• Brain



  • At Parker Adventist Hospital, we have skilled neurosurgeons with expertise to choose the right treatment choice based on an individual's needs. We have a specialized intensive care unit where the nursing staff is trained and skilled in giving the best care to the neuroscience patient. 


  • Brain.jpgBrain tumors can be classified as

    • Primary (originating in the brain tissue itself).
    • Secondary (Metastatic - cancer cells from other parts of the body spread to the brain). Secondary brain tumors are more common than Primary.

    They can also be classified as

    • Malignant (cancerous brain tumor).
    • Nonmalignant (benign brain tumor).

    The degree of malignancy is often referred to by its histology grade (cell appearance under a microscope). The grading system is from I to IV.

    • Grade I: Brain tumors are benign. The cells look nearly like normal brain cells and they grow slowly.
    • Grade II: The tissue is malignant. The cells look less like normal cells than the cells in a Grade I tumor.
    • Grade III: The malignant tissue has cells that look very different from normal cells. The abnormal cells are actively growing.
    • Grade IV: The malignant tissue has cells that look abnormal and tend to grow quickly.

    Grade II to IV brain tumors have increasing degrees of malignant characteristic and behavior. Malignant brain tumors contain cancerous cells. High-grade malignant brain tumors (Grade III-IV) grow rapidly and invade healthy tissue around them. These brain tumors eventually crowd out or destroy the normal cells and interfere with their function. These can be life threatening. Low grade tumors (Grade I to II) grow slowly over time.


    Nonmalignant (benign) brain tumors do not contain cancer cells and do not spread. However they can be located in vital or sensitive area of the brain and interfere with normal brain activity and critical functions. Common benign brain tumors include the meningiomas, schwannomas and pituitary adenomas.

    Brain Tumors

    Meningiomas
    Meningiomas are usually slow growing (benign) tumors that develop from the lining of the brain. They may be found over the surface of the brain, the base of the brain or between the two hemispheres of the brain. Meningiomas account for approximately 20 percent of all brain tumors.

    Astrocytomas/Gliomas
    Astrocytomas are the most common glioma and can occur in most parts of the brain. Astrocytomas can develop at any age, although they are more common in adults. The World Health Organization (WHO) grades the development and advancement of brain tumors.

    • Low Grade Astrocytomas (Grade I Astrocytomas) are uncommon tumors that can often be cured by surgically removing the tumor.
    • Grade II Astrocytomas are tumors that penetrate into the surrounding normal brain making a surgical cure more difficult.
    • Grade III Astrocytomas are referred to as "anaplastic astrocytoma." These tumors are more invasive and invade surrounding tissues. The standard initial treatment is to remove as much of the tumor as possible without worsening neurologic deficits and utilize radiation therapy for the remaining tumor.
    • Grade IV Astrocytomas are referred to as Glioblastoma multiforme. These are the most common and the most malignant primary brain tumors. These brain tumors spread quickly to other parts of the brain. For this reason they are difficult to treat and it is not uncommon for them to reoccur after initial treatment.

    Ependymomas
    Ependymomas are tumors that develop in the cells that line the passageways in the brain where cerebrospinal fluid (special fluid that protects the brain) flows. These are a rare glioma and can be found anywhere in the brain or spine. They are more common in the cerebrum (the main part of the brain). Surgical removal may cure the problem.

    Oligodendrogliomas
    Oligodendrogliomas are tumors that develop on the cells that support and nourish the nerve cells. This tumor is found in the cerebrum (the main part of the brain). They are a relatively uncommon type of brain tumor. Treatment options include surgery, radiation and chemotherapy.

    Diagnosing brain tumors

    • MRIMRI (Magnetic Resonance Imaging) - A large machine with a strong magnet linked to a computer that is used to make detailed pictures of the area inside your head. Sometimes a special dye is injected into the blood stream during the procedure to help better distinguish tumors from healthy tissue (MRI angiogram). The pictures can show abnormal cells in your brain (tumors). MRI scans are particularly useful in diagnosing brain tumors because they outline the normal brain structure in detail.
    • CT (Computerized Tomography) - An X-ray machine linked to a computer takes a series of detailed pictures of your head. You may receive a special dye that makes abnormal areas show up better.
    • Angiogram - A special dye is injected into the arteries that go to the brain. This can be seen on an X-ray. This test helps locate blood vessels in and around the brain tumor.
    • Biopsy - The removal of tissue to look for tumor cells. A pathologist looks at the cells under a microscope to check for abnormal cells. A biopsy can show cancer, tissue changes that may lead to cancer and other conditions. A biopsy is the only sure way to diagnose a brain tumor, learn what grade it is and plan treatment.

    Treatments

    • Surgery - The goal of surgery is to remove as much of the tumor as possible without removing delicate brain tissue. For some individuals, the tumors may be small and removed easily without disrupting normal brain tissues. This allows for full removal of the tumor. For other tumors that are larger or have invaded surrounding tissues, the surgeon may not be able to take out the entire tumor.
    • Radiation Therapy - Radiation therapy uses beams of high-energy particles, such as X-rays, to destroy the tumor cells.
    • Radiosurgery (also known as stereotactic radiosurgery) - Uses multiple beams of radiation to give a highly focused form of radiation directly on the tumor. Each beam of radiation is not that powerful; however the point where they all meet (directly on the tumor) has a powerful amount of radiation to destroy the tumor cells.
    • Chemotherapy - Chemotherapy is medication used to destroy tumor cells. This can be given as a pill or through your veins (IV).

    At Parker Adventist Hospital, we have skilled neurosurgeons with expertise to choose the right treatment choice based on an individual's needs. We have a specialized intensive care unit where the nursing staff is trained and skilled in giving the best care to the neuroscience patient.

    The pituitary gland is a small gland that is located in the center of the brain. This gland produces important hormones for your body. A pituitary tumor is an abnormal growth that develops on the pituitary gland in the brain. They are almost always noncancerous (benign). Although a pituitary tumor does not grow and spread extensively, it can exert pressure on the pituitary gland itself causing the gland to either produce an over amount or under amount of hormones for your body. This can cause serious health problems in other organs in your body. A pituitary tumor can also exert pressure on nearby nerves such as your optic nerve, which can cause visual impairments.

    Diagnosing

    • MRI (Magnetic Resonance Imaging) is the standard imaging test for pituitary tumors. An MRI uses magnetic fields and radio waves to generate images. MRI scans are particularly useful in diagnosing brain tumors because they outline soft tissues as well as bone. Sometimes a special dye is injected into the blood stream to distinguish tumors from healthy tissue.

    Treatment

    • Close observation may be done depending on the effects of the tumor. Very small pituitary tumors that do not impact the hormones in the body may not require surgical treatment. This accounts for approximately 60-70% of all pituitary tumors.
    • Medications may be used to help block the excess hormone secretions. Some medications may actually shrink certain types of pituitary tumors (prolactin hormone producing tumors and growth hormone producing tumors).
    • Surgery is the primary treatment recommendation for pituitary tumors. The "transsphenoidal endoscopic tumor removal" is a common approach for removal of these tumors. With this technique, the pituitary tumor is removed through the nasal cavity using a microscope and endoscope assisted technique. This type of surgery allows the surgeon to remove the tumor without impacting other areas of the brain. Patients experience fewer neurological complications and there is no visible scar. Patients also have shorter operating time and a shorter length of stay.
    • Radiation therapy is another option for some patients. This is often recommended when pituitary tumors persist or return after surgery. The most common form of radiation for pituitary tumors is stereotactic radiosurgery. This technology allows high doses of radiation to be delivered to the tumor with minimal exposure to surrounding healthy tissue.

    At Parker Adventist Hospital, we have skilled neurosurgeons with expertise to choose the right treatment choice based on an individual's needs. We have a specialized intensive care unit where the nursing staff is trained in giving the best care to the neuroscience patient.

    A Colloid cyst is a slow growing tumor typically found near the center of the brain. If large enough, it can stop the flow of cerebral spinal fluid (CSF - the brain's normal fluid) resulting in fluid build up in the ventricles (hydrocephalus). These tumors are considered congenital and are usually symptomatic in patients between the ages of 20-50 years. Approximately 0.5-1% of all primary brain tumors are colloid cysts.

    Diagnosing

    • MRI (magnetic resonance imaging)
    • CT (computed tomography)

    Treatments

    • Surgery - Surgery is often recommended for these types of tumors primarily to relieve hydrocephalus and prevent further deterioration.
    • CSF shunt - A CSF shunt may be recommended if the cyst is considered too high risk or if hydrocephalus continues despite removal of the cyst.

    At Parker Adventist Hospital, we have skilled neurosurgeons with expertise to choose the right treatment choice based on an individual's needs. We have a specialized intensive care unit where the nursing staff is trained and skilled in giving the best care to the neuroscience patient.

    An acoustic neuroma is a brain tumor that grows on the eighth cranial nerve (the nerve that runs from your brain to your inner ear). It is a benign brain tumor and usually slow growing. Acoustic neuromas are often times small so they never causes any problems. For others, it can cause hearing loss due to the tumor compressing on the nerve.

    Symptoms

    • Hearing loss
    • Ringing in the ears
    • Dizziness
    • Loss of balance
    • Facial numbness and weakness

    Diagnosing

    Treatment

    • Surgical - The goal of surgery is to remove the tumor and preserve the facial nerve to prevent facial paralysis and preserve hearing.
    • Radiosurgery - Radiosurgery (also known as Stereotactic Radiosurgery) uses multiple beams of radiation to give a highly focused form of radiation directly on the tumor. Each beam of radiation is not that powerful; however the point where they all meet (directly on the tumor) has a powerful amount of radiation to destroy the tumor cells.

    At Parker Adventist Hospital, we have skilled neurosurgeons with expertise to choose the right treatment choice based on an individual's needs. We have a specialized intensive care unit where the nursing staff is trained and skilled in giving the best care to the neuroscience patient.

  • At Parker Adventist Hospital, we have skilled neurosurgeons with expertise to choose the right treatment choice based on an individual's needs. We have a specialized intensive care unit where the nursing staff is trained and skilled in giving the best care to the neuroscience patient.

    Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve (the nerve that carries sensations from the face to the brain). This chronic pain causes extreme, sporadic, sudden burning or shock like face pain. The intensity of pain can be physically and mentally incapacitating. Trigeminal Neuralgia pain is typically felt on one side of the jaw or cheek. Activities such as brushing your teeth or slight wind/air on the face may trigger the pain.

    Other triggers include:

    • Shaving
    • Stroking your face
    • Eating
    • Drinking
    • Talking
    • Putting on makeup
    • Smiling

    Causes
    Often Trigeminal Neuralgia is caused by a blood vessel lying upon the nerve itself. This contact places pressure on the nerve and causes it to malfunction. In some cases, multiple sclerosis may cause the pain.

    Diagnosing
    Often times this is diagnosed by a neurological examination and history obtained by the physician. MRI is often helpful to rule out other causes (such as Multiple Sclerosis).

    Treatment

    • Medications - Medications may be helpful to lessen or block the pain signals to the brain.
    • Surgery - The goal of surgery is to stop the blood vessel from compressing the nerve or to damage the nerve to keep it from malfunctioning. Surgery can include a microvascular decompression. This procedure involves relocating or removing the blood vessels that are in contact with the nerve. The surgeon places a pad between the nerve and the vessel. If the vessel is a vein, the surgeon often times will remove it all together. In some cases the surgeon can cut the nerve at the base of the brain. This will stop the nerve from sending impulses to the brain; however, because the nerve is permanently cut, the individuals face will be permanemtly numb.

    At Parker Adventist Hospital, we have skilled neurosurgeons with expertise to choose the right treatment choice based on an individual's needs. We have a specialized intensive care unit where the nursing staff is trained and skilled in giving the best care to the neuroscience patient.

    Hydrocephalus (often referred to as water on the brain) is an abnormal buildup of the brain's normal water-like fluid (cerebrospinal fluid or CSF). CSF is a clear fluid that bathes the brain and the spinal cord, providing a cushion, nutrients and carrying waste. The fluid is made in the ventricles of the brain. The fluid then flows through a canal like pathway over the upper surface of the brain where it enters the veins through tiny openings called Arachnoid Villi.

     

    Diagnosing
    CT scans or MRI can accurately measure the size of the fluid spaces or ventricles within the skull.

     

    Treatment

    • Ventricular Shunt
      Surgical placement of a shunt (tube) into the ventricle is the most common form of treatment. A shunt is a tube that diverts the excess fluid from the expanded brain cavity (ventricle) to another part of the body. This procedure redirects the fluid to another body cavity such as the abdomen. In most cases, the fluid is diverted to the peritoneal cavity in the abdomen.

      A shunt is usually composed of three parts, a catheter that enters the enlarged ventricle, a one-way valve that only allows the flow of fluid away from the ventricle and the tubing which enters the cavity that is to receive the fluid. Each valve is designed to operate at a set pressure so that a high pressure valve will allow less fluid to flow through it than a low pressure valve. The entire shunt system is placed underneath the skin.

      Shunts often require additional surgeries. They can malfunction or become blocked. A shunt life expectancy averages 10 years and will need to be revised or replaced.
    • Endoscopic Third Ventriculostomy
      Third ventriculostomy is a one-time procedure unlike shunt surgeries, which in many cases are numerous. A third ventriculostomy consists of creating a small hole, about one millimeter in diameter in the wall of the third ventricle. This allows the CSF that was blocked to flow into the open spaces surrounding the brain. A third ventriculostomy is not available for all people with hydrocephalus.

     

    At Parker Adventist Hospital, we have skilled neurosurgeons with expertise to choose the right treatment choice based on an individual's needs. We have a specialized intensive care unit where the nursing staff is trained and skilled in giving the best care to the neuroscience patient.

    Symptoms
    Many individuals do not have symptoms of a chiari. Others may tend to have symptoms present after a trauma or later in life. Some common symptoms include:

    • Neck pain or stiff neck
    • Balance problems
    • Muscle weakness
    • Numbness or other abnormal feelings in the arm or legs
    • Dizziness
    • Vision problems
    • Difficulty swallowing
    • Ringing or buzzing in the ears
    • Hearing loss
    • Vomiting
    • Insomnia
    • Depression
    • Headache made worse with coughing or straining
    • Difficulty with hand coordination and fine motor skills

    Diagnosing

    • MRI (magnetic resonance imaging)
    • CT (computed tomography)

    Treatment

    • Medications - May relive the symptoms caused by Chiari Malformation.
    • Surgery - Posterior Fossa Decompression is the only treatment available to correct the functional abnormality or halt the progression of damage to the central nervous system. This surgery involves making an incision at the back of the head and removing the small portion of the bottom of the skull. The neurosurgeon may use a procedure called electrocautery to shrink the cerebellar tonsils that are extending beyond the base of the skull.

    At Parker Adventist Hospital, we have skilled neurosurgeons with expertise to choose the right treatment choice based on an individual's needs. We have a specialized intensive care unit where the nursing staff is trained and skilled in giving the best care to the neuroscience patient.

  • Traumatic Brain Injury (TBI) is a complex injury with a wide variety of symptoms. The impact on a person and his or her family can be devastating. Often times the person is normal one minute and the next, their life has abruptly changed. Since our brains define who we are, the consequences of a brain injury can affect all aspects of our lives including our personality.

    There are varying degrees of TBI. These are determined by a neurological exam, which determines the degree of TBI: mild, moderate or severe.

    The neurological exam that is performed is called the Glasgow Coma Scale. This neurological exam applies numbers based on the symptoms and what the patient can do. There are 3 categories within the exam and the total number is added up between the 3 categories. Based on the result of all 3 areas, physicians then can determine the degree of TBI.

    The Impact of Moderate/Severe Traumatic Brain Injury can include:

    Cognitive deficits including difficulties with

    • Attention
    • Concentration
    • Distractibility
    • Memory
    • Speed of processing
    • Confusion
    • Perseveration
    • Impulsiveness
    • Language processing
    • Executive functions
    • Speech and Language
      • Not understanding the spoken word (receptive aphasia)
      • Difficulty speaking and being understood (expressive aphasia)
      • Slurred speech
      • Speaking very fast or very slow
      • Problems reading
      • Problems writing
    • Sensory
      • Difficulties with interpretation of touch, temperature, movement, limb position and fine discrimination
    • Perceptual
      • The integration of patterning of sensory impressions into psychologically meaningful data
    • Vision
      • Partial or total loss of vision
      • Weakness of eye muscles and double vision (diplopia)
      • Blurred vision
      • Problems judging distance
      • Involuntary eye movements (nystagmus)
      • Intolerance of light (photophobia)
    • Hearing
      • Decrease or loss of hearing
      • Ringing in the ears (tinnitus)
      • Increased sensitivity to sounds
    • Smell
      • Loss of diminished sense of smell (anosmia)
    • Taste
      • Loss or diminished sense of taste
    • Seizures
      • The convulsions associated with epilepsy that can be several types and can involve disruption in consciousness, sensory perception, or motor movements

    Physical Changes

    • Physical paralysis/spasticity
    • Chronic pain
    • Control of bowel and bladder
    • Sleep disorders
    • Loss of stamina
    • Appetite changes
    • Regulation of body temperature
    • Menstrual difficulties

    Social - Emotional

    • Dependent behaviors
    • Emotional lability
    • Lack of motivation
    • Irritability
    • Aggression
    • Depression
    • Disinhibition
    • Denial/lack of awareness

    You don't have to be knocked unconscious or even hit your head to experience a mild traumatic brain injury that can have serious results.

     

    Emergency Signs in Adults

    If you have any of these symptoms, call 9-1-1 or go to a hospital emergency room immediately:

    • Loss of consciousness, even for just a few seconds
    • Seizures
    • Confusion (not knowing the date, time or location)
    • Bleeding from the ears, mouth, nose
    • Slurred speech
    • Loss of coordination
    • Weakness or numbness of arms, legs or face
    • Repeated vomiting six or more hours after the injury occurred
    • Cannot be woken easily after falling asleep
    • One pupil larger than the other or no change in pupil size with light

    Emergency Signs in Children

    If your child has any of these symptoms, call 9-1-1 or take the child to a hospital emergency room immediately:

    • Crankiness or continual crying
    • Cannot be calmed (especially with infants)
    • Will not nurse or eat
    • Change in play habits; loss of interest in favorite foods or toys
    • Loss of balance
    • Loss of newly acquired skills such as toilet training, walking or language

    Ongoing Signs & Symptoms

    Sometimes, you may not experience any of the immediate emergency symptoms of a MTBI, but you may notice subtle changes in your health or behavior. If you are experiencing these symptoms beyond seven days after the incident and these were not present before your injury, you should call your doctor:

    • Slowness in thinking, acting, speaking, reading or reacting
    • Getting lost or easily confused
    • Trouble concentrating, organizing daily tasks or making decisions
    • Increased sensitivity sound, light, distractions
    • Low-grade headaches that will not go away
    • Neck pain
    • Loss of balance, feeling light-headed or dizzy
    • Blurred or double vision, or eyes that tire easily
    • Ringing in the ears
    • Fatigue
    • Change in sleeping patterns, including insomnia or trouble waking up
    • Changes in mood, including anxiety, sadness or anger
    • Drastic change in sexual drive
    • Loss of one or more senses (taste, smell, hearing)

    Learn More

    Parker Adventist Hospital has a program to treat minor head injuries. Patients who are suspected of having minor head injuries are followed closely by a therapist specially trained in cognitive therapy. The therapist checks for symptoms such as forgetfulness, inability to concentrate, irritability or depression. If the patient exhibits any symptoms, the therapist works with the patient's physician to design a rehabilitation program. To learn more about minor head injuries, call the Parker Adventist Center for Rehabilitation & Sports Medicine at 303-269-4590.

    Diagnosing Traumatic Brain Injury (TBI)

    • Neurological Exam - a detailed exam is important and will bring out evidence of a brain injury
    • Brain imaging with CT scan
    • Brain imaging with MRI
    • Cognitive evaluations

    Treatment for TBI
    The goal of TBI treatment is to minimize secondary injuries. The initial treatment of a traumatic brain injury begins upon arrival at a hospital. At the hospital a team of medical professionals generally led by the trauma surgeon, will meet the patient. The trauma surgeon, acting as the leader, will direct the team. The trauma staff will initiate resuscitation procedures, monitor the body's vital functions, respond to potential life-threatening changes and coordinate care with other hospital personnel.

    While the physicians are assessing the patient and the response to treatment, the trauma nurse is caring for the patient providing resuscitation, stabilization and supportive care. The nurses have the responsibility of coordinating and providing communication within the hospital and with the family.

    Once stabilized the patient is transferred to a specialized trauma care unit. Care will be provided by the critical care nursing staff. The nursing staff's responsibility is to assess, monitor and interpret vital physiologic or body functions, notify the physician of changes, repeat assessments at regular intervals and provide information for the family.

    Other key staff will also play a role in the care of the patient. The respiratory therapist will help with the initial resuscitation efforts, will provide oxygen therapy and will configure the ventilator settings and will assure proper equipment functioning. In addition, the respiratory therapist will monitor the patients breathing, looking at blood gas results and listening to the lungs.

    A social worker will also work with the family after the injury. Like a psychologist, the social worker will prepare the family emotionally and physically to face the ill or disabled patient. The social worker will assist the family in making plans for the duration of recovery, especially if the recovery progresses slowly. The social worker will encourage the family to consider role and responsibility changes while the patient is ill, including changes in finances and family support. The social worker along with a discharge planner will assist the family in discharge planning.

    Surgical Treatment
    The overall goal of all surgical treatment is to prevent secondary injury by helping to maintain blood flow and oxygen to the brain and minimize swelling and pressure. A pressure measuring device may be in place to monitor responses to treatments and pressures within the brain cavity. If bleeding has occurred (a subdural or epidural hematoma) surgery may be necessary to remove or drain the blood clot. Bleeding vessels or tissue may need to be repaired. In severe cases, if there is extensive swelling and pressure on the brain, a portion of the brain may be removed or the skull may be removed to allow for more space for the living tissue.

    At Parker Adventist Hospital, we have skilled neurosurgeons with expertise to choose the right treatment choice based on an individual's needs. We have a specialized intensive care unit where the nursing staff is trained and skilled in giving the best care to the neuroscience patient.

    Understanding Concussions (Mild Traumatic Brain Injuries)

    If you watch professional sports or television hospital dramas, you've probably seen the flurry of activity that surrounds a head injury. Perhaps you've even had one yourself. A mild traumatic brain injury (MTBI) can feel like a close call, but what many people do not realize is that even though the injury could have been worse, a mild head injury can be a serious health concern.

     

    Q. What is a mild traumatic brain injury?
    Also known as a concussion or mild head injury, a MTBI occurs when the brain has been harmed due to a jolt to the head that causes the nerve cells in the brain to be stretched, torn or bruised. The symptoms may be as minor as a headache or as severe as confusion and vomiting.

     

    Q. What causes these head injuries?
    Most MTBIs are the result of falls, sports injuries and car accidents, but it's important to know that you don't actually have to hit your head at all to sustain an injury. Whiplash, for example, can cause the brain to be pushed against the skull and can lead to a brain injury.

     

     

    Q. Why is it important for me to know about head injuries?
    The effects of a head injury build on each other, which means that if you have a second head injury before your original injury fully heals, your risk permanent brain damage or even death increases. That's why health experts typically recommend no contact sports, strenuous activities or other risky behaviors that can cause a second head injury for at least two weeks after the symptoms have resolved completely. Your doctor will also let you know when it's safe to drive again and when you can return to work.

     

    Q. How long does it take to recover?
    Most people recover in three to seven days without any significant complications. However, some people can experience ongoing symptoms that are disruptive to their lives. If symptoms last more than a week, call your doctor.

     

    Q. How is a mild head injury diagnosed?
    A MTBI is diagnosed according to the symptoms a person is experiencing immediately or hours following the traumatic event. A diagnosis of post-concussive syndrome is made when a person has ongoing symptoms days or even weeks after the incident. A concussion does not show up on a CT scan or MRI, but these may be performed to rule out a brain injury requiring immediate attention.

     

    Learn More

    Parker Adventist Hospital has a program to treat mild head injuries. Patients who are suspected of having mild head injuries are followed closely by a therapist specially trained in cognitive therapy. The therapist checks for symptoms such as forgetfulness, inability to concentrate, irritability or depression. If the patient exhibits any symptoms, the therapist works with the patient's physician to design a rehabilitation program. To learn more about mild head injuries, call the Parker Adventist Center for Rehabilitation & Sports Medicine at 303-269-4590.

    A cerebral aneurysm is a weak or thin spot on a blood vessel that balloons out and fills with blood. The bulging aneurysm can put pressure on a nerve or surrounding brain tissue. It may also leak or rupture, spilling blood into the surrounding tissue (hemorrhage). Some cerebral aneurysms, particularly those that are very small, do not bleed or cause problems. These aneurysms can occur anywhere in the brain but are more commonly found with the larger vessels in the brain.

    Incidence

    • 10 in every 100,000 people
    • Commonly between the ages of 20 and 60

    Risk Factors

    • Alcohol abuse
    • Drug abuse (particularly cocaine)
    • Smoking
    • Severe traumatic head injury
    • Family history
    • Infection
    • Hypertension

     

     

    Diagnosing

    Cerebral AneurysmTreatment for non-ruptured Cerebral Aneurysms

    • Microvascular clipping - Involves cutting off the flow of blood to the aneurysms. The neurosurgeon uses a state of the art microscope to isolate the blood vessel that feeds the aneurysm and places a small, metal, clip on the aneurysm neck. The clip remains in the person and prevents the risk of future bleeding.
    • Endovascular embolization - A neuro interventional radiologist inserts a catheter into an artery and feeds it up into the brain to the area of the aneurysm. He then places special coils to fill the aneurysm and block it from the circulation. This causes the blood to clot which destroys the aneurysm.

    The best approach to treatment depends on the type of aneurysm and the location. For some, clipping of the aneurysm is the best approach, for others, endovascular embolization is the preferred choice.

    At Parker Adventist Hospital, we can help individuals determine the best approach through our  imaging and technologies. In our state of the art neuroscience operating room, we can safely perform microvascular clipping. Should an individual need embolization for the aneurysms, our sister hospital is equipped to perform that procedure under the guidance of our neurosurgeon.

    A subdural hematoma is a blood clot that occurs on the brain. The tiny veins between the surface of the brain and its outer covering become stretched and torn after an injury allowing for blood to bleed and collect. Often times these develop as a result of a serious head injury. This is often referred to as an "acute" subdural hematoma. An acute subdural can be very serious and can cause severe damage if the bleeding fills the brain area very rapidly compressing the brain tissue. When this occurs emergent treatment is necessary to remove the blood clot and alleviate the compression on the delicate brain tissue.

    A subdural hematoma can also develop with a mild brain injury, especially in the elderly. These can go unnoticed for days to weeks and are often called "chronic" subdural hematoma. In the elderly, the tiny veins become stretched and are more easily injured. Some subdural hematomas can occur without any cause. This too is more common in the elderly.

    Risk Factors

    • Anticoagulant medication (blood thinners including aspirin)
    • Long term abuse of alcohol
    • Recurrent falls
    • Repeated head injury
    • Very young and very old age

    Diagnosing

    • CT Scan (computed tomography)
    • MRI (magnetic resonance imaging)

    Treatment

    • Close neurological observation to observe for any further bleeding is essential. For some people, the hematoma does not compress the delicate tissue to cause neurological damage. For those people, close observation may be all that is necessary. If the hematoma enlarges than emergency surgery may be warranted.
    • A Burr hole is a surgical operation where a small opening in the skull is created to allow for a drainage tube to be placed. As the body naturally breaks down the blood clot, the drainage tube helps to eliminate the clot. This does not require as large of an opening to perform and is considered less invasive than a craniotomy.
    • Emergency surgery (craniotomy) is often performed for acute subdural hematomas where there is compression on the delicate brain tissue. Surgery depends on the location of the subdural hematoma, the amount of blood and how the patient is responding (the neurological exam).

    The best approach to treatment depends on the location and the amount of compression the blood clot is creating on the delicate tissues.

    At Parker Adventist Hospital, we have skilled neurosurgeons with expertise to choose the right surgery based on an individual's needs. We have a specialized intensive care unit where the nursing staff is trained and skilled in giving the best care to the neuroscience patient.

    An epidural hematoma is a blood clot that occurs on the outside of the brain between the skull and the surface of the brain and usually occurs when a violent blow breaks a blood vessel and forms a pressurized pocket of blood. This growing hematoma exerts pressure on the brain. These types of hematomas are less common then subdural hematomas.

    Risk Factors

    • Severe brain injury or blow to the side of the head

    Diagnosing

    • CT (computed tomography)
    • MRI (magnetic resonance imaging)

    Treatment

    • Close neurological observation to observe for any further bleeding is essential. For some people, the hematoma does not compress the delicate tissue to cause neurological damage. For those people, close observation may be all that is necessary. If the hematoma enlarges than emergency surgery may be warranted.
    • Emergency surgery (craniotomy) is often performed for acute subdural hematomas where there is compression on the delicate brain tissue. Surgery depends on the location of the subdural hematoma, the amount of blood and how the patient is responding (the neurological exam).

    The best approach to treatment depends on the location and the amount of compression the blood clot is creating on the delicate tissues.

    At Parker Adventist Hospital, we have skilled neurosurgeons with the expertise to choose the right treatment choice based on an individual's needs. We have a specialized intensive care unit where the nursing staff is trained and skilled in giving the best care to the neuroscience patient.

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