Other Brain conditions we treat

CHIARI MALFORMATION

Chiari malformation is a structural abnormality of the brain in which the lower part of the cerebellum, known as the cerebellar tonsils, extends into the upper spinal canal. Normally, the cerebellum, which is responsible for balance and coordination, rests above the foramen magnum (the opening at the base of the skull). In Chiari malformation, the cerebellar tonsils protrude through the foramen magnum and into the spinal canal.

Chiari malformation is classified into several types, including:

  • Type I: This is the most common type, typically present at birth but may go undetected until adolescence or adulthood. In Type I Chiari malformation, the cerebellar tonsils protrude into the upper spinal canal, but the rest of the brain structures remain in their normal positions.
  • Type II: Also known as Arnold-Chiari malformation, this type is usually present at birth and is often associated with a form of spina bifida called myelomeningocele. In Type II Chiari malformation, both the cerebellar tonsils and parts of the brainstem descend into the spinal canal.
  • Type III: This is a rare and severe form of Chiari malformation where brain tissue herniates through an opening in the back of the skull. Type III is associated with significant neurological abnormalities and is often fatal.
  • Type IV: This is the rarest and most severe type of Chiari malformation. It involves an underdeveloped or incomplete cerebellum and often occurs alongside other brain abnormalities.

The exact cause of Chiari malformation is not entirely understood. It is believed to be a congenital condition, meaning it is present at birth, and there may be a genetic component involved. In some cases, Chiari malformation may be associated with other conditions, such as hydrocephalus (excessive accumulation of cerebrospinal fluid in the brain) or spinal cord syringomyelia (the presence of a fluid-filled cyst in the spinal cord).

Chiari malformation can lead to a range of neurological symptoms, including headaches, neck pain, dizziness, balance problems, numbness or tingling in the extremities, difficulty swallowing, and muscle weakness. However, some individuals with Chiari malformation may not experience any symptoms and may only be diagnosed incidentally during imaging tests done for other reasons.

Treatment for Chiari malformation depends on the severity of symptoms and the type of malformation. In mild cases, close monitoring and symptom management may be sufficient. In more severe cases or when symptoms are debilitating, surgical intervention, such as posterior fossa decompression, may be recommended to create more space for the affected brain structures and improve cerebrospinal fluid flow.

It is important to work closely with your healthcare team to develop a comprehensive treatment plan that is tailored to your individual needs and goals. The team will be able to provide you with more detailed information about your specific situation and help you understand what to expect.

TRIGEMINAL NEURALGIA


Trigeminal neuralgia is a condition that causes sudden, severe facial pain that can be triggered by simple activities such as talking, eating, or even a light breeze. Here are some key points for patients to know about trigeminal neuralgia:

  • Causes: Trigeminal neuralgia is caused by irritation or damage to the trigeminal nerve, which is the largest of the cranial nerves that supplies sensation to the face.
  • Symptoms: The main symptom of trigeminal neuralgia is sudden, severe facial pain that can last for several seconds to several minutes. The pain can be triggered by simple activities such as talking, eating, or even a light breeze.
  • Diagnosis: Trigeminal neuralgia is usually diagnosed based on the patient’s symptoms and medical history. Further tests, such as an MRI, may be needed to rule out other conditions.
  • Treatment: Treatment options for trigeminal neuralgia include medications, nerve blocks, and surgery. The choice of treatment depends on the severity and frequency of the pain, as well as the patient’s overall health.
  • Prognosis: The prognosis for patients with trigeminal neuralgia varies depending on the underlying cause and the effectiveness of the chosen treatment.
  • Managing symptoms: Patients may also need to manage symptoms such as headache, nausea, and fatigue, which can be treated with medications and lifestyle changes.

Gamma Knife for trigeminal neuralgia
The gamma knife is a type of stereotactic radiosurgery that can be used to treat trigeminal neuralgia. Here are some key points for patients to know about the gamma knife for trigeminal neuralgia:

  • How it works: The gamma knife uses high-dose radiation to target the source of the pain in the trigeminal nerve, without the need for an incision. The radiation damages the nerve fibres responsible for transmitting pain signals, reducing or eliminating the pain.
  • Benefits: The gamma knife can provide significant pain relief for patients with trigeminal neuralgia and has a lower risk of side effects compared to traditional surgery.
  • Procedure: The procedure is performed under local anaesthesia and typically takes several hours. Patients may need to stay in the hospital overnight for observation.
  • Recovery: After the procedure, patients may experience some swelling and discomfort in the treated area. They will need to follow a specific rehabilitation program to help with their recovery.
  • Risks and complications: As with any medical procedure, there are risks and potential complications associated with the gamma knife, including infection, bleeding, and nerve damage.

It is important to work closely with your healthcare team to develop a comprehensive treatment plan that is tailored to your individual needs and goals. The team will be able to provide you with more detailed information about your specific situation and help you understand what to expect.

HYDROCEPHALUS

Hydrocephalus is a condition where there is an accumulation of cerebrospinal fluid (CSF) in the brain, causing an increase in pressure within the skull. Here are some key points for patients to know about hydrocephalus:

  • Causes: Hydrocephalus can be caused by a variety of factors, including congenital defects, brain injury, infection, tumours, and degenerative diseases.
  • Symptoms: Symptoms of hydrocephalus can include headache, nausea, vomiting, blurred vision, difficulty walking, and changes in mood or behaviour.
  • Diagnosis: Hydrocephalus is usually diagnosed through imaging tests, such as CT scans or MRI, and sometimes a lumbar puncture may be needed.
  • Treatment: The main treatment for hydrocephalus is a surgical procedure to drain excess fluid from the brain and relieve pressure. This may be done using a shunt, which is a device that drains fluid from the brain to another part of the body.
  • Prognosis: The prognosis for patients with hydrocephalus varies depending on the cause and severity of the condition, as well as the age and overall health of the patient.
  • Managing symptoms: Patients may also need to manage symptoms such as headache, nausea, and fatigue, which can be treated with medications and lifestyle changes.
  • It is important to work closely with your healthcare team to develop a comprehensive treatment plan that is tailored to your individual needs and goals. The team will be able to provide you with more detailed information about your specific situation and help you understand what to expect.