For most people, neurosurgery is only required by people who suffer from brain tumors. However, you should understand that neurosurgeons deal with the various kinds of ailments arising out of damages to the spine, brain, central and peripheral nervous system. You might be suffering from headaches which torture you by occurring in clusters of several days or weeks at a stretch, or which cause blurred vision, even vertigo. There might be difficulty in grasping objects; ringing in the ears, also known as tinnitus; a stiff neck which makes looking sideways agonizing; or any of a vast array of distresses including chronic pain which interferes with activities of daily living.
All diseases of the nervous system do not require invasive or surgical interventions. So, when you consult a neurologist for uncontrollable muscular spasms (dystonia) which make your head jerk suddenly, your eyes twitch, or when your speech becomes slurred and you have difficulty in chewing your food; you might be given medicines, and referred for different kinds of therapy. However, when certain symptoms are linked to various kinds of tumors, aneurysms, or some trauma to the brain or spine; your doctor might refer you to a neurosurgeon.
Every kind of pain which you might suffer from is rooted in the inflammation of some nerve. Take the example of trigeminal neuralgia. It is the pain caused by inflammation of the trigeminal nerve, and makes even smiling, chewing food, brushing your teeth, applying makeup, or washing your face a painful experience. In the milder form, when there are no other co-morbidities, your doctor might opt for medications and injections. However, if it has been caused by injury to the face or head; as a result of a stroke, brain lesion, or swollen blood vessel pressing on the trigeminal nerve; or due to surgical injury; then your neurosurgeon might opt for surgery with follow up regimen.
When you find it challenging to move your arms freely due to a frozen shoulder, stiff neck, repetitive activity, herniated disc, or arthritis; you should consult a neurosurgeon. Spondylitis is a degenerative disease caused by the narrowing of the space between two vertebrae, leading to undue pressure on the nerves connected with the vertebrae giving rise to severe pain, tremors, or vertigo. In a younger patient, it might have been caused by trauma, leading to numbness and/or tremors of the hands, arms, or legs. It can cause severe headaches, lower back aches which make it difficult for the patient to stand, sit, or lie down; or pain between the shoulder blades, which is relieved by the use of physical therapy. In extreme cases where the patient is getting paralyzed, or needs supports to move around, the neurosurgeon might opt for surgery, especially if vertebral tumors are complicating matters. Ewing’s sarcoma, chordoma, plasmacytoma, osteosarcoma, and chondrosarcoma are some of the more common tumors which grow on spinal bones, and are best treated by surgery. Pressure on the spinal cord might be caused by inflamed ligaments, or shrunk discs. Neurosurgery involving a procedure called laminectomy might be needed to ease that pressure by removing a part of the spinal vertebrae (lamina).
Headaches might also arise out of head injuries caused by falls, car crash, or sports related collision leading to skull fractures, and concussions. In such cases, the neurosurgeon removes bone fragments and blood clots from the brain, and repairs the broken skull bones. In case of a blinding headache caused by a ruptured aneurysm, or a subarachnoid hemorrhage, i.e., bleeding in the space between your brain and its surrounding tissues, immediate intervention in the form of surgical clipping, or endovascular coiling is required. Epileptic patients whose seizures are worsening might benefit from deep brain stimulation (DBS). When there is excessive buildup of plaque in the carotid artery which supplies blood to the brain, your neurosurgeon might carry out a procedure known as carotid artery endarterectomy.
Cluster headaches and migraines are not life threatening usually. But sometimes they can be so distressing that at times a patient might feel it is better to be headless. It is advisable to search for underlying causes which might range from a ruptured aneurysm to hydrocephalus (buildup of cerebrospinal fluid in the brain) to brain tumor and other lesions in the brain. These conditions require surgical intervention; sometimes on an emergency basis. When cluster headaches don’t respond to medications, or when the patient’s co-morbidities don’t permit the use of aggressive treatments, then DBS, which involves implanting an electrode in the hypothalamus; noninvasive sphenopalatine ganglion stimulation, vagus nerve stimulation (VNS), and occipital nerve stimulation are some of the ways that your neurosurgeon might treat such headaches.
Peripheral nerve injuries might impair your sense of balance; your ability to perceive pain or temperature; or simply reduced communication between the brain, the muscles, and vital organs to make carrying out of simple daily activities challenging. Electromyography (EMG), nerve conduction study, and magnetic resonance imaging (MRI) are carried out to identify, and measure the extent of damage. If needed, surgery to restore function is done by removing the damaged end of the affected nerve, and either implanting a healthy nerve from another part of the body, or reconnecting healthy nerve ends.
Few people realize it, but according to the WHO the commonest neurological disorder to affect adults and children is hearing impairment, including total deafness. It might be caused by an interruption of the nervous impulses being carried from the inner ear to the brain. These might result from tumors, ear infections, German measles, injury to the tympanic membrane when you prod the ear to clear ear wax, or fluid retention after a swim or a bath. Since the auditory nerve and cilia — sensory hair cells — cannot be repaired, neurosurgeons often compensate sensorineural hearing loss by recommending hearing aids, or cochlear implants which epitomize one of the most beneficial neurosurgical interventions to aid the hearing impaired. If the damage is minor, then it might be bypassed by the neurosurgeon to prevent further degeneration.