not normal.' In terms of recovery, the life-threatening physical part of it was a lot easier than the emotional burden."

Today, Alex's headaches, memory loss, dizziness, blurred vision and nausea are pretty much gone. He is working back into an exercise routine and spending a lot more time with his four children – age seven and younger.

"All things considered," he said, "I feel great."

~ Cliff Peale

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Hope Story Disclaimer -"Alex's Story" is about one patient's health-care experience. Please bear in mind that because every patient is unique, individual patients may respond to treatment in different ways. Results are influenced by many factors and may vary from patient to patient.

Related links:

Dr. Yair Gozal

Endoscopic pituitary surgery

Pituitary Tumors