Bishop Maher Has 2nd Brain Tumor Operation

Roman Catholic Bishop Leo T. Maher underwent a second brain operation Wednesday to remove necrotic tumor tissue that was causing spinal fluid to accumulate in his brain.

Maher,, 74,,, was in fair condition Wednesday afternoon after a two-hour operation that began about 9:30 a.m., said Dr. Thomas Waltz, chief of neurosurgery at Scripps Clinic.

“We’re very hopeful his neurologic function will be improved, but only time will tell,” Waltz said after the surgery. “We know that the tumor has done some damage to the brain, but it has not done any damage to the part of the brain that has to do with speech and mental function. It’s had to do with the function of his left extremities.”

Maher, bishop of the San Diego Roman Catholic Diocese, had returned to Scripps’ Green Hospital on Tuesday for tests preparatory to radiation treatments for his brain tumor. Doctors removed about 80% of the tumor April 25.

The bishop was not as alert Tuesday as he had been earlier, Waltz said. He also was complaining of increasing difficulty using his left arm and leg, and of back pain from a fall he suffered while recuperating at home from the original surgery.

The radiation treatments were put off, and a second surgery was recommended after brain imaging showed the tumor remnant had swollen. It was causing pressure and was also probably blocking the release of spinal fluid, Waltz said.

The brain produces about a pint of spinal fluid a day in structures called ventricles, releasing into the rest of the nervous system. The tumor was trapping fluid in a section of a ventricle called the temporal horn, Waltz said.

During surgery, Dr. Brian Copeland and Waltz found that the residual tumor had begun decomposing after the previous surgery cut off its blood supply. This necrosis caused the tumor tissue to swell.

Maher’s chances of surviving the brain tumor, which is of a particularly virulent type, are no worse than before the second operation, Waltz said. Having removed more of the tumor might be seen as a positive sign, since that leaves fewer cancer cells to be destroyed by radiation therapy, he said.

But Waltz said he is certain there has been some brain damage. Over the next few days, doctors will be watching Maher closely to determine its extent.

“We won’t know until he’s awake, and we can examine him to test him,” Waltz said, adding: “To recover to be a person who can be active and enjoy life and get things out of life and contribute to life, I think he has a reasonably decent chance of getting to that goal.”

Waltz said that, before surgery, the bishop was having increasing difficulty using his left arm and leg, because he couldn’t tell where they were without looking at them.

This neurological problem had improved slightly after the first surgery, but worsened again earlier this week, he said.

Waltz said radiation therapy could begin about two weeks after Wednesday’s surgery.

Maher has led the diocese of more than 460,000 Roman Catholics since 1969. He is scheduled to retire on July 1, his 75th birthday.