NEUROSURGERY ARTICLES

FREQENTLY ASKED QUESTIONS

What is Neurosurgery?

When people hear the word neurosurgery, they often think of brain surgery. However, neurosurgery encompasses far more than the brain. Neurosurgery is the medical specialty concerned with the diagnosis and treatment of the entire nervous system, composed of the brain, spinal cord, and spinal column, as well as the nerves that travel through all parts of the body (hands, legs, arms, face).

What conditions do neurosurgeons routinely treat?

Neurosurgeons routinely see patients for low back pain, carpel tunnel syndrome, epilepsy, stroke, Parkinson's disease, sciatica, pinched nerves in the neck, sports injuries, chronic pain, and many other ailments. A recent statistical study showed the range of neurosurgeons expertise. The number one surgical procedure performed by neurosurgeons was spine (includes neck and back disorders), followed by brain (includes aneurysms, tumors, and head injuries), CSF shunting (for hydrocephalus), peripheral nerve (includes carpal tunnel), pain-functional (includes medication pumps and deep brain stimulation), and blood vessel abnormalities (includes strokes).

Do neurosurgeons often provide or recommend non-surgical care?

Yes. They diagnose what is wrong and work with the patient to develop the optimal treatment plan, whether that includes surgery or not. For example, most cases of back pain are treated with antiinflammatory medication, physical therapy, and muscle relaxants. A common treatment a generation ago, surgery is now considered necessary for only a small percentage of back pain patients.

What is a cerebral aneurysm?

Cerebral aneurysms, also called intracerebral or intracranial aneurysms, are balloon-like outpouchings of the arteries in the brain. They arise from a weak point in the wall of the artery and enlarge over time as a result of the pressure within the artery. Because aneurysms have thin walls, their primary danger is that they may rupture, bleed into the brain, and have potentially disastrous consequences. This type of bleeding is known as subarachnoid hemorrhage.

What can I do to decrease my risk for aneurysm occurrence?

Several factors are known to increase the chances of aneurysm development and rupture. These include cigarette smoking, excess alcohol consumption and heart disease. Some families have a definite genetic predisposition; in such families aneurysms may run as high as 10 percent. While there is no way to prevent aneurysm rupture, certain lifestyle modifications such as a smoking cessation classes can help decrease your risk.

What does AVM stand for?

Arteriovenous malformations, or AVMs, are complex tangles of arteries and veins which result from abnormal development. They are congenital (present at birth) but enlarge during a person's lifetime. AVMs divert arterial blood, which is under high pressure, directly to the venous system without intervening capillaries. This may have several effects, including hemorrhage and seizures. AVMs may also be associated with aneurysms.

How has the treatment for brain tumors changed?

Treatment for brain tumors has changed in many ways over the last decade. Neurosurgeons today use sophisticated techniques and tools. They rely on computers, MRIs, and image-guidance technology to help them navigate through the complex terrain of the brain with greater precision. The new techniques and tools insure the safest and most complete removal of tumors. One of the most common advanced surgical tools used to treat tumors is a high-powered microscope. Microsurgery produces a magnified view of the surgical field, making it easier to see and remove tumor tissue without disturbing healthy tissue. Image guidance, or stereotaxis, involves the use of magnetic resonance imaging (MRI) or computerized tomography (CT) scanning. A neurosurgeon, in the operating room, uses the latest computer technology to reformat data previously obtained from an MRI or CT scan to guide him/her in the safe resection of tumor tissue. An intraoperative MRI (soon to be available to neurosurgeons of UCI) further aids a neurosurgeon. Because the brain "shifts" slightly during an operation, the real-time imaging allows for a more precise removal of the brain tumor.

Can parents, coaches, and players take precautionary measures to prevent head injuries?

Yes. The American Association of Neurological Surgeons (AANS) estimates that brain-related football injuries occur at a rate of one in every 3.5 games. Of over 250,000 football players, 15 percent suffer a concussion each season. In any given season, 10 percent of all college players will sustain a head injury and 20 percent of high school players sustain brain injuries. After a concussion, the most common sports-related injury, the patient can have problems with amnesia, confusion, and concentration. The damage caused after one concussion is often reversible after an appropriate recovery time, but if a second injury is sustained before then, the damage can be devastating. Every head injury should be taken seriously and it is important to understand that the damage done by multiple concussions can be cumulative. Football players are not alone. Athletes in hockey, baseball, boxing, gymnastics, biking, skiing, snow boarding, and soccer can all suffer from head injuries. Parents should be certain that players wear appropriate safety gear; that the playing surface is conducive to safe play; and leagues and teams should be selected, which have the same commitment to safety as the parents do. Each player should receive baseline neurological testing before the season so that the results can be used for comparison in the event the athlete receives a blow to the head.

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