Keep looking for a reason

Sarah was 22 when she presented with the dreadful signs of a large space-occupying lesion deep in the dominant parietal lobe. She was drowsy with a severe headache, had severe dysphasia, and there was a significant rightsided weakness. The computed tomography said it all;a malignant intrinsic tumour at the trigone of the lateral ventricle, probably a glioblastoma.

She rallied a little on steroids overnight and so I performed a craniotomy, having suitably warned her worried family of the likely outcome and prognosis. I found a very bloody tumour that had some definition from the surrounding brain. The pathologist told me that the frozen section showed a highly malignant brain tumour, consistent with the radiologist's diagnosis.

The survival from this type of tumour in this position is measured in months, and …