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Brain Disorders and Tumors

Neurosurgeons can surgically remove some tumors completely (called resection or complete removal). If the tumor is near sensitive areas of the brain, neurosurgeons will only be able to remove part of it. Even partial removal can relieve symptoms and increase the effectiveness of other treatments.

A brain tumor, whether malignant (cancerous) or benign (non-cancerous), is a serious condition that requires quick and thorough treatment. Even benign tumors of the brain can grow slowly, and become life threatening. Primary tumors are those that grow in the brain, while secondary tumors start somewhere else in the body and have spread to the brain. Brain tumor resection removes part or all of a tumor with the goal of not damaging neurological functions. If complete resection cannot be completed, the tumor can recur and continue growing. Although there are risks involved with brain tumor resection, the dangers of an untreated tumor are worse. Resection may be followed by chemotherapy or radiation, especially if the tumor is not completely removed.

University Health System, in partnership with UT Medicine San Antonio, provides high-quality care with doctors skilled in general neurosurgery and trained in specific specialties. Our neurosurgeons specialize in the treatment and care for the following types of brain disorders and tumors:

  • Arachnoid Cyst
  • Arnold Chiari Malformation
  • Arteriovenous or Neurovascular Malformations (AVM)
  • Brain Aneurysm
  • Hydrocephalus
  • Intrinsic Brain Tumors
    • Ependymomas
    • Glioblastomas
    • Insular Gliomas
    • Medulloblastomas
    • Oligodendrogliomas
  • Metastatic Diease to the Brain
  • Parkinson’s Disease
  • Skull Base Tumors
    • Chondrosarcomas
    • Clival Chordomas
    • Meningiomas
    • Orbital Tumors
    • Osteosarcomas
    • Pituary Tumors
    • Schwannomas
    • Sinonasal Carcinomas

Arachnoid Cysts are the most common type of brain cyst. They are congenital lesions that happen as a result of the splitting of the arachnoid membrane. The cysts are fluid-filled sacs, not tumors, showing up in one of the three layers of tissue covering the central nervous system.

Arnold Chiari Malformation is a congenital (present at birth) defect occurring in the back of the head where the brain and spinal cord connect. There are four types of Chiari malformations.

Type 1 happens when the base of the skull and upper spinal area do not form properly, a type 1 Chiari malformation usually goes unnoticed until problems are seen in the teenage or adult years of life. The headaches most typical of Chiari 1 malformations are usually located at the back of the head, and are often made worse by exertion;

Type 2 are the most common of all Chiari malformations, and are caused by part of the back of the brain shifting downward through the bottom of the skull. They are usually seen in infants born with spina bifida – a neurological condition that causes a portion of the spinal cord and the surrounding structures to develop outside, instead of inside, the body. Type 2 Chiari malformations can also be associated with hydrocephalus, a condition in which there is an overproduction or lack of absorption of the cerebral spinal fluid (CSF) that is found inside of the ventricles (fluid-filled areas) inside of the brain. The increased fluid causes the pressure inside of the head to increase and the skull bones to expand to a larger-than-normal appearance.

Type 3 Chiari malformations happen when the back of the brain sticks out of an opening in the back of the skull area.

Type 4 Chiari malformations occur when the back of the brain fails to develop normally.

Arteriovenous or Neurovascular Malformations(AVM) are abnormal connections between arteries and veins that usually form before birth. Cerebral Arteriovenous Malformations develop between arteries and veins in the brain. Small blood vessels (capillaries) normally connect arteries and veins but are absent with AVM, resulting in a tangle of arteries and veins, which disrupt the normal blood flow in the brain. Without the benefit of capillaries serving as connectors to spread the buildup of pressure between the arteries and veins, the abnormal structure is open to leaks, ruptures (brain hemorrhage) and the forming of aneurysms. AVMs change in size and location in the brain and account for two percent of all strokes.

Brain Aneurysm is a bulging, weak area in the wall of an artery that supplies blood to the brain. In most cases, a brain aneurysm causes no symptoms and goes unnoticed. In rare cases, the brain aneurysm ruptures, releasing blood into the skull and causing a stroke.

Hydrocephalus and Shunt Treatment is the most common surgery for the treatment of hydrocephalus (water on the brain) using the insertion of a shunt - a device that moves fluid from the brain into the stomach cavity where it is safely absorbed into the blood stream. Though a shunt may be inserted in infants, children and adults, the procedure is essentially the same regardless of the size of the patient.

Intrinsic Brain Tumors are primary brain tumors that grow within the brain. They are named after the type of brain cell they grow from. Most intrinsic primary brain tumors are gliomas. Gliomas grow from glial cells, which support the nerve cells in your brain.

  • Ependymomas is a type of glioma that grows from empendymal cells. Ependymomas usually grow in the lining of the ventricles or in the spinal cord and are most commonly found near the cerebellum. The tumor often blocks the flow of the cerebral spinal fluid causing increased intracranial pressure. They are rare, accounting for just 2-3 percent of primary brain tumors, and about 8-10 percent of brain tumors in children.
  • Glioblastomas are the most common and fast growing primary brain tumors, and have been called “grow and go” tumors.  They not only grow rapidly at a given site, they also move quickly to new sites.
  • Medulloblastomas are the most common brain tumor of children. Unlike adult brain tumors, these tumors most often happen in the back part of the brain and grow from cells of neuronal lineage rather than glial lineage.  Because of their small growth, they can be cured by surgery. They often spread through cerebrospinal fluid.
  • Oligodendrogliomas is a type of glioma that grows from the supportive tissue cells of the brain, and are usually found in the cerebrum. They are most common in young and middle-aged adults. Seizures are a very common symptom of these gliomas, as well as headache, weakness, or changes in behavior or sleepiness.  Oligodendrogliomas have a better prognosis than most other gliomas, but can become more malignant (cancerous) with time.

Metastatic Disease to the Brain is one of the most feared complication of systemic cancer and the most common intracranial tumor in adults. The incidence of brain metastasis is rising with the increase in survival of cancer patients. About 40 percent of intracranial neoplasms are metastatic (spread). Lung, breast, melanoma, renal, and colon cancers are the most common primary tumors to spread to the brain.

Parkinson’s Disease is a disorder of the central nervous system that damages motor skills and speech. It is a movement disorder. Signs include stiff muscles, muscle shakes, a slowing of movement, and in some cases loss of movement. Medications or surgery can provide relief. The drug Levodopa is a widely used treatment.

Deep Brain Stimulation is a surgical procedure used to treat the symptoms of Parkinson’s Disease. It uses a surgically-implanted, battery-operated device to deliver electrical stimulation to targeted areas in the brain that control movement and blocks the abnormal nerve signals that cause the Parkinson’s symptoms.

Skull Base Tumors are tumors and conditions that tend to grow in certain areas of the skull base.
The three main regions of the skull base and the tumors and conditions that occur there most commonly are:

  • Chondrosarcoma is a type of cancer that begins in the bone (primary bone cancer). Chondrosarcoma cells produce cartilage as they invade the bone. Less commonly, chondrosarcomas can grow outside the bone, usually next to muscles. Although bone cancer is rare, chondrosarcoma is the second most common type of bone cancer, after osteosarcoma. Chondrosarcoma tumors typically grow in the pelvis, legs or shoulders of adults over 40.
  • Clival Chordomas grow in a bone in the middle of the head. Chordomas growing in the head are sometimes called brain tumors, however they do not actually form from brain cells. Chordomas grow out of the bone but because of their location in the skull, they often touch, compress, or invade critical nearby structures such as the nerves, arteries, dura and brainstem.
  • Meningiomas are a type of tumor that grows from the protective membranes, called meninges, which surround the brain and spinal cord. Most meningiomas are benign (not cancerous) and slow growing; however, some can be malignant (cancerous). Symptoms typically appear gradually and change depending on the location and brain area affected. Because these are slow-growing tumors, not all meningiomas need to be treated immediately. Treatments focus on removing the tumor and relieving the compression on the brain.
  • Orbital Tumors are any tumors that grow within the orbit of the eye. The orbit is a bony housing in the skull about two inches deep that provides protection to the entire eyeball except the front surface. It is lined by the orbital bones and contains the eyeball, its muscles, blood supply, nerve supply, and fat. Tumors may grow from any of these structures, but neurological surgeons primarily treat those of neural origin, which are the most common tumors of the orbit.
  • Osteosarcoma is the most common type of bone cancer, and the sixth most common type of cancer in children. Although other types of cancer can eventually spread to parts of the skeleton, osteosarcoma is one of the few that actually begin in bones and sometimes spread (or metastasize) elsewhere, usually to the lungs or other bones.
  • Pituary Tumors are abnormal growths that develop in the pituitary gland. Some pituitary tumors cause over production of hormones that regulate important functions of the body. Other pituitary tumors can limit normal functions of your pituitary gland, causing it to produce lower levels of hormones. The majority of pituitary tumors are noncancerous growths (adenomas). Adenomas remain confined to your pituitary gland or surrounding tissues and don't spread to other parts of your body.
  • Schwannoma is a benign (non-cancerous) tumor also known as vestibular schwannoma or neurilemmoma. Schwannomas involve the Schwann cells in the protective covering of nerves, called the myelin sheath, and can grow anywhere Schwann cells are present. As schwannomas grow, they can cause pressure, irritation or damage to the nerve. Usually, only one tumor develops, but multiple schwannomas may be present.
  • Sinonasal Carcinoma is a rare cancer of the nasal cavity. Symptoms range from bloody nose, runny nose, double vision and bulging eye to chronic infections and nasal obstruction.

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