"My Grandmother was horrified when I suggested that my father's brain tumor was caused by a genetic disease. `Heavens, no!,' she said. `It was caused by a high school football injury!'" -- Frank G., New York

Actually, Grandma may well have been engaging in some reasonable deductive reasoning. While the VHL brain tumors in these cases were not caused by these injuries -- they were caused by defective genes -- the injury might have been the trigger which spurred its growth. There are a few reports in the medical literature in which head injury preceded symptomatic cerebellar hemangioblastoma development.

In two cases with which I am familiar, cerebellar hemangioblastomas were diagnosed within six months of head injuries sustained in automobile and industrial accidents. Both head injuries were significant, involving loss of consciousness. It is likely that small quiescent cerebellar hemangioblastomas were present before the head injuries. It is possible that head trauma caused the tumors to grow.

This is not something we can plan for or avoid, nor is it a reason to limit the activity of people with VHL. For example, a person with VHL could safely participate in almost all school sports, but boxing would not be a good idea because of repeated head trauma. Nonetheless it does help to justify Grandma's deductions.

-- Dr. James M. Lamiell, Col., U.S. Army, Fort Sam Houston, Texas

As published in the VHL Family Forum 1:3, September 1993. For permission to reprint, please contact the VHL Family Alliance at editor@vhl.org. Further information is available from the VHL Family Alliance, info@vhl.org.