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Johns Hopkins

Johns Hopkins Pediatric

Treating Patients With Complex Brain Tumors

Youssef Comair

Neurosurgeon Yousef Comair has specialized expertise in craniotomies to remove falcotentorial meningiomas — tumors where the two halves of the brain converge — which are quite rare.

When a middle-aged man experiencing alarming problems with memory and vision was diagnosed with a rare type of brain tumor, his doctor at another institution advised him to hold off on treatment. Due to the tumor's tricky location at a critical junction of the brain, surgery was a daunting prospect. The risk of mortality was close to 50%.

But when the patient’s condition deteriorated, and an MRI showed progression of the lesion, he was referred to Youssef Comair, a professor of neurosurgery based at Suburban Hospital and Sibley Memorial Hospital. Comair made a name for himself at UCLA in the 1990s with his pioneering work in awake craniotomies.

An internationally renowned neurosurgeon with a long track record treating complex brain tumors, Comair has specialized expertise in craniotomies to remove falcotentorial meningiomas — tumors where the two halves of the brain converge.

These brain tumors are quite rare, with just about 100 cases described in the medical literature. Symptoms include headaches, cognitive and behavioral changes, and vision and gait problems.  

“These lesions are deep in the brain, located at exactly the center and adjacent to important structures that control behaviors such as eye movement,” Comair says. “They’re also attached to important vasculature in the brain veins and arteries, so interruption in these deep-seated veins could have major consequences.”

The tumors can be particularly complicated when they encroach into the left side of the brain, which is responsible for critical cognitive functions like language, vision, memory and reasoning.

Comair’s patient had exactly this condition. After surgery at The Johns Hopkins Hospital by Comair and the neurosurgery team, his prognosis improved dramatically. “The patient fully recovered his vision, speech, and movement, and became fully functional again,” Comair says. “The patient was admitted to the Neurosciences Critical Care Unit at The Johns Hopkins Hospital for close post-op monitoring, but left the hospital within five days. He did require radiotherapy.”

Comair, who joined Johns Hopkins in 2022, is one of only a handful of surgeons in the country with expertise in excising falcotentorial meningiomas through left prone supratentorial and infratentorial craniotomies.

At Johns Hopkins, Comair is part of the Comprehensive Brain Tumor Center, one of the largest brain tumor centers in the world. Neurosurgeons with expertise in base of the skull surgery, neuroendoscopy, interventional and neurovascular surgery, neurooncologists, radiation therapists, neuroradiologists, neurophysiologists, neurointensivists, and neuroanesthesiologists collaborate to devise the best surgical approach and treatment for the particular pathology. Achieving the best possible outcome is dependent on the experience, expertise and close collaboration that is characteristic of the Brain Tumor Center.

“My philosophy in patient care is that I treat my patients as I would treat a family member," he says. “Patients come to us and entrust us with their most valuable assets — their life, memory, speech, motor function or sensory function, or even more importantly, a dear person such as a spouse or a child. I will convey to my patient my experience, and will not hesitate to refer you to another colleague if I believe that he or she has more experience in handling that problem.”

To refer a patient, call 301-896-6069.

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