• Acoustic Neuroma

  Also called vestibular schwannoma, this benign and usually slow-growing tumor develops on the main nerve leading from the inner ear to the brain. It is occasionally responsible for hearing loss, and in extreme cases the tumor can grow large enough to affect certain functions of the brain. Radiation treatment or surgical removal may be called for after regular monitoring determines that the tumor is still growing.

• Arteriovenous Malformation

  Arteriovenous Malformation is an abnormal connection between arteries and veins that bypasses the capillary system. This anomaly occurs most often in the central nervous system. While seven out of eight patients display no symptoms, AVM can cause severe pain, seizures and bleeding, sometimes including cerebral hemorrhage. Neurosurgery, radiation or a procedure in which a small device or substance is used to block blood supply to the AVM are the preferred treatment alternatives.

• Brain Abscess

  This is a collection of pus, immune-system cells and other material in the brain, usually from a bacterial or fungal infection. The brain can swell, putting pressure on delicate cranial tissue, and the abscess can block blood vessels in the brain. Pressure inside the skull may get high enough to become life threatening, so immediate treatment is required. Antibiotics or antifungal meds usually are the first choice, but surgery to drain the abscess may be called for if swelling continues.

• Brain Tumor

  Such tumors, defined as an abnormal and uncontrolled growth of cells, may be benign or malignant. Brain cancer may originate in that part of the body, or it can spread from a malignancy elsewhere; the latter refers to when cancer has metastasized. A brain tumor inherently is a serious condition because of where it occurs. But cancer in the brain – even in malignant cases – is not always fatal. People with benign tumors may leave the hospital a day after surgery. Malignant tumors typically require more aggressive treatment, often including radiation and/or chemotherapy after surgery.

• Carpal Tunnel Syndrome

  A condition that is progressively painful in the hand and arm, this is caused by a pinched nerve in the wrist. The carpal tunnel is a narrow passage – about as wide as the thumb –on the palm side of the wrist. The tunnel, bound by ligaments and small bones, protects a key nerve to the hand and nine tendons that bend all but the little fingers. People who spend a lot of time using a keyboard may be afflicted, but the anatomy of a patient’s wrist and other health problems such as a thyroid condition or diabetes may be factors. For many people, physical therapy and rest – sometimes accompanied by use of a wrist brace – can relieve the pain, tingling, weakness and numbness and restore normal use. In severe cases, surgery may be performed to create more room in the carpal tunnel to relieve pressure on the median nerve, which runs from the forearm to the hand.

• Cerebral Aneurysm

  This happens when a weakness in the wall of an artery or vein in the brain causes that section of the vessel to expand like a balloon. The effects can range from no symptoms at all for a small aneurysm to sudden death if the weakened area of the blood vessel bursts. Before a larger aneurysm ruptures, the patient may experience a horrendous headache, impaired vision and nausea or vomiting. The risk of aneurysm may be increased by high blood pressure, smoking, alcohol or cocaine abuse and obesity. About 60 percent of victims die immediately after the rupture of a large aneurysm. Those who survive may be treated by efforts to reduce pressure inside the brain, stanching the aneurysm with a surgical clip or the use of platinum coils inserted by means of a catheter to prevent further bleeding.

• Craniopharyngioma

  The condition is a benign brain tumor that forms near the pituitary gland at the base of the brain. It most often affects children between the ages of 5 and 10. Craniopharyngioma can increase pressure on the brain, disrupt the function of the pituitary gland, and damage the optic nerve. There may be decreased hormone production, and many patients suffer vision problems. A compromised pituitary gland may cause stunted growth along with increased thirst and urination. Pressure on the brain can cause nausea and vomiting, headaches and difficulty with balance. Surgery usually is called for to remove the tumor – with or without radiation treatment.

• Cubital Tunnel Syndrome

  This is a condition brought on by heightened pressure on the ulnar nerve at the elbow. This nerve passes under a small hump of bone on the inside of the elbow where there is little padding. (This site often is called “the funny bone.”) When pressure on the nerve becomes too great, pain, tingling or numbness may result in the elbow, forearm, hand and/or fingers. If pressure on the ulnar nerve is minimal, surgery may be avoided, and the condition can improve when patients learn to change ways they use or move their elbow. Something as simple as not resting the elbow on a hard surface can help. In some cases, an elbow split or brace is useful. When necessary, surgery can adjust the position of the nerve in such a way that there is a cushion of fat between it and the bone.

• Epilepsy

  Epilepsy is a medical condition that produces seizures affecting a variety of mental and physical functions. It is also called a seizure disorder. When a person has two or more unprovoked seizures, they are considered to have epilepsy. Epilepsy and its seizures can be controlled but not cured with anticonvulsant medication. Surgery is considered when a patient has what is called a focal epilepsy. This arises from an epileptic focus, which is a small portion of the brain that serves as the irritant driving seizure responses. The goal of surgery is to remove one or more lesions, which may be tumors or arteriovenous malformation, from this part of the brain and eradicate seizures for good.

• Hemifacial Spasm

  A rare neuromuscular disease, hemifacial spasm produces involuntary muscle contractions, or spasms, on one side of the face at irregular intervals. This affliction can happen to anyone, though it is more common in women of middle age or older and among Asian people. Hemifacial spasm may be caused by an injury to the facial nerve on either side of the face, a tumor, a blood vessel pressing on the nerve where it leaves the brainstem, or its cause in a given patient may never be known. The disease may first present as a twitching of the eyelid or elsewhere around the eye; it can then move to the lips and cheeks. Treatment is often the same as for trigeminal neuralgia with an anticonvulsant being tried first, then a surgical procedure called microvascular decompression if medication fails to resolve the problem.

• Herniated Disc Cervical

  A herniated disc in the cervical region is a spine condition that occurs when the gel-like center of a disc ruptures through a weak area in the tough outer wall diminishing the disc’s ability to cushion the vertebrae. Minor herniations can heal after several weeks. Physical therapy also may help or a combination of physical therapy and prescribed painkillers, including strong opiates or their derivatives such as morphine, Dilaudid (hydromorphone) or oxycodone. In severe cases, surgery may be required to trim away bulging areas of the disc so they do not impinge on nerves, replace the disc with a man-made material, or fuse together the two vertebrae above and below the herniated disc.

• Herniated Disc Lumbar

  A herniated disc in the lower back occurs when trauma – whether from a slip and fall, injury from improper lifting, an auto accident – or aging or disease causes one or more of the discs that serve as shock absorbers between each of the vertebrae to bulge outward, pressing on a nerve root and causing pain that may radiate down a leg. A bulging disc sometimes may rupture, and the jelly-like material inside the tough, fibrous outer membrane can ooze out, diminishing the disc’s ability to cushion the vertebrae. Minor herniations can heal after several weeks. Physical therapy also may help. In severe cases, surgery may be required to trim away bulging areas of the disc so they do not impinge on nerves, replace the disc with a man-made material, or fuse together the two vertebrae above and below the herniated disc.

• Hydrocephalus

  Also known as “water on the brain,” this is a condition in which there is an abnormal accumulation of cerebrospinal fluid in the small cavities of the brain. This can cause increased pressure inside the skull and progressive enlargement of the head. These factors, in turn, can lead to mental disorders, vision problems, convulsions and even death. The first symptoms to present may be headaches, vomiting, swelling in the brain, sleepiness or coma. Treatment for this disorder generally is surgical with the use of a shunt to drain excess fluid to other parts of the body, where the circulatory system will dispose of it.

• Movement Disorders

  Movement disorders are comprised of a variety of conditions resulting in abnormalities in the motor system. These can include Parkinson’s disease, Tourette syndrome, cerebral palsy, chorea, restless leg syndrome, Huntington’s disease, ataxia and more. Many movement disorders are inherited and treatment varies by disorder. Medicine can cure some disorders. Other conditions require treatment or surgery to see positive results. Often, however, there is no cure and in that case, the goal of treatment is to improve symptoms and relieve pain.

• Moyamoya Disease

  With this condition, certain arteries in the brain are constricted, and blood flow may be fully or partially blocked. The term “moyamoya” (Japanese for “puff of smoke”) refers to the appearance on diagnostic imaging of a collateral network of blood vessels that develop adjacent to the constricted vessels. Collateral circulation develops almost anywhere in the body to create alternative paths for blood flow when the primary route shuts down for some reason. But these makeshift vessels tend to be smaller and weaker than normal arteries and veins, increasing the chances of stroke or aneurysm.

• Pituitary Tumors

  The pituitary gland, located at the base of the brain, is about the size of an acorn. It sometimes is referred to as the “master gland” because it releases substances that control the basic functions of growth, metabolism and reproduction. A tumor in the pituitary gland causes symptoms by either releasing too much of a hormone or by pressing on the gland causing it to release too little hormone. A pituitary tumor, like the craniopharyngioma discussed above, may also cause symptoms by growing and pressing on the structures, such as nerves to the eyes, surrounding the gland. Only one kind of pituitary tumor, the type that secretes a hormone called prolactin, can be successfully treated with medication. Others require radiation or surgery.

• Rathkes Cleft Cyst

  These lesions located in spaces at the base of the brain are thought to originate from remnants of Rathke’s pouch, which is an embryonic structure that comes from the roof of the mouth and forms the anterior pituitary gland. The cysts often produce no symptoms, but larger ones can cause compression of the pituitary gland or other glands, nerves or structures in that area. Patients may complain of headaches and visual problems. Many will have glandular dysfunctions due to involvement of the pituitary or hypothalamus. A few patients can present with seizures. Surgery is necessary to remove the cyst and relieve any pressure on the brain.

• Spinal AVM

  This comprises a group of disorders in the network of blood vessels that nourish the spinal cord. There are four kinds of spinal arteriovenous malformations, which are characterized based on where they originate. Treatment either is surgery to remove a piece of bone over the spinal cord so the lesion can be cut away or what is called endovascular therapy. This involves placing a catheter into the AVM from the groin through femoral artery and injecting glue or beads into the AVM to stop its blood flow. Each spinal AVM is unique and requires an individualized treatment strategy.

• Spinal Cord Injury

  Such injuries involve damage to the spinal cord that results in a loss of function below the level of the lesion, including paralysis, sensory loss, bowel/bladder/sexual dysfunction. These injuries most commonly occur after trauma, however there other causes including pathologic fractures, spinal tumors, infections and congenital spinal anomalies. There are more than 450,000 people in the United States with spinal cord injuries. About 10,000 new cases occur each year of which the majority of are males between the ages of 16-30. A complete spinal cord injury means there is no voluntary movement or sense of touch below the level of the injuries, while a so-called incomplete injury leaves a patient with the ability to move one limb or to have feeling in a limb that cannot move. Surgery cannot cure a severe spinal cord injury but is meant to stabilize the spine to prevent further injury to the cord and allow the patient to move into rehabilitation to maximize use of his or her limbs.

• Spinal Cord Tumors

  These growths are categorized according to their location: outside the dura, which is the tough, fibrous covering of the spinal cord; between the dura and the cord; or within the spinal cord itself. The most common spinal cord tumors are those on the exterior of the dura, and most of those metastasize from a cancer elsewhere in the body. Surgery alone usually cures benign tumors. Those that are malignant may require radiation therapy after surgery.

• Spinal Deformity

  These afflictions fall into two broad categories: scoliosis, which is an abnormal curvature of the spine on the side-to-side plane, and kyphosis, which is seen when a person’s spinal balance has moved too far forward to allow the spine to effectively carry the body weight without progressive deformity, pain or neurologic loss of function. Patients typically walk in a forward flexed posture being unable to stand up straight. Braces may be effective for younger patients when the spine may be encouraged to grow straighter. Physical therapy may strengthen the muscles around the spine to improve the patient’s range of motion and balance. Cortisone injections can provide relief from pain and inflammation. Surgery is considered only when the more conservative approaches have failed or the curvature is getting progressively worse.

• Spinal Fractures

  Fractures to one or more vertebrae can result from a fall, osteoporosis, traumatic accident, spinal tumor or spinal infection. Many cases will never require surgery; use of an external brace until the bone heals may be sufficient. For other patients, surgery is essential to avoid serious long-term problems, which may include paralysis. A factor that may determine whether surgery is necessary is the presence of neurological problems. If bone fragments are pressing on the spinal cord or nerve roots, causing severe pain and weakness, surgery likely will be necessary. Such operations may involve the use of hardware such as plates, pins, rods, screws or a cage and/or fusion in which two or more vertebrae are joined together with a bone graft.

• Spinal Stenosis

  With aging, and sometimes because of trauma, the discs that separate one vertebra from another to cushion the spine can degenerate and narrow. This produces abnormal motion at that spinal level. In an attempt to repair this condition, the spine generates bone spurs and thickened ligaments. This process leads to gradual narrowing of the spinal canal, which is called spinal stenosis. Rest and anti-inflammatory medicines help patients with mild cases of stenosis; exercise and physical therapy help rebuild fatigued muscles and encourage proper alignment of the spine. Surgery may be called for in more complicated cases. A bone graft and fusion after the injured disc is removed is one option. The recent development of artificial discs to replace the diseased disc offers surgeons another alternative.

• Stroke

  A stroke is a condition in which the brain cells suddenly die because of a lack of oxygen. This can be caused by and obstruction in the blood flow or the rupture of an artery that feeds the brain. The two main types of stroke include ischemic stroke and hemorrahagic stroke. An ischemic stroke results from a sudden loss of blood supply to the brain because of an obstruction – often a blood clot in the brain or in one of the major arteries leading to the brain such as the carotid. A hemorrhagic stroke, on the other hand, involves the rupture of a blood vessel in the brain. About seven out of eight strokes are of the ischemic variety; the other 13 percent are hemorrhagic. When a patient with an ischemic stroke is treated within the first hour with a clot-busting medication, recovery can be complete. Hemorrhagic strokes, on the other hand, are more problematic because a ruptured blood vessel in the brain must be repaired surgically, and lengthy physical and speech therapy often are necessary for patients to regain some level of partial recovery.

• Traumatic Brain Injury

  In the United States, 1.4 million people suffer a traumatic brain injury each year, though the vast majority are treated at a hospital emergency room and released. Trauma to the head can result in several types of injuries, including skull fractures, concussions, cerebral contusions (bruising), and hematomas, which is bleeding inside the body. This can take place between the skull and the tough outer membrane covering the brain (the dura), between the dura and another membrane that envelops the brain, or within the brain itself. Surgery is necessary to remove blood that has pooled from ruptured blood vessels and relieve pressure on the brain.

• Trigeminal Neuralgia

  When a cranial artery presses on one or both trigeminal nerves, which lead from the brain to the scalp and face from a point behind the ear, extreme pain can result. Treatment with an anticonvulsant medication called carbamazepine is tried first; opiate-style painkillers may also be used. When treatment with medication fails, surgery may be called for. The most effective option is to isolate the offending artery and place a soft buffering material between the blood vessel and the nerve so the nerve no longer is impinged.

• Vein of Galen Malformation

  This is an aneurysm that results from a malformation of blood vessels of the brain that occurs prior to birth. Specifically, it is a deformity that shunts blood from cerebral arteries into a dilated vein of Galen (a deep internal cerebral vein). This malformation shunts blood from the arteries into the veins rather quickly, increasing overall blood flow and, in turn, increasing the work of the heart. The result often is heart failure. This problem usually is diagnosed while the fetus is still inside the mother’s womb. Treatment usually involves the use of a catheter to reach the vein of Galen and injection of glue or coils into the lesion to close it off and stop the shunting of blood. This may need to be done several times before the child reaches age 2 to stop all the internal bleeding.