Medical Marvels: Saving a teen from a rare, life-threatening cyst on the brain

NEW YORK -- Andrew is a talented high school student who excels in academics, sports and music. During his Freshman year in 2020, Andrew began suffering severe headaches and nausea that led to vomiting and vision problems. He was just 15 years old. An MRI revealed that Andrew had a dangerous, life-threatening cyst in his brain that could cause death at any moment. His parents immediately sought help at NewYork-Presbyterian, which has a dedicated pediatric neuro ICU.

"The offending lesion that Andrew had that caused the blockage of fluid is extremely, extremely infrequent," noted Mark Souweidane, MD, Vice Chair, Department of Neurosurgery, Director of Pediatric Neurosurgery, NewYork-Presbyterian & Weill Cornell Medicine.

These types of benign brain tumors happen in about one per million individuals, could be life threatening, and a certain percentage of individuals with the disease end up dying abruptly.

Dr. Souweidane, a pediatric neurosurgeon with an expertise in treating pediatric brain tumors, proposed an endoscopic colloid cyst removal. Endoscopic surgery is minimally invasive and performed using a scope with a camera attached to guide the surgeon through the procedure. This type of brain surgery is performed frequently by only a handful of surgeons in the United States, and Dr. Souweidane accelerated the surgical technique at NewYork-Presbyterian.

The other option would be to do a full craniotomy and open up Andrew's head. Andrew and his parents agreed that a minimally invasive procedure made a lot more sense. An endoscopic approach would also mean less recovery time.

"It's an area of my career focus and it has been for over a quarter century," Dr. Souweidane said. "This is something that I've championed based on a principal and a belief that these patients in particular benefit greatly from it. These are difficult operations. It takes skill. It takes a lot of experience with the endoscope. The big risk for these types of procedures is memory and cognitive decline. You're working around a part of the brain that's extremely small and the tumor is wrapped around two small fibers which serve short-term memory."

Instead of opening up Andrew's skull, Dr. Souweidane was able to make an incision about one and a half inches long and use the endoscopy technique to remove Andrew's cyst. Thankfully, the surgery went phenomenally well.

"Right when I got home, like that week, I played piano pretty much as fast as I could," Andrew said.

Playing piano comforted him and brought him back to reality. Today, Andrew feels that he is back to normal with no differences in his academic ability.

Andrew is really incredibly thankful for everything Dr. Souweidane, his team and the hospital has done for him.

"They saved my life and I'll forever be grateful for that."