Brain
BRAIN TUMOR
What is it?
A brain tumor is a mass of tissue that forms by the accumulation of abnormal cells in one location. As cells age, they typically die and get replaced by new cells. Tumors form when something disrupts the cycle so that the cells grow instead of dying. As the process continues, new cells are added to the mass and the tumor continues to grow.
Not all brain tumors are cancerous. The ones that are malignant typically grow faster than benign tumors and can spread to other parts of the brain and central nervous system.
Brain tumors are divided into many classifications. Primary brain tumors refer to tumors that originate in the brain, and metastatic tumors are tumors that originate elsewhere in the body and travel through the bloodstream to the brain. Primary brain tumors may be either benign or malignant. Metastatic tumors are malignant.
New treatments are being developed rapidly and the prognosis for patients with brain tumors is brighter than it ever was in the past.
Symptoms
Symptoms caused by a herniated disc in the lumbar spine include:
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Headaches
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Seizures
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Double vision
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Weakness
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Numbness
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Nausea
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Vomiting
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Decreased vision
The procedure
Regardless of whether the tumor is benign or malignant, it’s important that it be removed, if at all possible. Brain tumors can damage the cells around them by causing inflammation and putting increased pressure on the tissue under and around it as well as inside the skull. For those tumors that can’t be surgically removed due to the location in the brain, chemotherapy and radiation therapy may be options for killing or shrining the tumor. These therapies are sometimes recommended after surgery on malignant tumors to kill any remaining cancer cells.
BRAIN METASTASIS
What is it?
If you’ve been told your tumor is metastatic, it means you have a primary cancerous tumor that began in a different area of your body and then spread to your brain through your bloodstream. Brain metastasis is pretty common, affecting an estimated 150,000 – 200,000, or 24 – 45 percent of all cancer patients in the U.S. Compare this to the approximately 17,000 people diagnosed each year with a primary brain tumor.
Although any cancer can spread to the brain, the three most likely to do so are breast cancer, lung cancer, and melanoma. Other cancers that often spread to the brain include colon cancer, gynecologic cancers, and renal cell carcinoma.
Cancer can metastasize (or spread) to a single location or to multiple locations in the brain. It can also spread to the cerebrospinal fluid or to the leptomeninges, the outer lining of the brain and spinal cord. This type of metastasis is known as leptomeningeal disease (LMD), or leptomeningeal carcinomatosis.
Increasingly, metastatic tumors can be treated using gamma knife technology, a non-invasive procedure in which Dr. Adler is specifically trained.
Symptoms
Symptoms caused by a herniated disc in the lumbar spine include:
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Pain in the leg, especially in the buttocks, thigh, and calf
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Numbness or tingling in your leg
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Weakness of your leg
Pain is caused by inflammatory chemicals that are released around the injured area, and the injured disc can also put pressure on the nerve roots as they travel through the adjoining tunnel to and from the spinal cord. This can cause pain, pins and needles and numbness into your leg and also lead to significant muscular weakness.
Treatment
If symptoms don’t respond to conservative measures or time then Dr. Adler may recommend surgery, particularly if there is persistent pain or weakness in your legs. If surgery is needed, it is aimed at reducing the pressure from the herniated disc on surrounding tissues or relieving any pressure on the nerve roots as they exit from the spinal cord. This should relieve any pain or sensation traveling down into your legs.
PITUITARY
ADENOMA
What is it?
A pituitary adenoma is a typically slow-growing, benign growth or tumor on the pituitary gland that isn’t considered cancerous and won’t spread to other parts of the body.
However, because the pituitary gland is located below the brain and above the nasal passages, a pituitary adenoma can grow and press upon nearby nerves that lead to the brain, thus causing symptoms. Additionally, a large adenoma can crush normal pituitary cells and impede them from working properly, causing visual changes, headaches, and additional symptoms.
Symptoms
General symptoms can include:
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Headaches
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Vision changes
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Extreme tiredness
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Low blood pressure
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Nausea or vomiting
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Nasal drainage
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Achy joints or muscle weakness
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Unexplained weight gain or loss
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Sexual dysfunction
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Infertility
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Changes in your menstrual cycle
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Early menopause
Treatment
Pituitary adenomas can be treated with medication, surgery, radiation, or a combination of these.
Through medical management, some types of pituitary adenomas can be shrunk and symptoms relieved, while radiation therapy can kill the cells and thus shrink the tumor. When surgery is indicated, Dr. Adler will typically use endoscopic surgery to remove the tumor.
SUBDURAL
HEMATOMA
What is it?
A subdural hematoma is a pooling of the blood outside the brain and is usually caused by a head injury severe enough to burst blood vessels. This condition can be life-threatening because the bleeding increases pressure on the brain, which in turn compresses brain tissue, which can lead to death.
Although anyone can contract a subdural hematoma, the following conditions increase the risk:
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Blood-thinning medications
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Poor blood clotting
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Long-term alcohol use
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Repeated head injury
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Age (either very young or older adults)
Symptoms
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Symptoms include:
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Headaches
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Confusion
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Nausea or vomiting
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Slurred speech
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Memory loss
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Double vision
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Seizures
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Changes in vision or speech
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Coma
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Weakness, numbness, or tingling in the arms or legs
Treatment
A large subdural hematoma with accompanying neurological symptoms requires immediate medical attention, and in most cases, emergency surgery to drain the hematoma and ease the pressure on the brain.
There are a variety of surgeries used to treat subdural hematomas – Dr. Adler will review your options with you and give you his recommendation that will achieve optimal results with the most minimal invasiveness.
TRIGEMINAL
NEURALGIA
What is it?
Trigeminal neuralgia is a condition that causes excruciating facial pain. The pain is often triggered by everyday activities such as touching your mouth, talking, eating, brushing your teeth, shaving, etc. These pains often last only moments, but the pain is so severe that it can be incapacitating.
Trigeminal neuralgia is caused by vascular compression of the fifth cranial (trigeminal) nerve. It may involve one, two or (rarely) three branches of the nerve and almost exclusively occurs on only one side of the face.
Symptoms
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Episodes of facial pain are the main symptom of trigeminal neuralgia. These may start out as short and mild attacks, but the condition usually progresses and causes longer, more frequent bouts of pain. The pain is typically triggered by things like touching your face, chewing, talking, or brushing your teeth. It can also manifest as a constant aching, burning feeling in areas fed by the trigeminal nerve such as the cheek, jaw, teeth, gums, lips, or (less often) the eye and forehead.
The procedure
Treatment of trigeminal neuralgia usually begins with medication such as anticonvulsants, muscle relaxers, and even Botox injections. If medications are not effective or side effects of the medications are unacceptable, surgical treatment may be considered. Most often, Dr. Adler's surgical approaches include blocking the appropriate nerve or microvascular decompression or employing a gamma knife procedure
