Brain aneurysm – a weak bleb along a brain artery that can burst, often resulting in death or brain damage. Brain aneurysms can be repaired from the inside of the artery (coiling) or with open surgery (clipping).
Brain arteriovenous malformation (AVM) may cause seizures, brain dysfunction or bleeding. AVMs can be filled with glue from the inside (embolization), treated with radiation to shut down the abnormal vessels, or they can be removed with open brain surgery.
Brain tumors AKA primary brain tumors are neoplastic masses that involve brain tissue. They may have a slow growth rate and non-invasive growth pattern (benign) or they may be fast growing and invasive (malignant). Brain tumors are a major deal because they can cause serious damage including blindness, deafness, paralysis, seizures, personality changes, disability, care dependency, coma and death. Like for tumors elsewhere in the body, treatments may include radiation, chemotherapy, open surgery or a combination of treatments. Surgery for brain tumors is either done by opening the skull (craniotomy), through a small burr hole (endoscopic) or through the nose (transsphenoidal).
Chiari malformation causes pressure on brain and nerves resulting in pain and numbness and nerve dysfunction. Surgery can help to reduce the pressure by removing parts of the skull and spine.
Hemorrhagic stroke is bleeding inside the brain substance resulting from a ruptured artery. Small hemorrhages often do not need surgery. Large hemorrhages may require craniotomy, burr holes and drain placement.
Hydrocephalus is a buildup of cerebrospinal fluid (CSF) inside the skull. The fluid may need to be drained to the outside through a ventriculostomy procedure, or diverted into the belly cavity or chest cavity using a shunting tube.
Ischemic stroke is caused by blockage in brain circulation resulting in brain tissue damage. If the stroke is complete, the infarcted brain tissue often swells and puts pressure on the rest of the brain leading to coma or death. Removal of the skull (decompressive craniectomy) may become necessary to take the pressure off to save the patient’s life. The skull bone will be placed back (cranioplasty) several weeks or months later.
Pituitary adenoma is a slow growing (benign) tumor that develops from the pituitary gland, the body’s main hormone gland located just below the brain’s hormone control center, the hypothalamus, at the base of the skull a few centimetres in from the eye sockets. This type of tumor is usually identified because it changes hormone levels in the body leading to abnormal menstrual cycles, milk secretion, abnormal growth of hands and feet, heart trouble or weight gain. Sometimes hormones are not affected but patients report headaches or visual changes such as tunnel vision from compression of the optic nerves. When a pituitary adenoma is found, specialized imaging and hormone testing and visual testing is done right away. Next steps may be watchful observation with re-imaging to see if there is any more growth, or pharmacological treatment with medications that suppress hormone production, or decision to remove the tumor in surgery. Surgery is typically done through the nose, using an endoscopic transsphenoidal approach to access the sella, a bony outpouching in the skull base that contains the pituitary gland.
Subdural hematoma is build-up of blood between the brain and the skull bone. Pressure on the brain may require draining the hematoma through burr holes or open craniotomy.
Traumatic brain injury (TBI) may require emergent removal of skull (craniectomy), repair of bleeding blood vessels, and removal of damaged brain tissue. A pressure sensor may be implanted to help monitor brain pressures after TBI.