BRAIN DISORDER OVERVIEW

The concept of a Brain problem and particularly BRAIN SURGERY can be, for most people, quite alarming if not terrifying. So much of our very being, our personalities — our intellect, instincts, temperament, capacity for language and spatial relationships, memories, dreams — is carefully encoded within the cellular structure of our "grey matter". The prospect of any risk to alter Brain tissue in some way involves the risk of changing who we are to a greater or lesser extent.

In the event that you have a good medical reason to undergo Brain surgery, it is essential to trust the professional capabilities of your Neurosurgeon. Select one carefully. Get recommendations from physicians and/or nurses whom you know and trust. Interviewing several Neurosurgeons and asking questions can be helpful. The more you trust your physician and the more you know what to expect, the more relaxed you can be about the surgical process. Get as much education about your condition as you can. Being informed and feeling confident that you have placed yourself in good hands can benefit your recovery process.

The surgeons and staff at Neurosurgical Consultants are sensitive to the difficulties involved in finding the "best doctor" for your problem and have prepared some tips on How to Choose a Neurosurgeon.

REASONS FOR HOPE

WHY WOULD BRAIN SURGERY BE NECESSARY?

1. Mass Lesions such as Brain Tumors or Brain Abscess that exert undue pressure on the Brain. Brain Tumors are abnormal growths of Brain tissue which can be either Benign (non-cancerous) or Malignant (cancer). Based on size and/or location either can cause serious progressive neurological damage and/or death. There are many different kinds of Benign Brain Tumors, including Pituitary Gland Tumors, Acoustic Neuroma, Meningioma, Epidermoid and Neurofibroma, to name only a few.

   Malignant Brain Tumors (Astrocytoma, Glioma, Ependymoma, Oligodendroglioma, Mixed Glioma, Anaplastic Astrocytoma and Glioblastoma Multiforme) can originate from the different types of Brain cells (Astrocytes, Oligodendrogliocytes, Ependymal Cells or Neurons) or from a cancerous disease from another part of the body (Metastatic Tumor). When a cancer spreads from another part of the body to the Brain or any other part of the body, it is referred to as "metastasis".

   Symptoms of a Brain tumor (or any other "Mass Lesion") can include:

   • Headache upon arising in the morning or during the night
   • Dull, persistent headache
   • Persistent nausea or vomiting
   • Visual problems (blurring/double vision/impaired peripheral vision)
   • Physical weakness
   • Epilepsy (seizures)
   • New onset of Neurological Deficits (Speech disorder, Dysequilibrium, Clumsiness)
   The most effective method to treat most Brain Tumors involves some form of surgical removal since many can be entirely cured. This is not necessarily the case for all Brain tumors. Some tumor types require treatment with chemotherapy and/or radiation therapy with or without a Brain operation. However, if a Brain tumor (and/or the associated Brain swelling which occurs consequent to the presence of the Brain tumor) becomes so large that the Brain tissue begins to push against the bony confinement of the Skull, the situation becomes critical. This condition, known as Increased Intracranial Pressure (^ICP), usually requires immediate treatment. Hospitalization and stabilization of the intracranial pressure becomes an urgent necessity. Oftentimes this can be effectively accomplished with high dose intravenous steroid treatment and/or a temporary diversion of intracranial fluid (either with a "Shunt" or "Ventriculostomy"). The IMPERATIVE at this point is to improve the condition of the Brain since the results from any surgery are influenced by the general condition of the Brain at the time of operation. At some point surgery will be done to remove or reduce the tumor and alleviate the danger. If left untreated, coma can result.

2. Intracranial Cerebrovascular abnormalities such as Aneurysms, Arteriovenous Malformations Cavernous Angioma and Vein of Galen Aneurysm. Patients who experience a hemorrhage inside the Brain (Intracerebral Hemorrhage - ICH) as happens in relationship to severe hypertension (Hypertensive Intra-cerebral Hemorrhage) or due some other medical condition or medication (Leukemia; Anticoagulation therapy, etc) may also require Neurosurgical intervention.

3. Congenital Abnormalities such as Arnold-Chiari Malformation and Intracranial Arachnoid Cysts among other problems.

4. Medically Refractory Epilepsy where seizures are a major problem that will not respond to aggressive medical management.

5. Pain & Quality of Life Issues. Brain surgery is helpful for conditions which interfere with the quality of life such as Trigeminal Neuralgia and Glossopharyngeal Neuralgia (when they cause medically refractory, excruciating pain) or Hemifacial Spasm (uncontrollable muscle contractions of one side of the face.)

6. Trauma. Head and Brain trauma account for a large proportion of patients undergoing a Neurosurgical operation.

WEBSITE INFORMATION

The following information, listed at WebMD.com, may also be useful:

• Brain tumors, adult: Treatment - Health Professional Information (NCI PDQ) - Treatment Option Overview

• Brain tumors, adult: Treatment - Patient Information (NCI PDQ) - Types of Adult Brain Tumor

This page last edited on 2/19