Characterized by headaches and seizures, an arteriovenous malformation (AVM) of the brain is a derivative of arteriovenous malformation, a disorder of the body’s circulatory system. An AVM of the brain, also known as a cerebral AVM, is a malformed group of blood vessels composed of an intricate tangle of arteries and veins. Though localized, cerebral AVMs can lead to severe neurological problems. Research in the field of arteriovenous malformation is growing particularly with noninvasive treatment options.
What are cerebral AVMs?
Cerebral AVMs may form during prenatal stages of a child’s development, either during embryonic or fetal growth. Studies have found a certain number of cases form shortly after birth; however, the condition frequently presents in adults in their 20s or 30s. Cerebral AVMs are commonly misdiagnosed, with most cases found only incidentally through the performance of CT (computed tomography) scans on the brain. Patients complain of regular headaches and seizures before diagnosis.
Other neurological complications can develop including speech and visual difficulty, dizziness, memory deficits, confusion, hallucinations, dementia and difficulty with event planning. Physical side effects range from loss of coordination, numbness, tingling and spontaneous pain to permanent paralysis. Patients’ symptoms are directly associated with the location of the cerebral AVM with certain sites causing hydrocephalus. Hydrocephalus is caused by a cerebral AVM preventing the circulation of cerebrospinal fluid thereby causing fluid build-up in the skull.
What are the potential health consequences of cerebral AVMs?
Hemorrhaging is the most common side effect of patients experiencing cerebral AVM. The size and location of the cerebral AVM determines the patient’s likelihood of experiencing hemorrhaging. Research has found between 2 and 4 percent of all AVMs to hemorrhage each year with most episodes going undetected. Minor hemorrhaging does not cause neurological damage, hence the reason patients and doctors remain unaware it takes place. On the other hand, massive hemorrhaging has been documented with some cases being fatal. Once a cerebral AVM bleeds, the risk of hemmorahaging again within the next year is nine times as likely. Though research has grown extensively, doctors are still unable to predict whether a patient with cerebral AVM will or will not experience hemorrhaging.
While there is no definitive research, doctors have found certain cases to have a higher likelihood of causing bleeding. Though it may seem contradictory, smaller AVMs have a greater chance of hemorrhaging than larger ones. Increased blood pressure and blood volume from being pregnant also increases a patient’s potential for bleeding. Lastly, deeply situated AVMs with extremely narrow veins impair proper drainage leading to an increased risk for hemorrhaging.
Once again, the location of the hemorrhaging AVM is directly proportionate to the side effects of hemorrhaging. Bleeding AVMs situated deep within the brain, called intracerebral or parenchymal cerebral hemorrhage, cause the most damage.
In addition to brain hemorrhaging, AVMs on their own can inflict harsh brain and spinal dysfunctions. Patients who experience severe side effects are typically victims of one of three problems. Aside from hemorrhaging, AVMs reduce oxygen reaching neurological tissues and compress and displace parts of the brain. The larger the lesion, the greater chance of the latter problem occurring with certain AVMs reaching up to 2.5 inches in diameter. Certain lesions have been documented to distort an entire hemisphere of the brain.
Wednesday, April 1, 2009
Brain Tumor Types With Their Treatments
Astrocytomas represent the most common type of glioma. They develop from the supporting cells of the brain, which are star-shaped glial cells called astrocytes. In children, most astrocytomas are considered low-grade, while in adults most are high-grade. They occur in most parts of the brain, including the brain stem.
Treatment
Radiation therapy is required to treat gliomas. Radiation therapy may also be beneficial in the short-term for tumors that have spread from other parts of the body. Chemotherapy also benefits some patients with such brain tumors.
Chemotherapy is only marginally effective in the treatment of Anaplastic astrocytoma and Glioblastoma multiforme. Typical chemotherapy agents include carmustine (BCNU) and lomustine (CCNU).
Craniopharyngiomas are tumors near the brain’s pituitary gland and most commonly affect infants and children. Because the pituitary gland releases chemicals essential for growth and metabolism, a craniopharyngioma may result in a child’s stunted growth. The patient’s vision may also be affected. These tumors develop from cells left over from early fetal development.
Treatment
Surgery: Because of their location close to vital parts of the brain, surgical removal is often difficult. However, surgery is the usual treatment for these tumors. Radiation therapy may also be used.
Ependymal tumors begin in the ependyma, cells that line the passageways in the brain where cerebrospinal fluid (CSF) is produced and stored. Ependymomas are classified as either supratentorial (in the cerebral hemispheres) or infratentorial (in the back of the brain). Variations of this tumor type include subependymoma, subependymal giant-cell astrocytoma, and malignant ependymoma. Ependymoblastoma, which occurs in infants and children under three years, is no longer considered a subtype of ependymoma.
Treatment
Treatment of grade I and grade II ependymomas is usually surgery with or without radiation therapy.
Treatment of anaplastic ependymoma may include the following:
1. Surgery plus radiation therapy.
2. A clinical trial of surgery followed by chemotherapy before, during, and after radiation therapy.
3. A clinical trial of chemotherapy and/or biologic therapy.
Metastatic Brain Tumor. A metastatic, or secondary, brain tumor is one that begins as cancer in another part of the body. Some of the cancer cells may be carried to the brain by the blood or lymphatic fluid, or may spread from adjacent tissue. The site where the cancerous cells originated is referred to as the primary cancer. Metastatic brain tumors are often referred to as lesions or brain metastases. Metastatic brain tumors are the most common brain tumors. There has been an increase in metastatic lesions as people are surviving primary cancers for longer periods of time.
Treatment
Surgery
Brain tumors are often difficult to diagnose and surgical removal demands great skill. Mayo's team of specialists in secondary brain tumors offer the most up-to-date treatment opportunities, utilizing the latest technological advances.
Surgery, the mainstay of brain tumor treatment, involves removing as much of the tumor as possible while minimizing damage to healthy tissue.
Treatment
Radiation therapy is required to treat gliomas. Radiation therapy may also be beneficial in the short-term for tumors that have spread from other parts of the body. Chemotherapy also benefits some patients with such brain tumors.
Chemotherapy is only marginally effective in the treatment of Anaplastic astrocytoma and Glioblastoma multiforme. Typical chemotherapy agents include carmustine (BCNU) and lomustine (CCNU).
Craniopharyngiomas are tumors near the brain’s pituitary gland and most commonly affect infants and children. Because the pituitary gland releases chemicals essential for growth and metabolism, a craniopharyngioma may result in a child’s stunted growth. The patient’s vision may also be affected. These tumors develop from cells left over from early fetal development.
Treatment
Surgery: Because of their location close to vital parts of the brain, surgical removal is often difficult. However, surgery is the usual treatment for these tumors. Radiation therapy may also be used.
Ependymal tumors begin in the ependyma, cells that line the passageways in the brain where cerebrospinal fluid (CSF) is produced and stored. Ependymomas are classified as either supratentorial (in the cerebral hemispheres) or infratentorial (in the back of the brain). Variations of this tumor type include subependymoma, subependymal giant-cell astrocytoma, and malignant ependymoma. Ependymoblastoma, which occurs in infants and children under three years, is no longer considered a subtype of ependymoma.
Treatment
Treatment of grade I and grade II ependymomas is usually surgery with or without radiation therapy.
Treatment of anaplastic ependymoma may include the following:
1. Surgery plus radiation therapy.
2. A clinical trial of surgery followed by chemotherapy before, during, and after radiation therapy.
3. A clinical trial of chemotherapy and/or biologic therapy.
Metastatic Brain Tumor. A metastatic, or secondary, brain tumor is one that begins as cancer in another part of the body. Some of the cancer cells may be carried to the brain by the blood or lymphatic fluid, or may spread from adjacent tissue. The site where the cancerous cells originated is referred to as the primary cancer. Metastatic brain tumors are often referred to as lesions or brain metastases. Metastatic brain tumors are the most common brain tumors. There has been an increase in metastatic lesions as people are surviving primary cancers for longer periods of time.
Treatment
Surgery
Brain tumors are often difficult to diagnose and surgical removal demands great skill. Mayo's team of specialists in secondary brain tumors offer the most up-to-date treatment opportunities, utilizing the latest technological advances.
Surgery, the mainstay of brain tumor treatment, involves removing as much of the tumor as possible while minimizing damage to healthy tissue.
Brain Tumor Surgery
India is now days becoming a medical hub and a growing destination for brain tumor surgery because of the availability of most advanced surgical treatment facilities and highly experienced surgeons in India. Because of these available treatment facilities, very low cost of treatment and very good success rate of surgery, many international patients are attracted to India for their low cost brain tumor surgery in India. International patients are looking forward to India just because of first class medical facilities at third class rates. The cost of treatment provided in India is very less compared to that of the cost of same surgical treatment in other developed countries for different treatment procedures like brain tumor surgery and these too are provided to patients with very good success rate. Because of the availability of very good treatment facilities, most experienced surgeons, very low cost of surgical treatment and very good success rate of brain tumor surgery in India many international patients’ select India as a destination for their surgical treatment.
Treatment for brain tumors depends on a number of factors including the type, location and size of the tumor as well as the patient's age and general health. Treatment methods and schedules differ for children and adults. Brain tumors are treated with surgery, radiation therapy and chemotherapy. Our doctors also are studying a vaccine for treating a recurrent cancer of the central nervous system that occurs primarily in the brain, known as glioma. Depending on patients’ needs, several methods may be used. Before treatment begins, most patients are given steroids, drugs that relieve swelling or edema. Your may receive anticonvulsant medicine to prevent or control seizures. If hydrocephalus is present, you may need a shunt to drain cerebrospinal fluid. A shunt is a long, thin tube placed in a ventricle of the brain and then threaded under the skin to another part of the body, usually the abdomen. It works like a drainpipe. Excess fluid is carried away from the brain and is absorbed in the abdomen. In some cases, the fluid is drained into the heart. Surgery is the usual treatment for most brain tumors. To remove a brain tumor, a neurosurgeon makes an opening in the skull. This operation is called a craniotomy. Whenever possible, the surgeon attempts to remove the entire tumor. If the tumor cannot be completely removed without damaging vital brain tissue, your doctor may remove as much of the tumor as possible. Partial removal helps to relieve symptoms by reducing pressure on the brain and reduces the amount of tumor to be treated by radiation therapy or chemotherapy. Some tumors cannot be removed. In such cases, your doctor may do only a biopsy. A small piece of the tumor is removed so that a pathologist can examine it under a microscope to determine the type of cells it contains. This helps doctors decide which treatment to use.
Treatment for brain tumors depends on a number of factors including the type, location and size of the tumor as well as the patient's age and general health. Treatment methods and schedules differ for children and adults. Brain tumors are treated with surgery, radiation therapy and chemotherapy. Our doctors also are studying a vaccine for treating a recurrent cancer of the central nervous system that occurs primarily in the brain, known as glioma. Depending on patients’ needs, several methods may be used. Before treatment begins, most patients are given steroids, drugs that relieve swelling or edema. Your may receive anticonvulsant medicine to prevent or control seizures. If hydrocephalus is present, you may need a shunt to drain cerebrospinal fluid. A shunt is a long, thin tube placed in a ventricle of the brain and then threaded under the skin to another part of the body, usually the abdomen. It works like a drainpipe. Excess fluid is carried away from the brain and is absorbed in the abdomen. In some cases, the fluid is drained into the heart. Surgery is the usual treatment for most brain tumors. To remove a brain tumor, a neurosurgeon makes an opening in the skull. This operation is called a craniotomy. Whenever possible, the surgeon attempts to remove the entire tumor. If the tumor cannot be completely removed without damaging vital brain tissue, your doctor may remove as much of the tumor as possible. Partial removal helps to relieve symptoms by reducing pressure on the brain and reduces the amount of tumor to be treated by radiation therapy or chemotherapy. Some tumors cannot be removed. In such cases, your doctor may do only a biopsy. A small piece of the tumor is removed so that a pathologist can examine it under a microscope to determine the type of cells it contains. This helps doctors decide which treatment to use.
Different Types of Brain Injury
Brain injury can be as individual as people, because every case of brain injury can happen for different reasons and have different effects on people. Classifying the different types of brain injury can require a lot of research. Generally the classification starts with the two more common types of brain injury: traumatic brain injury and acquired brain injury. The levels are ranted as mild, moderate or severe. Brain injuries can also be classified as an open or closed brain injury. In this article, we'll talk about the more common types of brain injuries.
Traumatic Brain Injury
Traumatic brain injury can happen whenever something strikes the head with force. The force would be strong enough to cause the brain to move in the skull causing internal damage to the brain. It can also occur if the skull breaks and the break itself injures the brain.
There are various reasons for this type of force. It could due to a violent experience, sports injury or a variety of other causes. Any event that causes the head to be struck hard enough an cause this type of traumatic brain injury.
This type of brain injury can also occur from rapid movement back and forth, shaking the brain hard enough in the skull that it becomes damaged. This more commonly happens in auto accidents or in cases such as Shaken Baby Syndrome. The rapid movement back and forth can do severe damage to the brain.
How To Tell If You've Suffered Traumatic Brain Injury
If you have suffered a severe blow to the head, or have been in an accident where your head was violently shaken, or suspect someone else has had this type of injury, go to the emergency room immediately or call 911 for further assistance. It is recommended that you do not wait. Severe brain injuries can become worse and could become fatal if not treated immediately.
Common symptoms of traumatic brain injury are as follows:
Spinal fluid coming out of the ears or nose, looking like thin, watery liquid
Loss of consciousness
Suspected concussion - not all concussions cause loss of consciousness
Severe dizziness or loss of balance
Dilated eyes
Loss of vision, or change in vision, either improved or reduced
Slow pulse
Slow breathing
Vomiting
Lethargic
Headache
Confusion
Numbness or tingling sensations in any parts of the body
Different Types of Traumatic Brain Injury
Depending on how severe the injury is, the brain can suffer many types of injuries. Some of the more common classifications of such injuries include:
Diffuse Axonal Injury - This type of injury seems to be more common with the rapid movement of the head as occurs with Shaken Baby Syndrome. It usually happens because the skull is moving faster than the brain, causing certain structures in the brain to tear. This injury can be temporary or permanent, causing a coma or even possibly producing fatal effects.
Concussion - A concussion can be caused by violent action toward the head, by severe blows, or a whiplash effect. This type of injury causes blood vessels to stretch. It's one of the more common types of brain injuries, and a concussion can take months or even years to fully heal.
Contusion - Again, this type of traumatic brain injury will happen with a violent action at the head. The injury is caused by bruising or bleeding on the brain. If the injury is severe and there is much bruising and bleeding, it can require surgery to correct.
Acquired Brain Injury
An acquired brain injury occurs any time after birth and is not induced by birth trauma or hereditary. This type of injury occurs on a cellular level. Such an injury can affect the entire brain, rather than a limited area like a traumatic brain injury.
Such injuries can occur for any of the following reasons: air obstruction, chocking, throat swelling, near drowning, electrical shock, trauma to the head, severe blood loss from open wounds, heart attack, stroke, infectious diseases, Meningitis, AIDS, brain tumors, toxic exposure, illegal drug use, overdose of drugs, alcohol abuse.
Symptoms of Acquired Brain Injury
Because this type of brain injury is internal, you might have a harder time trying to identify the symptoms. Some of the more common symptoms for acquired brain injury are:
Impairment of function, motor skills or memory
Long lengths of time spent in a still, 'vegetative' state
Sudden or severe behavior changes or problems - depression, restlessness, anxiety, psychosis, etc
As with traumatic brain injury, if you suspect someone may have acquired brain injury, call 911 or get the person to the emergency room right away.
Different Types of Acquired Brain Injury
Anoxic Brain Injury - This type of injury occurs when the brain is deprived of oxygen. There are three types of anoxia: Anoxic which is no oxygen is getting through, anemic which means severely limited amounts of oxygen is getting through, and toxic which means something is blocking the oxygen in the blood from being used in the brain.
Hypoxic Brain Injury - This sort of brain injury occurs when the brain does get oxygen, but doesn't seem to get enough oxygen. It could happen because of lack of blood flow or blood pressure is weak.
Traumatic Brain Injury
Traumatic brain injury can happen whenever something strikes the head with force. The force would be strong enough to cause the brain to move in the skull causing internal damage to the brain. It can also occur if the skull breaks and the break itself injures the brain.
There are various reasons for this type of force. It could due to a violent experience, sports injury or a variety of other causes. Any event that causes the head to be struck hard enough an cause this type of traumatic brain injury.
This type of brain injury can also occur from rapid movement back and forth, shaking the brain hard enough in the skull that it becomes damaged. This more commonly happens in auto accidents or in cases such as Shaken Baby Syndrome. The rapid movement back and forth can do severe damage to the brain.
How To Tell If You've Suffered Traumatic Brain Injury
If you have suffered a severe blow to the head, or have been in an accident where your head was violently shaken, or suspect someone else has had this type of injury, go to the emergency room immediately or call 911 for further assistance. It is recommended that you do not wait. Severe brain injuries can become worse and could become fatal if not treated immediately.
Common symptoms of traumatic brain injury are as follows:
Spinal fluid coming out of the ears or nose, looking like thin, watery liquid
Loss of consciousness
Suspected concussion - not all concussions cause loss of consciousness
Severe dizziness or loss of balance
Dilated eyes
Loss of vision, or change in vision, either improved or reduced
Slow pulse
Slow breathing
Vomiting
Lethargic
Headache
Confusion
Numbness or tingling sensations in any parts of the body
Different Types of Traumatic Brain Injury
Depending on how severe the injury is, the brain can suffer many types of injuries. Some of the more common classifications of such injuries include:
Diffuse Axonal Injury - This type of injury seems to be more common with the rapid movement of the head as occurs with Shaken Baby Syndrome. It usually happens because the skull is moving faster than the brain, causing certain structures in the brain to tear. This injury can be temporary or permanent, causing a coma or even possibly producing fatal effects.
Concussion - A concussion can be caused by violent action toward the head, by severe blows, or a whiplash effect. This type of injury causes blood vessels to stretch. It's one of the more common types of brain injuries, and a concussion can take months or even years to fully heal.
Contusion - Again, this type of traumatic brain injury will happen with a violent action at the head. The injury is caused by bruising or bleeding on the brain. If the injury is severe and there is much bruising and bleeding, it can require surgery to correct.
Acquired Brain Injury
An acquired brain injury occurs any time after birth and is not induced by birth trauma or hereditary. This type of injury occurs on a cellular level. Such an injury can affect the entire brain, rather than a limited area like a traumatic brain injury.
Such injuries can occur for any of the following reasons: air obstruction, chocking, throat swelling, near drowning, electrical shock, trauma to the head, severe blood loss from open wounds, heart attack, stroke, infectious diseases, Meningitis, AIDS, brain tumors, toxic exposure, illegal drug use, overdose of drugs, alcohol abuse.
Symptoms of Acquired Brain Injury
Because this type of brain injury is internal, you might have a harder time trying to identify the symptoms. Some of the more common symptoms for acquired brain injury are:
Impairment of function, motor skills or memory
Long lengths of time spent in a still, 'vegetative' state
Sudden or severe behavior changes or problems - depression, restlessness, anxiety, psychosis, etc
As with traumatic brain injury, if you suspect someone may have acquired brain injury, call 911 or get the person to the emergency room right away.
Different Types of Acquired Brain Injury
Anoxic Brain Injury - This type of injury occurs when the brain is deprived of oxygen. There are three types of anoxia: Anoxic which is no oxygen is getting through, anemic which means severely limited amounts of oxygen is getting through, and toxic which means something is blocking the oxygen in the blood from being used in the brain.
Hypoxic Brain Injury - This sort of brain injury occurs when the brain does get oxygen, but doesn't seem to get enough oxygen. It could happen because of lack of blood flow or blood pressure is weak.
Radiosurgery: Brain Surgery
Each year cancer research programs continue to grow: funding increases, new technologies make year-old discoveries obsolete, and more doctors and scientists contribute their ideas and methods to understanding and eradicating cancer. As these strides are made, more treatment options become available and fewer people are forced to endure painful and invasive treatments.
Radiosurgery is a non-invasive, non-surgical treatment of brain cancer that allows doctors to direct beams of radiation to precise locations in order to focus it directly over a brain tumor. This method can help treat and remove intracranial tumors that would otherwise not be accessible for open surgery.
Choosing radiosurgery as an option over more invasive routines is the method of choice for some patients, but is more likely to be a necessity for patients with certain types of tumors that are not easily accessed through open surgery -- such as skull base tumors.
Radiosurgery often uses the Leksell Gamma Knife which concentrates gamma radiation to the targeted portion of the patient's brain. The radiation is so concentrated that, while some residual radiation exists, the vast majority of it is focused onto a much smaller area, thus degenerating the affected area and leaving the rest of the brain unaffected.
The Leksell Gamma Knife form of radiotherapy has been known to work with only one treatment.
What to Expect When Entering Radiation Therapy
Although there are many different types of radiation treatments, radiosurgery focusing specifically on the treatment of head, neck, and brain cancers, the side effects of general radiotherapy and radiosurgery will be very similar.
With radiosurgery, because the radiation is focused around the head and brain area, the patient can often expect to lose hair as a result of the treatment. Other side effects may include a reddening if the skin around the treated area where the radiation beams are passed through, physical fatigue (patients may feel tired more often than normal and sleep longer hours), nausea, and decreased immune response requiring that patients avoid being in public as much as possible to minimize the possibility of catching a virus or other sickness.
When used to treat cancer, radiation therapy is often administered in conjunction with surgery and chemotherapy. In operable cases, surgery may be conducted to remove as much of the cancer as possible, then treatment is followed up by radiation therapy to kill any remaining cancer cells. The same is true of treatment in conjunction with chemotherapy.
In some cases, a combination of all three treatments will be used. In cases where the threat is not as immediate, radiation therapy alone may be the only treatment necessary.
Radiosurgery is a non-invasive, non-surgical treatment of brain cancer that allows doctors to direct beams of radiation to precise locations in order to focus it directly over a brain tumor. This method can help treat and remove intracranial tumors that would otherwise not be accessible for open surgery.
Choosing radiosurgery as an option over more invasive routines is the method of choice for some patients, but is more likely to be a necessity for patients with certain types of tumors that are not easily accessed through open surgery -- such as skull base tumors.
Radiosurgery often uses the Leksell Gamma Knife which concentrates gamma radiation to the targeted portion of the patient's brain. The radiation is so concentrated that, while some residual radiation exists, the vast majority of it is focused onto a much smaller area, thus degenerating the affected area and leaving the rest of the brain unaffected.
The Leksell Gamma Knife form of radiotherapy has been known to work with only one treatment.
What to Expect When Entering Radiation Therapy
Although there are many different types of radiation treatments, radiosurgery focusing specifically on the treatment of head, neck, and brain cancers, the side effects of general radiotherapy and radiosurgery will be very similar.
With radiosurgery, because the radiation is focused around the head and brain area, the patient can often expect to lose hair as a result of the treatment. Other side effects may include a reddening if the skin around the treated area where the radiation beams are passed through, physical fatigue (patients may feel tired more often than normal and sleep longer hours), nausea, and decreased immune response requiring that patients avoid being in public as much as possible to minimize the possibility of catching a virus or other sickness.
When used to treat cancer, radiation therapy is often administered in conjunction with surgery and chemotherapy. In operable cases, surgery may be conducted to remove as much of the cancer as possible, then treatment is followed up by radiation therapy to kill any remaining cancer cells. The same is true of treatment in conjunction with chemotherapy.
In some cases, a combination of all three treatments will be used. In cases where the threat is not as immediate, radiation therapy alone may be the only treatment necessary.
Carotid Surgery Is Necessary to Prevent Stroke Attack
Carotid surgery is necessary when there is blockage of the internal carotid artery. Carotid arteries, also called common carotid, are placed on each side of the neck. This carotid splits into branches called internal and external branch. Internal branch is responsible for taking oxygen rich blood to the brain while external branch supplies blood to the face. Blockage of the internal carotid can lead to stroke. This happens when the supply of blood to the brain is reduced considerably. The blockage of the internal carotid is caused by the build up of calcium, fat, cholesterol and other substances. Aside from blocking the internal carotid, this built up plaque can also hinder the flow of blood, thus resulting to blood clot.
Blood clot prevents the small arteries to get blood from the main vessel. Some blood clots travel, while others do not. Traveling clots are called embolism while those that do not travel are called thrombus. Thrombus affects the internal carotid while embolism does target the small arteries. You may know that you have them if you constantly experience blurred vision, weakness, slurred speech and the symptoms of stroke. Thrombus and embolism lead to stroke.
To prevent stroke, a person with a blocked carotid will have to undergo a carotid surgery which is also called a carotid endarterectomy. It is a form of medical operation which involves removal of the inner lining of the carotid. This procedure is done if the lining has become thickened or damaged. Carotid surgery removes the build up of plaque from the artery to restore the normal blood flow.
Carotid surgery can remove the build up of existing plaque in the carotid arteries. But even after the operation, the person is still prone to experience the same problem. The carotid surgery cannot prevent the build up of the plaque. It can only remove it. That is why a person has to be extra careful about his health. He should maintain a healthy lifestyle and avoid eating too much food and beverages that can cause blockage. He should also stop smoking to avoid the same problem in the future. Typically, the attending physician will have information on hand that can help the patient make the necessary lifestyle changes that will help to keep the plaque under control. By observing the dietary guidelines, getting regular exercise and giving up tobacco, the patient can avoid the need to have a second round of this surgery.
Blood clot prevents the small arteries to get blood from the main vessel. Some blood clots travel, while others do not. Traveling clots are called embolism while those that do not travel are called thrombus. Thrombus affects the internal carotid while embolism does target the small arteries. You may know that you have them if you constantly experience blurred vision, weakness, slurred speech and the symptoms of stroke. Thrombus and embolism lead to stroke.
To prevent stroke, a person with a blocked carotid will have to undergo a carotid surgery which is also called a carotid endarterectomy. It is a form of medical operation which involves removal of the inner lining of the carotid. This procedure is done if the lining has become thickened or damaged. Carotid surgery removes the build up of plaque from the artery to restore the normal blood flow.
Carotid surgery can remove the build up of existing plaque in the carotid arteries. But even after the operation, the person is still prone to experience the same problem. The carotid surgery cannot prevent the build up of the plaque. It can only remove it. That is why a person has to be extra careful about his health. He should maintain a healthy lifestyle and avoid eating too much food and beverages that can cause blockage. He should also stop smoking to avoid the same problem in the future. Typically, the attending physician will have information on hand that can help the patient make the necessary lifestyle changes that will help to keep the plaque under control. By observing the dietary guidelines, getting regular exercise and giving up tobacco, the patient can avoid the need to have a second round of this surgery.
Brain Cancer - Causes, Diagnosis, Symptoms, Treatment and Prognosis
Malignant brain tumors occur in about 4.5 people per 100,000 population, they may occur at any age but brain cancer is the leading cause of cancer-related death in patients younger than age 35. In adults, incidence is generally highest between ages 40 to 60.
There are two main types of brain cancer. Primary brain tumors start in the brain. Metastatic brain tumours start somewhere else in the body and moves to the brain. The most common tumor types in adults are gliomas and meningiomas. In children, incidence is generally highest before age 1 and again between ages 2 and 12. The most common types of brain tumour in children are astrocytomas, medulloblastomas, ependymomas and brain stem gliomas.
CAUSES OF BRAIN CANCER
What causes brain cancer is not exactly known but there has recently been a great deal of speculation on the role of cell phone radiation in the development of brain cancer. In fact, while studies generally have shown no link between cell phones and brain cancer, there is some conflicting scientific evidence that may be worth additional study, according to the FDA.
More accepted risk factors for brain cancer include; exposure to vinyl chloride and individuals with risk factors such as having a job in an oil refinery, as a chemist, embalmer, or rubber industry worker show higher rates of brain cancer. Other risk factors such as smoking, radiation exposure, and viral infection (HIV) have been suggested but not proven to cause brain cancer. Patients with a history of melanoma, lung, breast, colon, or kidney cancer are at risk for secondary brain cancer.
SIGNS AND SYMPTOMS OF BRAIN CANCER
Onset of symptoms is usually insidious and brain tumors are often misdiagnosed. Brain Cancers cause central nervous system changes by invading and destroying tissues and by secondary effects such as pressure on the brain. Symptoms vary but in general, brain cancer symptoms include: Abnormal pulse and breathing rates, deep, dull headaches that recur often and persist without relief for long periods of time, difficulty walking or speaking, dizziness, eyesight problems including double vision, seizures, vomiting and at the late stages of the disorder dramatic changes in blood pressure may occur. Although headaches are often a symptom of brain cancer, it is important to remember that most headaches are due to less serious conditions such as migraine or tension, not cancer.
DIAGNOSIS OF BRAIN CANCERS
In most cases a definitive diagnosis is made by a tissue biopsy. Other diagnostic tools include; patient history, a neurologic assessment, skull x-rays, a brain scan, CT scan, MRI, a lumbar puncture and cerebral angiography. Meningiomas, arising from the covering around the brain or spinal cord, account for about 20% of brain cancers and are generally more benign.
TREATMENT OF BRAIN TUMORS
How to treat brain tumors depends on the age of the patient, the stage of the disease, the type and location of the tumor, and whether the cancer is a primary tumor or brain metastases. Brain cancer and brain tumors are somewhat unique because of the blood brain barrier, which severely restricts the types of substances in the bloodstream that are allowed by the body into the brain and makes drug treatment extremely difficult. Because of this more and more research is being undertaken in delivering medication by means of nanoparticles, amongst the properties of nanoparticles that make them ideal candidates for recognizing and treating brain cancer, their ability to deliver a wide variety of payloads across the blood-brain barrier is perhaps the most important.
Brain cancer's location and ability to spread quickly makes treatment with surgery or radiation like fighting an enemy hiding out among minefields and caves, and explains why the term brain cancer is all too often associated with the word inoperable.
Brain cancer survival statistics for the deadliest of tumors such as gliomas have not improved significantly over the past two decades and the clinical armamentarium is, to a large extent, still dependent on surgery and radiation therapy, treatments known to leave survivors with devastating cognitive deficits. Gamma knife surgery is a radiosurgery technique used to treat people with brain cancer and other neurological disorders
The most deadly form of brain cancer may be treatable with a vaccine that uses proteins. Unlike measles or mumps vaccines, which are meant to prevent disease, the brain cancer vaccine turns on the patient's own immune system so it will help kill the tumor. When the vaccine is injected, it stimulates the immune system to kill off brain cancer cells and prevent the regrowth of tumors that have already been treated.
There are two main types of brain cancer. Primary brain tumors start in the brain. Metastatic brain tumours start somewhere else in the body and moves to the brain. The most common tumor types in adults are gliomas and meningiomas. In children, incidence is generally highest before age 1 and again between ages 2 and 12. The most common types of brain tumour in children are astrocytomas, medulloblastomas, ependymomas and brain stem gliomas.
CAUSES OF BRAIN CANCER
What causes brain cancer is not exactly known but there has recently been a great deal of speculation on the role of cell phone radiation in the development of brain cancer. In fact, while studies generally have shown no link between cell phones and brain cancer, there is some conflicting scientific evidence that may be worth additional study, according to the FDA.
More accepted risk factors for brain cancer include; exposure to vinyl chloride and individuals with risk factors such as having a job in an oil refinery, as a chemist, embalmer, or rubber industry worker show higher rates of brain cancer. Other risk factors such as smoking, radiation exposure, and viral infection (HIV) have been suggested but not proven to cause brain cancer. Patients with a history of melanoma, lung, breast, colon, or kidney cancer are at risk for secondary brain cancer.
SIGNS AND SYMPTOMS OF BRAIN CANCER
Onset of symptoms is usually insidious and brain tumors are often misdiagnosed. Brain Cancers cause central nervous system changes by invading and destroying tissues and by secondary effects such as pressure on the brain. Symptoms vary but in general, brain cancer symptoms include: Abnormal pulse and breathing rates, deep, dull headaches that recur often and persist without relief for long periods of time, difficulty walking or speaking, dizziness, eyesight problems including double vision, seizures, vomiting and at the late stages of the disorder dramatic changes in blood pressure may occur. Although headaches are often a symptom of brain cancer, it is important to remember that most headaches are due to less serious conditions such as migraine or tension, not cancer.
DIAGNOSIS OF BRAIN CANCERS
In most cases a definitive diagnosis is made by a tissue biopsy. Other diagnostic tools include; patient history, a neurologic assessment, skull x-rays, a brain scan, CT scan, MRI, a lumbar puncture and cerebral angiography. Meningiomas, arising from the covering around the brain or spinal cord, account for about 20% of brain cancers and are generally more benign.
TREATMENT OF BRAIN TUMORS
How to treat brain tumors depends on the age of the patient, the stage of the disease, the type and location of the tumor, and whether the cancer is a primary tumor or brain metastases. Brain cancer and brain tumors are somewhat unique because of the blood brain barrier, which severely restricts the types of substances in the bloodstream that are allowed by the body into the brain and makes drug treatment extremely difficult. Because of this more and more research is being undertaken in delivering medication by means of nanoparticles, amongst the properties of nanoparticles that make them ideal candidates for recognizing and treating brain cancer, their ability to deliver a wide variety of payloads across the blood-brain barrier is perhaps the most important.
Brain cancer's location and ability to spread quickly makes treatment with surgery or radiation like fighting an enemy hiding out among minefields and caves, and explains why the term brain cancer is all too often associated with the word inoperable.
Brain cancer survival statistics for the deadliest of tumors such as gliomas have not improved significantly over the past two decades and the clinical armamentarium is, to a large extent, still dependent on surgery and radiation therapy, treatments known to leave survivors with devastating cognitive deficits. Gamma knife surgery is a radiosurgery technique used to treat people with brain cancer and other neurological disorders
The most deadly form of brain cancer may be treatable with a vaccine that uses proteins. Unlike measles or mumps vaccines, which are meant to prevent disease, the brain cancer vaccine turns on the patient's own immune system so it will help kill the tumor. When the vaccine is injected, it stimulates the immune system to kill off brain cancer cells and prevent the regrowth of tumors that have already been treated.
Brain Tumor Information
The brain is a soft, spongy mass of tissue. It is protected by the bones of the skull and three thin membranes called meninges. Watery fluid called cerebrospinal fluid cushions the brain. Human brain controls the central nervous system (CNS), by way of the cranial nerves and spinal cord, the peripheral nervous system (PNS) and regulates virtually all human activity. A brain tumor is a vry big problem of brain. A brain tumor is a mass or growth of abnormal cells in your brain. Brain tumors produce a variety of symptoms, ranging from headache to stroke. There are two types of brain tumors: primary brain tumors and seondry brains tumors. Primary brain tumors can be cancerous or noncancerous. Primary brain tumors include any tumor that starts in the brain.
Tumors may be confined to a small area, invasive (spread to nearby areas), benign (not cancerous), or malignant (cancerous). Primary brain tumors account for 50% of intracranial tumors and secondary brain cancer accounts for the remaining cases. The cause of primary brain tumors is unknown but there are many possible risk factors that could play a role. Exposure to some types of radiation, head injuries, and hormone replacement therapy may be risk factors, as well as many others. Secondary brain cancer occurs in 20–30% of patients with metastatic disease and incidence increases with age. Symptoms of brain tumors may depend on two factors first tumor size (volume) and second is tumor location. Treatment can involve surgery, radiation therapy, and chemotherapy.
Surgery is necessary for most primary brain tumors. Some tumors may be completely removed. High-energy radiation can be used to destroy tumor cells. Corticosteroids such as dexamethasone to reduce brain swelling. Chemotherapy drugs helps kill cancerous tumor cells. Osmotic diuretics such as urea or mannitol to reduce brain swelling and pressure. Anti-convulsants such as phenytoin to reduce seizures. Antacids or histamine blockers to control stress ulcers. Physical therapy can help you regain lost motor skills or muscle strength. Corticosteroids such as dexamethasone to reduce brain swelling. Osmotic diuretics such as urea or mannitol to reduce brain swelling and pressure. Anti-convulsants such as phenytoin to reduce seizures. Antacids or histamine blockers to control stress ulcers.
Brain Tumor Treatment and Prevention Tips
1. Anti-convulsants such as phenytoin to reduce seizures.
2. Surgery is the usual treatment for most brain tumors.
3. Support groups are beneficial in brain tumor.
4. Radiation therapy usually is given five days a week for several weeks.
5. Corticosteroids such as dexamethasone to reduce brain swelling
6. Osmotic diuretics such as urea or mannitol to reduce brain swelling and pressure.
Tumors may be confined to a small area, invasive (spread to nearby areas), benign (not cancerous), or malignant (cancerous). Primary brain tumors account for 50% of intracranial tumors and secondary brain cancer accounts for the remaining cases. The cause of primary brain tumors is unknown but there are many possible risk factors that could play a role. Exposure to some types of radiation, head injuries, and hormone replacement therapy may be risk factors, as well as many others. Secondary brain cancer occurs in 20–30% of patients with metastatic disease and incidence increases with age. Symptoms of brain tumors may depend on two factors first tumor size (volume) and second is tumor location. Treatment can involve surgery, radiation therapy, and chemotherapy.
Surgery is necessary for most primary brain tumors. Some tumors may be completely removed. High-energy radiation can be used to destroy tumor cells. Corticosteroids such as dexamethasone to reduce brain swelling. Chemotherapy drugs helps kill cancerous tumor cells. Osmotic diuretics such as urea or mannitol to reduce brain swelling and pressure. Anti-convulsants such as phenytoin to reduce seizures. Antacids or histamine blockers to control stress ulcers. Physical therapy can help you regain lost motor skills or muscle strength. Corticosteroids such as dexamethasone to reduce brain swelling. Osmotic diuretics such as urea or mannitol to reduce brain swelling and pressure. Anti-convulsants such as phenytoin to reduce seizures. Antacids or histamine blockers to control stress ulcers.
Brain Tumor Treatment and Prevention Tips
1. Anti-convulsants such as phenytoin to reduce seizures.
2. Surgery is the usual treatment for most brain tumors.
3. Support groups are beneficial in brain tumor.
4. Radiation therapy usually is given five days a week for several weeks.
5. Corticosteroids such as dexamethasone to reduce brain swelling
6. Osmotic diuretics such as urea or mannitol to reduce brain swelling and pressure.
Kennedy Brain Tumor Surgery
There are no minor brain surgeries. And when one is at the age that Ted Kennedy is, the body doesn't do well with the procedure; however, GOOD NEWS has come from the doctors this morning after Ted's surgery. Sen. Kennedy underwent what his doctors called successful surgery Monday to treat his cancerous brain tumor, and told his wife shortly after that he "felt like a million bucks," a family spokeswoman said.
Regardless of political affiliation we should all be rejoicing for he and his family.
The surgery at Duke University Medical Center took about 3 1/2 hours. He is expected to undergo chemotherapy and radiation in coming weeks. He is expected to remain at the North Carolina hospital for about a week. You have to know that he had the best of doctors and patient care.
Kennedy is 76-year-old and was diagnosed last month with a malignant glioma, a lethal type of brain tumor. Experts had said Dr. Allan Friedman -- the top neurosurgeon at Duke and an internationally known tumor and vascular surgeon -- was likely try to remove as much of the tumor as possible while balancing the risk of harming healthy brain tissue that affects movement and speech.
Foloowing the surgery, Dr. Friedman said the surgery "was successful and accomplished our goals." Kennedy was awake during the procedure, and should not experience any permanent neurological effects, he said. AWAKE! Amazing what's done these days.
After a brief recuperation, he will begin radiation at Massachusetts General Hospital and chemotherapy treatment. Family spokeswoman Stephanie Cutter said Kennedy spoke to his wife, Vicki, and told her: "I feel like a million bucks. I think I'll do that again tomorrow." RIGHT!
Kennedy had a seizure at his home on Cape Cod which led doctors to later announced that he had a malignant glioma in his left parietal lobe, a brain region that governs sensation but also plays some role in movement and language. A malignant glioma is one of the worst kinds of brain cancer, and malignant gliomas are diagnosed in about 9,000 Americans a year.
Here is the complete statement from Dr. Freidman:
"I am pleased to report that Senator Kennedy's surgery was successful and accomplished our goals. Senator Kennedy was awake during the resection, and should therefore experience no permanent neurological affects from the surgery. The surgery lasted roughly three and a half hours and is just the first step in Senator Kennedy's treatment plan. After a brief recuperation, he will begin targeted radiation at Massachusetts General Hospital and chemotherapy treatment. I hope that everyone will join us in praying for Senator Kennedy to have an uneventful and robust recovery."
Brain Surgery and the Application of Radiation
Generally speaking, tumors that grow in the brain are often good candidates for radiosurgery. This involves an application of radiation that goes through the skull and tissue and concentrates on the targeted mass. The whole process is bloodless, so skin and skull do not have to be opened to apply.
Radiosurgery is the common term for a type of radiation therapy that is usually done on the brain. Also known as stereotactic surgery, it usually involves one application of strong radiation concentrated on the tumor, yet saving the healthy normal tissue. The patient will receive radiation via linear accelerator or some radiation source directed by a collator. There will be many small beams sent through the skull into the brain converging on the mass. Radiation therapy will work both for malignant and non-malignant tumors.
Types of Radiation Brain Surgery
Radiation therapy has been a great boost for the field of brain surgery. This is a technique that will not only mean less invasive methods, but the patient's cost and recovery time is greatly reduced.
Radiation particles come in many forms, for example the company Elekta's radiosurgery tool, the "Gamma Knife," uses doses of gamma rays that bombard the cancer growth. This uses 201 beams of small focused radiation to converge onto the cancer tumor. The source of radiation comes from an isotope of cobalt. The concept was created more that 30 years ago by a scientist named Lars Leksel, Professor of Neurosurgery at Karolinsk Institute in Stockholm, Sweden.
Another radiosurgery tool, with the trade name Cyberknife, sends out tumor killing x-rays instead of Gamma ones. The beam is controlled by a robotic arm that uses data from mapping software to target the mass. The software that is used, called 6D, maps the tumor in an unusual way. It will compensate for patient movement as well as use the x-ray data to pinpoint the targeted area while compensating for projected error. They claim to bring the accuracy to 0.5 mm of error. Like the Gammaknife, it can be used for both malignant and non-malignant matter. However, one main different between the two is that Gammaknife is designed only for cranial radiation therapy.
Radiosurgery is the common term for a type of radiation therapy that is usually done on the brain. Also known as stereotactic surgery, it usually involves one application of strong radiation concentrated on the tumor, yet saving the healthy normal tissue. The patient will receive radiation via linear accelerator or some radiation source directed by a collator. There will be many small beams sent through the skull into the brain converging on the mass. Radiation therapy will work both for malignant and non-malignant tumors.
Types of Radiation Brain Surgery
Radiation therapy has been a great boost for the field of brain surgery. This is a technique that will not only mean less invasive methods, but the patient's cost and recovery time is greatly reduced.
Radiation particles come in many forms, for example the company Elekta's radiosurgery tool, the "Gamma Knife," uses doses of gamma rays that bombard the cancer growth. This uses 201 beams of small focused radiation to converge onto the cancer tumor. The source of radiation comes from an isotope of cobalt. The concept was created more that 30 years ago by a scientist named Lars Leksel, Professor of Neurosurgery at Karolinsk Institute in Stockholm, Sweden.
Another radiosurgery tool, with the trade name Cyberknife, sends out tumor killing x-rays instead of Gamma ones. The beam is controlled by a robotic arm that uses data from mapping software to target the mass. The software that is used, called 6D, maps the tumor in an unusual way. It will compensate for patient movement as well as use the x-ray data to pinpoint the targeted area while compensating for projected error. They claim to bring the accuracy to 0.5 mm of error. Like the Gammaknife, it can be used for both malignant and non-malignant matter. However, one main different between the two is that Gammaknife is designed only for cranial radiation therapy.
Brain Tumor – Treatment of Brain Tumor
The brain is the body’s most complex organ, so it’s no overstatement that treatment for brain tumors requires the latest technology skillfully used by a highly experienced medical team. Brain tumors typically are categorized as either primary or secondary. Primary brain tumors originate in your brain and can be noncancerous (benign) or cancerous (malignant). Secondary brain tumors result from cancer that began elsewhere and spread to your brain.
A tumor is a mass or growth of abnormal cells. Brain tumors typically are categorized as primary or secondary. Primary brain tumors (gliomas) originate in the brain and can be benign (slow growing) or malignant (fast growing). Secondary brain tumors (metastatic brain tumors), which are malignant, are more common. These tumors result from cancer that started elsewhere in the body and spread (metastasized) to the brain. Brain tumors are often challenging for doctors to treat.
Treatment of Brain Tumor
Surgery: This is the mainstay of brain tumor treatment. It involves removing as much of the tumor as possible while trying to minimize damage to healthy tissue. Some tumors can be removed completely, while others can be removed only partially or not all. If a tumor is slow-growing, doctors may not operate immediately, but take a watch-and-wait approach.
Tumors can be difficult to remove completely by surgery alone, because the tumor invades surrounding brain tissue much like roots from a plant spread through soil. In cases where the tumor cannot be removed, surgery may still help reduce pressure and relieve symptoms.
The body and its internal organs are virtually impossible to immobilize, requiring imaging throughout a linac treatment. The physician needs constant imaging to treat with confidence and often reduces the dose and increases the number of treatment sessions to compensate.
Radiation: High-energy radiation can be used to destroy tumor cells in your brain. Radiation plays a central role in the successful treatment of many brain tumors, both benign and malignant. After surgery, any remaining tumor cells can be treated and controlled with radiation, often reducing their size and rate of growth. Radiation also helps to prevent or delay the recurrence of tumors. Additionally, radiation has proven to be extremely helpful in treating inoperable tumors. There are different forms of radiation used for specific types and sizes of tumors.
Chemotherapy: These drugs, taken by mouth or intravenously, can help kill cancerous tumor cells. Chemotherapy consists of a series of drugs that interfere with the normal functioning of the rapidly dividing cells of the tumor. This prevents the tumor from growing. Most of these chemotherapy drugs are given in combination so that they are most effective. Research is being conducted to determine the best combination of chemotherapy drugs to combat brain tumors. Some chemotherapy drugs are injected directly into the bloodstream while others can be taken by pill, at home.
A tumor is a mass or growth of abnormal cells. Brain tumors typically are categorized as primary or secondary. Primary brain tumors (gliomas) originate in the brain and can be benign (slow growing) or malignant (fast growing). Secondary brain tumors (metastatic brain tumors), which are malignant, are more common. These tumors result from cancer that started elsewhere in the body and spread (metastasized) to the brain. Brain tumors are often challenging for doctors to treat.
Treatment of Brain Tumor
Surgery: This is the mainstay of brain tumor treatment. It involves removing as much of the tumor as possible while trying to minimize damage to healthy tissue. Some tumors can be removed completely, while others can be removed only partially or not all. If a tumor is slow-growing, doctors may not operate immediately, but take a watch-and-wait approach.
Tumors can be difficult to remove completely by surgery alone, because the tumor invades surrounding brain tissue much like roots from a plant spread through soil. In cases where the tumor cannot be removed, surgery may still help reduce pressure and relieve symptoms.
The body and its internal organs are virtually impossible to immobilize, requiring imaging throughout a linac treatment. The physician needs constant imaging to treat with confidence and often reduces the dose and increases the number of treatment sessions to compensate.
Radiation: High-energy radiation can be used to destroy tumor cells in your brain. Radiation plays a central role in the successful treatment of many brain tumors, both benign and malignant. After surgery, any remaining tumor cells can be treated and controlled with radiation, often reducing their size and rate of growth. Radiation also helps to prevent or delay the recurrence of tumors. Additionally, radiation has proven to be extremely helpful in treating inoperable tumors. There are different forms of radiation used for specific types and sizes of tumors.
Chemotherapy: These drugs, taken by mouth or intravenously, can help kill cancerous tumor cells. Chemotherapy consists of a series of drugs that interfere with the normal functioning of the rapidly dividing cells of the tumor. This prevents the tumor from growing. Most of these chemotherapy drugs are given in combination so that they are most effective. Research is being conducted to determine the best combination of chemotherapy drugs to combat brain tumors. Some chemotherapy drugs are injected directly into the bloodstream while others can be taken by pill, at home.
BRAIN SURGERY - CRANIOTOMY
What is Brain Surgery ?
Craniotomy is the broad term used to describe any operation where a hole is made in the skull. It is one of the oldest operations known to man. Archaeologists have found healed craniotomy openings in the skulls of Stone Age man, presumably made to release evil spirits!
Why is Brain Surgery being performed ?
There are many reasons for performing a craniotomy. It may be done as an emergency following a head injury or brain haemorrhage. This is to remove blood clots which are pressing on the brain. It may be necessary to remove a brain abscess. As a planned procedure, a craniotomy may be essential to remove a tumour or to clip an aneurysm.
What Happens during Brain Surgery ?
If a craniotomy is planned, there will be full discussion of the procedure between the surgeon, you and your relatives. In an emergency, the operation may be performed before relatives are even aware that you are in hospital: speed can be life-saving. A craniotomy will only be performed after investigation of your condition. This usually involves computerized x-ray (CT) or magnetic resonance scanning (MRI). Angiography is often performed. This is an x-ray procedure for seeing the arteries in the brain. For this, dye is injected via a fine tube inserted in the groin. You will be starved from about 8 hours before the operation and usually commenced on steroid (cortisone) tablets to reduce brain swelling. These tablets can sometimes cause stomach upset: the doctor must be told if you have previously had a stomach ulcer. When asleep, tubes will be placed into veins and arteries in the arms in order to give drugs and closely monitor blood pressure. The head will have to be closely shaved; sometimes this is only around the wound; sometimes the whole head must be shaved. The risk of infection is too high if it is not done. You will be placed on the operating table and the wound area thoroughly cleaned. The skull is exposed by making a curved cut over the appropriate area, called a flap, and hinging the flap out of the way. A square of bone is then cut out. Between the brain and skull is a thick membrane called the dura which is opened to expose the brain. When the operation is completed, the dura is closed with stitches. The bone disc is put back and held in place with stitches or wire. The scalp flap is sewn back in place with a layer of stitches or skin staples. A tube to drain any blood from under the scalp is usually left in place and a dressing to the wound applied. Some surgeons then put a heavy bandage over the whole head, others don't.
Possible Complications during Brain Surgery
All operations carry some risks. Brain surgery carries more than most. Any operation can be complicated by heart trouble, chest infection, blood clots in the leg (thrombosis) and wound infection. The chances of these complications are greater in elderly or unhealthy patients and, in particular, those who smoke or drink heavily. The major specific complications of brain surgery are damage to the brain at the time of surgery and bleeding within the head after the operation. Meningitis and epilepsy occasionally follow craniotomy. When bleeding is suspected, you would have to return to theatre within a few hours of the operation for a reopening of the wound. Sometimes deterioration is due to brain swelling and the bone flap is left out, being stored frozen in antibiotic solution. It may then be replaced at a later date when the swelling has settled down. The actual risk in a particular case will depend on the complexity of the operation. This will be explained by the surgeon beforehand. Most craniotomies are performed with no major complications and good results for the patient.
After Brain Surgery
You will probably wake rapidly after surgery but for the next 24 hours will be constantly watched in a special ward. If well, you will be allowed to drink and eat next day and sit out of bed. Intravenous drips and drain tubes will be removed after about 48 hours and stitches (or staples) will be taken out between 2 and 10 days later, depending on the particular operation and surgeon. Steroid tablets will be reduced gradually over several days. When everyone considers that you should be able to manage at home, you will be discharged, but will be seen for further follow-up. Return to work will depend on the underlying reason for the operation. The DVLC will usually withdraw the driving licence for 1 year after the operation because of the slightly increased risk of epilepsy after brain surgery. This risk is usually not large enough to require anti-epileptic tablets. Flying as a passenger within a couple of weeks of a craniotomy is no problem. The area around the wound is usually numb or itches slightly for up to 6 months after surgery, which is normal. For operations on the front of the head, the muscle which opens the mouth is cut and this can leave the jaw stiff and hard to open wide. This usually recovers within a few weeks. Recovery is aided by chewing gum or tough meat.
If Brain Surgery is not performed
This operation is never performed unless absolutely essential.
Brain surgery - Overview
Alternative Names
Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy
Definition of Brain surgery:
Brain surgery treats problems in the brain and the structures around it through an opening (craniotomy) in the skull (cranium).
Description:
The hair on part of the scalp is shaved. The scalp is cleansed and prepared for surgery. An incision is made through the scalp. The incision may be made behind the hairline and in front of your ear, at the hairline near your neck, or elsewhere, based on where the problem in your brain is located.
- The scalp is pulled up. A hole is created in the skull. A piece of the skull (a bone flap) is removed. Most of the time, this flap will be placed back after the surgery is over.
- Through this hole, your surgeon may clip off an aneurysm to cut off the blood flow, biopsy or remove a tumor, remove an abnormal part of your brain, or drain blood or an infection.
- Your surgeon may use a special microscope to perform the procedure. Monitors to check pressure may also be used.
- If possible, the surgeon will make a smaller hole and insert a tube with a light and camera on the end (endoscope). The surgery will be done with tools placed through the endoscope.
The surgeon may use computers to help find the exact spot that needs to be treated (MRI or CT scans).
The bone is usually replaced and secured in place using small metal plates, sutures, or wires. The bone flap may not be put back if your surgery involved a tumor or an infection, or if the brain was swollen. (This is called a craniectomy.)
History of Brain Surgery
Brain surgery is perhaps the oldest of the practiced medical arts. No hard evidence exists suggesting a beginning to the practice of other facets of medicine such as pharmacology -- using drugs, chemical and natural ingredients to help a fellow human being. There is ample evidence, however, of brain surgery, dating back to the Neolithic (late Stone Age) period. 
Unearthed remains of successful brain operations, as well as surgical implements, were found in France-- at one of Europe's noted archeological digs.
Unearthed remains of successful brain operations, as well as surgical implements, were found in France-- at one of Europe's noted archeological digs. And, the success rate was remarkable, even circa 7,000 B.C.
But, pre-historic evidence of brain surgery was not limited to Europe. Pre-Incan civilization used brain surgery as an extensive practice as early as 2,000 B.C. In Paracas, Peru, a desert strip south of Lima, archeologic evidence indicates that brain surgery was used extensively. Here, too, an inordinate success rate was noted as patients were restored to health. The treatment was used for mental illnesses, epilepsy, headaches, organic diseases, osteomylitis, as well as head injuries.
Brain surgery was also used for both spiritual and magical reasons; often, the practice was limited to kings, priests and the nobility.
Surgical tools in South America were made of both bronze and man-shaped obsidian (a hard, sharp-edged volcanic rock).
Africa showed evidence of brain surgery as early as 3,000 B.C. in papyrus writings found in Egypt. "Brain," the actual word itself, is used here for the first time in any language. Egyptian knowledge of anatomy may have been rudimentary, but the ancient civilization did contribute important notations on the nervous system.
Hippocrates, the father of modern medical ethics, left many texts on brain surgery. Born on the Aegean Island of Cos in 470 B.C., Hippocrates was quite familiar with the clinical signs of head injuries. He also described seizures accurately, as well as spasms and classified head contusions, fractures and depressions. Many concepts found in his texts were still in good stead two thousand years after his death in 360 B.C. 
Ancient Rome in the first century A.D. had its brain surgeon star, Aulus Cornelius Celsus. Hippocrates did not operate on depressed skull fractures; Celsus often did. Celsus also described the symptoms of brain injury in great detail.
Asia was home to many talented brain surgeons: Galenus of Pergamon, born in Turkey, and the physicians of Byzance such as Oribasius (4th century) and Paul of Aegina. An Islamic school of brain surgery also flourished from 800 to 1200 A.D., the height of Islamic influence in the world. Abu Bekr Muhammed el Razi, who lived from 852 to 932 in the Common Era, was perhaps the greatest of Islamic brain srugeons. A second Islamic brain surgeon, Abu l'Qluasim Khalaf, lived and practiced in Cordoba, Spain, and was one of the great influences on western brain surgery.
The Christian surgeons of the Middle Ages were clerics, well educated, knowledgeable in Latin, and familiar with the realm of medical literature. Despite the church's ban on study of anatomy, many churchmen of great renown (advisors and confessors to a succession of Popes) were outstanding physicians and surgeons. Leonardo Davinci's portfolio containing hundreds of accurate anatomical sketches indicates the intense intellectual interest in the workings of the human body despite the Church's ban.
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