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Brainstem Tumors?

There's Always Room for Jallo
Winter 2004, Volume 16, Number 2

Do you think Molly has a limp?" Kody Taylor asked her husband, Gary, as they watched their 3-year-old walking to the car. "Nah, it's just the way she walks." But then, in the way things can snowball, a sprained ankle led to an orthopedist who suggested Molly have an MRI to rule out mild cerebral palsy. That week the South Carolina couple learned their daughter had, instead, a brainstem tumor, possibly a pontine glioma, a usually inoperable cancer.

George Jallo, M.D.
Jallo checks the endoscope's
light -- a star, of sorts, on Molly
Taylor's Christmas tree.

Talks with their neurologist and a fevered Internet search led the Taylors to meet with pediatric neurosurgeon George Jallo, M.D. "Brainstem tumors aren't common in children, and they're not something you want to see. They're delicate, intricate growths," Jallo says. "Many consider them inoperable, even when benign, because of the real estate they're in." The brainstem holds centers of autonomic function like breathing and heartbeat. But in Molly's case, Jallo was fairly sure her tumor was not malignant, despite what the Taylors had heard, and that he could tackle it. He presented her work-up before Hopkins' tumor board and the operation, though risky, got a green light.

Fortunately, Jallo is expert in minimally invasive endoscopic brain surgery for children, having trained under the surgeon who pioneered the procedure. Though he's new to Hopkins, Jallo has more than 100 such surgeries to his credit-he did about one a week in his previous position. Now he's the only pediatric neurosurgeon in the Hopkins area to tackle such tumors endoscopically.

In addition to brainstem surgery, Jallo also takes an endoscopic approach for children with Chiari malformation or with ventricle tumors and resulting hydrocephalus. "Where you'd previously have to insert multiple shunts or do an open-skull operation, the technique lets us remove the tumor and open paths between the ventricles, eliminating the need for shunts." Jallo also treats patients at Kennedy Krieger's Spina Bifida Center.

For Molly, he made a small opening in her skull last October, gently feeding in the laser and necessary surgical tools. The prune-size tumor was teased free and, to everyone's relief, was definitely a low-grade pilocytic astrocytoma, a benign growth. Now Molly's getting physical therapy for temporary arm weakness, but, says Jallo, "she should be right as rain."

For more information, call 410.955.7851.



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