Thursday, October 11, 2012

Embry: Pediatric Neurosurgeon

Today Embry had an MRI and we met with Embry's Pediatric Neurosurgeon at Children's Hospital.

Here's a note from Jacob...

How Today’s MRI Differed from Previous Sonograms


Before today, the doctors had only used sonograms to look inside Embry’s brain.  The sonograms were helpful, but they weren’t detailed enough to tell us what caused Embry’s hydrocephalus.  Finding out the cause is important because the ultimate outcomes for babies with hydrocephalus are highly correlated to the causes.  Today’s MRI gave us a slightly better idea of the cause of Embry’s hydrocephalus.  But it didn’t answer all of our questions.

What Caused Embry’s Hydrocephalus


Before Embry was born (between 22 weeks and 37 weeks of gestation), she had a small hemorrhage in her brain.  The extra fluid in Embry’s brain is secondary to (was caused by) the hemorrhage.  I believe the precise medical term for Embry’s condition is “fetal hydrocephalus secondary to prenatal intraventricular hemorrhage.”  We don’t know why she had the hemorrhage (and we probably never will).  We also don’t know why the hemorrhage caused the hydrocephalus, i.e. a blockage, excess fluid, etc. (we probably will get an answer to this question). 

What Else the MRI Told Us


First, the MRI showed that Embry’s brain structure is totally normal (everything is where it’s supposed to be).  But it did not tell us anything about her brain function.  This is something we’ll have to observe over time, based on her developmental milestones.

The MRI also showed that there’s some volume loss in Embry’s brain, meaning the brain isn’t as thick as normal.  The medical term for this is “cerebral atrophy.”

It also looks like Embry will not need a shunt.  The fluid hasn’t increased and, as far as we can tell, isn’t putting any pressure on the brain.

Going Forward


Today’s MRI answered many questions for us, but it raised far more questions to which we don’t have answers.  Dr. Swift told us that we will monitor three things over the next few years: (1) developmental milestones, (2) MRIs, and (3) head circumference.

One of the themes Dr. Swift conveyed to us is that it’s difficult to compare an image of Embry’s brain to images of other babies and predict how she will turn out.  A more predictive process is to look at images of Embry’s brain over a period of time.

In six to eight weeks, Embry will have another MRI.  Today’s MRI took about 40 images.  The one in 6-8 weeks will be much more detailed.  It will take about 400 images and Embry will be sedated.  She’ll probably have several more MRIs in the future.  The bad thing about these MRIs is that they probably are only capable of showing us the bad things (increased fluid, etc.).  For the good things, we’ll probably have to wait-and-see.

From The Both of Us


The doctor told us two things we're going to try to remind ourselves of daily....

1. If everyone in the US had a scan done of themselves we'd all have something "wrong" with us, or something that is "not normal". We now know a lot of information on Embry and we're hoping and praying that it's something we look back on and wonder why we worried so much.

2. We have to try our best to not think too much about all of this information and just look down and be reminded that we have a perfect little baby who is doing everything she needs to be doing right now. She's eating great, sleeping great, pooping great...pretty much the three things a normal newborn should be doing.

Videos


Here are two videos from her first two days of life! So thrilled we captured these moments on film...





Much love, Jacob, Cori & Embry

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