In addition to brain tumors, Neurosurgery of Kalamazoo diagnose and treat a variety of brain and skull related disorders and injuries. We can help relieve intense pain and our practice remains committed to developing and delivering effective treatments.
This condition is caused by an increased amount of cerebrospinal fluid (commonly called CSF) in the brain’s ventricles. The ventricles are a system of large, fluid-filled open spaces inside the brain. Too much CSF in the ventricles can elevate pressure in the skull. It can damage delicate brain tissue.
Normal pressure hydrocephalus (NPH) is an abnormal buildup of cerebrospinal fluid (CSF) in the brain’s ventricles, or cavities. It occurs when the normal flow of CSF throughout the brain and spinal cord is blocked. The ventricles enlarge which puts pressure on the brain. While it can occur in people of any age, it most typically is found in the elderly. It may result from a subarachnoid hemorrhage, head trauma, infection, tumor, or complications of surgery. If a person develops NPH without any of these factors then the cause is unknown. Symptoms of NPH often resemble those of Parkinson’s Disease and/or Alzheimer’s Disease.
TN diagnosis is based primarily on the person’s history and description of symptoms, along with results from physical and neurological examinations. Other disorders that cause facial pain should be ruled out before TN is diagnosed. Some disorders that cause facial pain include post-herpetic neuralgia (nerve pain following an outbreak of shingles), cluster headaches, and temporomandibular joint disorder (TMJ, which causes pain and dysfunction in the jaw joint and muscles that control jaw movement). Because of overlapping symptoms and the large number of conditions that can cause facial pain, obtaining a correct diagnosis is difficult, but finding the cause of the pain is important as the treatments for different types of pain may differ.
Most people with TN eventually will undergo a magnetic resonance imaging (MRI) scan to rule out a tumor or multiple sclerosis as the cause of their pain. This scan may or may not clearly show a blood vessel compressing the nerve. Special MRI imaging procedures can reveal the presence and severity of compression of the nerve by a blood vessel.
A diagnosis of classic trigeminal neuralgia may be supported by an individual’s positive response to a short course of an antiseizure medication. Diagnosis of TN2 is more complex and difficult, but tends to be supported by a positive response to low doses of tricyclic antidepressant medications (such as amitriptyline and nortriptyline), similar to other neuropathic pain diagnoses.
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Surgical placement of a shunt in the brain to drain excess CSF into the abdomen where it can be absorbed as part of the normal circulatory process. This allows the brain ventricles to return to their normal size. Regular follow-up care by a physician is important in order to identify subtle changes that might indicate problems with the shunt.
Although some people may experience temporary improvements, the symptoms of NPH usually get worse over time if the condition is not treated. Treatment with shunts varies from person to person, some people can recover quickly after treatment and enjoy a good quality of life. Early diagnosis and treatment improves the chance of a good recovery. Without treatment, symptoms may worsen and cause death.
Trigeminal neuralgia (TN), is a chronic pain condition that affects the trigeminal or 5th cranial nerve, one of the most widely distributed nerves in the head. TN is a form of neuropathic pain (pain associated with nerve injury or nerve lesion.) The typical form of the disorder (called “Type 1” or TN1) causes extreme, sporadic, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as two minutes per episode. These attacks can occur in quick succession, lasting as long as two hours. The “atypical” form of the disorder (called “Type 2” or TN2), is characterized by constant aching, burning, stabbing pain of somewhat lower intensity than Type 1. Both forms of pain may occur in the same person, sometimes at the same time. The intensity of pain can be physically and mentally incapacitating.
If NPH or another form of Adult Hydrocephalus is suspected, a brain imaging study will be ordered such as a CT or MRI scan. Our specialists review the patient’s history, physical findings, and imaging studies and make recommendations regarding surgery, further testing, or specialized diagnostic studies. These other studies may include a spinal tap (LP), a lumbar infusion study or a lumbar drainage study, and are used to help determine if surgery is indicated.
Treatment options can include medication or surgery.
Anticonvulsant medicines—used to block nerve firing—are generally effective in treating TN1 but often less effective in TN2. Tricyclic antidepressants such as amitriptyline or nortriptyline can be used to treat pain. Common analgesics and opioids are not usually helpful in treating the sharp, recurring pain caused by TN1, although some individuals with TN2 do respond to opioids. Eventually, if medication fails to relieve pain or produces intolerable side effects such as cognitive disturbances, memory loss, excess fatigue, bone marrow suppression, or allergy, then surgical treatment may be indicated. Since TN is a progressive disorder that often becomes resistant to medication over time, individuals often seek surgical treatment.
Several neurosurgical procedures are available to treat TN, depending on the nature of the pain; the individual’s preference, physical health, blood pressure, and previous surgeries; presence of multiple sclerosis, and the distribution of trigeminal nerve involvement (particularly when the upper/ophthalmic branch is involved). Some procedures are done on an outpatient basis, while others may involve a more complex operation that is performed under general anesthesia. Some degree of facial numbness is expected after many of these procedures, and TN will often return even if the procedure is initially successful. Depending on the procedure, other surgical risks include hearing loss, balance problems, leaking of the cerebrospinal fluid (the fluid that bathes the brain and spinal cord), infection, anesthesia dolorosa (a combination of surface numbness and deep burning pain), and stroke, although the latter is rare.
The brain is the control center of the human body. It forms your thoughts and preserves your memories. It regulates your body’s actions, from the movements you choose to perform to the functions you don’t even consciously think about. Let’s take a closer look at the anatomy and the function of the brain.
This condition, sometimes called a false brain tumor, is a buildup of cerebrospinal fluid pressure in the skull. It most commonly affects obese women ages 20 to 50. The reason it develops is unknown.
During this surgical procedure, a small drainage tube is implanted to relieve the pressure of hydrocephalus. Hydrocephalus is a condition that develops when excess cerebrospinal fluid builds up within the ventricles of the brain.
This procedure eliminates (or greatly reduces) the sharp bursts of pain in the facial nerves caused by trigeminal neuralgia. The procedure is performed under general anesthesia and requires a short hospital stay.
This is a structural problem with the back of the brain. It involves the cerebellum. That’s the part of your brain that controls balance. Normally, the cerebellum sits in a space at the base of the skull. It’s just above the opening to the spinal canal, called the “foramen magnum.” With Chiari malformation, the cerebellum slips down through this opening.
This surgery is used to treat Chiari malformation, an abnormality that results in a part of the brain extending into the upper spinal canal. During the procedure, small sections of bone are removed from the rear of the skull and spine to create more space for the errant brain tissue.
This is a pocket of pus in your brain. Tissue has grown around it, walling it off from the rest of your body. The mass is filled with white blood cells, dead tissue and germs. It can grow and press harmfully against your brain, causing a medical emergency.
This condition is a buildup of clotted blood between the brain’s outer layer and the membrane that covers the brain (called the dura). It usually occurs in the elderly, and can be caused by even a minor bump to the head.
Like every part of your body, your brain changes as you age. And some changes affect how you think. Let’s look at what’s normal, and let’s talk about things that may be cause for concern.
This procedure creates one or more holes in the skull to release excess fluid pressure in the brain caused by a chronic subdural hematoma (blood clot on the brain). It can be performed under local anesthesia.
This procedure, performed under general anesthesia, creates an opening through the skull for removal of a blood clot on the surface of the brain. Subdural hematomas commonly result from trauma to the head, and can place harmful pressure on the brain.
This procedure, performed under general anesthesia, creates an opening through the skull for removal of a blood clot between the skull and the dura (the membrane that surrounds the brain). Epidural hematomas commonly result from trauma to the head, and can place harmful pressure on the brain.
This procedure, performed under general anesthesia, creates an opening through the skull for removal of a blood clot inside the brain. Intracerebral hematomas can result from trauma to the head. They can also occur spontaneously in patients with abnormally high blood pressure, or a blood vessel abnormality. Intracerebral hematomas can place harmful pressure on the brain.
This reconstructive surgical procedure is performed to correct congenital problems of the skull, or to repair the skull after a traumatic injury or medical procedure. During the procedure, a custom plate made from porous plastic or titanium is fitted over the defect in the skull, restoring the skull to its normal shape.
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