Brain & Spine Disorders

Adult hydrocephalus is a condition in which excessive cerebrospinal fluid (CSF) accumulates within the ventricles of the brain. Among adults, hydrocephalus may be indicated by symptoms that include severe nausea and vomiting, sleep problems, migraine-like headaches, general lethargy, exhaustion, vision problems, and irritability. The condition can result from brain injury, stroke, or diseases such as Alzheimer disease. The condition can sometimes be treated by inserting a shunt into the ventricular system of the brain, allowing the problematic excessive fluid to be released.

Alzheimer disease is a progressive brain disorder that impacts patients’ memory and their ability to function normally. The disease affects reasoning ability and communication skills and may also cause personality and behavior changes, anxiety and irritability, or even delusions. Alzheimer disease is now recognized as the leading cause of dementia. After initially attacking parts of the brain that control memory, the disease will also destroy other areas, impacting other body functions. Many other conditions, such as chemical imbalances or head injury, can cause similar symptoms to Alzheimer, and doctors can only diagnose the disease after a thorough examination.

Dementia is the name given to a group of conditions—Alzheimer disease and Parkinson disease among them—that destroy mental function by attacking brain cells. So-called vascular dementia results from reduced blood flow to the nerve cells of the brain. Among the other conditions that result in dementia are Creutzfeldt–Jakob disease, frontotemporal dementia, and dementia with Lewy bodies.

Arteriovenous malformations are defects within the human circulatory system. These defects are believed to develop during fetal development or soon after birth. The most damaging varieties of arteriovenous malformations affect the brain or spinal cord. Though most of these defects cause limited or no symptoms at all, a small percentage (12 percent, according to the National Institutes of Health) can result in symptoms that include headaches, seizures, paralysis, vision problems, communication problems, memory problems, confusion, and dementia, among others. Medication can treat some arteriovenous malformations, though others require surgery.

One of the most common of all health problems, back pain will affect four of every five adults. Not surprisingly, countless conditions can cause back pain, including everything from simple strained muscles to poor posture to severe injury or illness. Among the specific conditions that cause back pain are herniated discs, spinal stenosis, spondylosis (arthritis of the back), cancer of the spine, and infection of the spine. Treatment options vary.

A traumatic brain injury is a blow to the head that results in a disruption of the functioning of the brain. These injuries can range from mild—relatively small injuries that result in temporary changes in function—to severe. Severe brain injuries can result in coma or long-term amnesia. Nearly 1.5 million people sustain a brain injury each year.

Brain metastases are tumors that first grow in tissues elsewhere in the body before spreading to the brain. Metastasis to the brain is a common complication of systemic cancers and is a significant cause of death. According to some statistics, roughly 170,000 new cases of brain metastasis occur each year in the United States, and some experts believe incidence of metastasis to the brain may be increasing. Lung, breast, melanoma, renal, and colon cancers are the most common causes of metastasis to the brain.

Brain tumors are tumors of the brain. Each year, nearly 200,000 people in the United States are diagnosed with the more than 120 varieties of brain tumors—either primary or metastatic—and brain tumors are now the leading cause of solid tumor death among children under 20 years of age. Because of their location in the brain, these tumors can have devastating effects on a person’s ability to function normally. Among the many symptoms of brain tumors are headaches, seizures, personality changes, nausea or vomiting, and memory loss, among others. Only a third of patients diagnosed with brain tumors survive five years following diagnosis.

Cerebral aneurysm is a weak spot on the wall of a brain artery or vein (like the weak spot on the inner tube of a tire) that is prone to dilation, bulging, or ballooning. Aneurysms can form from injury or infection or from simple wear and tear—they are much more common in adults than in children. Some small aneurysms may produce no symptoms, while larger ones may cause loss of feeling in face, or vision problems. In the moments before an aneurysm bursts, symptoms may include nausea, headache, or loss of consciousness. Ruptured aneurysms require emergency treatment, usually followed by surgery.

Unlike “acute pain,” which generally results from specific injury or illness, chronic pain can result from any number of conditions and can persist for, in some cases, years. Among the most common forms of chronic pain are headache, cancer pain, low back pain, arthritis, and psychogenic pain, which is not rooted in any specific injury or condition. Treatments for chronic pain are numerous as well—medication, surgery, acupuncture, and psychotherapy are among the techniques doctors can use to treat chronic pain.

Degenerative disorders include a large number of diseases and conditions that affect the normal functioning of the body and include such neurologic conditions as Alzheimer disease, Parkinson disease, and vascular dementia, and disorders of the spine such as spondylosis and stenosis. Among the many other degenerative disorders are multiple sclerosis, Alexander disease, and chorea.

Pervasive developmental disorders cause delays in the development of basic skills, including emotional, behavioral and social skills. Among the numerous conditions that belong to this group of disorders are Asperger disorder and Rett syndrome. The most commonly known developmental disorder— autism—is believed to affect up to 1.5 million Americans.

Epilepsy is a neurologic disorder that results in recurring disturbances of brain function that can cause impairment or loss of consciousness, as well as abnormal movements or behavior. Epilepsy is often diagnosed after patients have experienced two seizures not caused by some other condition. Epilepsy can result from brain injury or genetic predisposition.

General neurology departments can provide comprehensive care to patients with any number of neurologic disorders. Symptoms of these disorders vary but often include headaches, dizziness, back pain, memory problems, weakness or fatigue, and seizures.

One of the most common of all health problems, headaches result from the interaction of the brain, nerves, and blood vessels. Headaches occur when certain nerves in blood vessels and muscles of the head are activated, sending pain signals to the brain. There are 150 different categories of headache, including common types such as migraine headaches, tension headaches, and cluster headaches. More than 45 million Americans suffer from chronic headaches, and 28 million suffer from migraines. Treatment options for headaches can range from medication to counseling.

Psychosomatic medicine is the study of how emotional disturbances are manifested in physical conditions. Among the physical conditions believed to be caused at least in part by psychologic factors are hypertension, diabetes, asthma, and some gastrointestinal problems. Sigmund Freud is credited with launching the psychosomatic movement, and a recent development in the field—pscyhoneuroimmunology—studies the interactions of the endocrine system, central nervous system, and immune system.

Movement disorders are neurologic conditions that affect a patient’s ability to move. They can affect how quickly a patient can move (dyskinesia), cause involuntary movement (hyperkinesia), or interfere with movement entirely (hypokinesia). Among the many movement disorders are ataxia, dystonia, Huntington disease, and Tourette syndrome. Parkinson’s disease, possibly the most widely known movement disorder, affects more than 1 million people. The disease is a chronic neurodegenerative disorder that causes rigidity, slow movement, difficulty in walking, and other symptoms.

Multiple sclerosis is a disease that affects the central nervous system by destroying a fatty tissue called myelin. When myelin is destroyed, nerve fibers are unable to function properly, resulting in the signature symptoms of MS. Those symptoms include fatigue, difficulty in walking, depression, bladder dysfunction, memory problems, and vision problems. Approximately 400,000 Americans have MS. Most are diagnosed between the ages of 20 and 50. The disease generally affects more women than men.

Myasthenia gravis is a chronic autoimmune neuromuscular disorder characterized by weakness of voluntary muscle groups. It is believed that the condition affects more than 20 people in every 100,000. Myasthenia gravis most often affects the muscles that control the eyes and eyelids, chewing, swallowing, coughing, facial expression, and movement of the arms and legs. A complete medical evaluation and any number of tests may be used to diagnose the condition, for which there is no cure. Treatments include medication, thymectomy, and plasmapheresis.

Neuromuscular disorders are diseases that affect the functioning of the nerves, muscles, and neuromuscular junctions, or “synapses.” Included among neuromuscular disorders are muscular dystrophies, a group of more than 30 diseases that cause progressive degeneration of the muscles. The most common of the muscular dystrophies, Duchenne MD, primarily affects boys, with onset occurring between the ages of 3 and 5. No cure exists for the muscular dystrophies. Treatments can include physical therapy, respiratory therapy, speech therapy, the use of orthopedic appliances, and surgery.

A pinched nerve can cause tingling, numbness, pain, or weakness and occurs when pressure is applied to a nerve by surrounding tissue. Among the causes of this pinching are injury, repetitive motion, joint disease, or even pregnancy. Pinched nerves are most often found in the nerves of the arms, from the shoulders to the hands. With treatment, pinched nerves can be healed in a few days or weeks.

Peripheral neuropathy is damage to the peripheral nervous system, which is the system responsible for sending information from the brain and spinal cord to the rest of the body. More than 100 types of peripheral neuropathy exist, and the symptoms vary widely. In some instances, peripheral neuropathy may cause relatively minor symptoms such as tingling, numbness, or muscle weakness. In more severe cases, symptoms may include paralysis or organ dysfunction. Peripheral neuropathy can be caused by injury, alcoholism, tumors, and any number of disorders and diseases. There is no cure for peripheral neuropathy, but the condition can be treated and symptoms can be alleviated through therapy and the adoption of healthy living habits.

Post-polio syndrome affects polio survivors, causing weakening in the muscles that were attacked by polio infection and sometimes in muscles that were apparently unaffected by the original infection. Symptoms of post-polio syndrome include pain, fatigue, muscle weakness, and muscle atrophy. The National Center for Health Statistics estimates that nearly 450,000 polio survivors may be at risk for post-polio syndrome, for which there is no pharmaceutical cure.

Sleep disorders affect the ability of people to sleep normally and maintain good sleep health. These disorders affect approximately 40 million people in the United States alone. More than 70 varieties of sleep disorders exist, but they all fall into one of three categories: those that cause lack of sleep, those that cause disturbed or unsatisfactory sleep, and those that cause excessive sleep. Various treatments are available for sleep disorders, from basic hygiene to medication.

Spasticity, one of the signature symptoms of muscular sclerosis, results in a feeling of stiffness and muscle spasms. Mild spasticity may result in only the discomfort of muscle tightness, while more severe spasticity may cause painful and uncontrollable spasms of the arms and legs. It is more common in the legs. Treatments include medication and exercise.

Spinal cord injuries typically result from traumatic injury to the spine. These traumatic injuries can fracture or dislocate the vertebrae, causing bone fragments or other material to damage spinal cord tissue, including the axons. Axons are extensions of nerve cells that are responsible for carrying signals from the brain to the rest of the body. When axons are destroyed, those signals are interrupted and paralysis can occur. Spinal cord injuries can be complete or incomplete. Complete spinal cord injuries result in a total lack of function below the point of spinal injury.

A stroke results from the blocking of an artery (due to blood clot) or from the bursting of a blood vessel in the brain. When a blockage or burst vessel occurs, blood flow to the brain is interrupted, brain cells die, and brain function is damaged. Among the functions that can be affected by stroke are movement, speech, and memory. Strokes vary in severity. They are the third-leading cause of death in America and the number-one cause of adult disability, but doctors say that 80 percent of strokes are preventable. Maintaining healthy habits can go a long way toward preventing stroke.