Hi, This is regards to my mother who has been experiencing some speech slur, hand shaking, and difficulty walking reasonable distances. She is 65, 5'5", 72 kgs and resides in India. They ran through several tests and were finally suggested a brain MRI.

The diagnosis by a neurologist in consultancy with a neurosurgeon was the following:
1.Tectal plate Cavernoma causing obstruction of aqueduct.

2. Dilated 3rd and lateral ventricles.

A shunt procedure to drain the CSF was suggested.

Upon consulting a second neurosurgeon, a shunt procedure followed by a surgical correction of the source of the problem was suggested. It was not clarified by me whether this surgeon diagnosed it as a Cavernoma or another issue.

With the original MRI in hand, we consulted a neurosurgeon and neuro-radiologist here in the US, with the help of a mutual contact, and their reading of it was it was not a cavernoma, but a Ependymoma, in the wall of the ventricle, located near the Pons in the brain and Cereballa aqueduct, thus causing the blockage in CSF draining. It was suggested that along with a shunt procedure, a followup surgery to remove the tumor should be done. They also suggested MRI of the spine to rule out tumors there.

My questions are the following:

- Are the diagnosis received cause for immediate concern, i.e., does the shunt procedure have to be done immediately? (I can upload MRI scans as needed)
- Considering the difference in opinion is it better to have procedure done here in the US? Is the particular expertise and operating facilities required in this case highly advanced and available more pervasively here in the US? (Any ballpark cost estimate would be fantastic)
- What are the recovery timelines and complications (if any) for a surgical remove of the tumor?

Please guide in any possible way. Thanks so much in advance!