• Traumatic Brain Injury
• Hematoma
• Brain Tumor
• Hydrocephalus
• AVM
• Cerebral Aneurysm

Hematoma

A hematoma (also called a hemorrhage) is a localized collection of blood, usually clotted in a tissue or organ, caused by bleeding from a ruptured blood vessel. If the bleeding occurs quickly or spontaneously (like an aneurysm) it is called acute, and if it occurs slowly over weeks it is chronic. While hematomas can occur anywhere on the body, for instance minor bruises or black eyes, they are most serious when they occur inside the brain. The most common types are: epidural (between the cranium and dura), subdural (between the dura and arachnoid), intracerebral (in the brain tissue), intracranial (within the skull), intraparenchymal (in the white matter) and subarachnoid (around the surface of the brain).    

Symptoms
Hematomas usually develop after a traumatic head injury with an associated fracture. The particular danger is that as they expand, they compress the underlying brain tissues, potentially causing significant neurological abnormalities.

Some of the main symptoms include:

• Headache
• Nausea
• Vomiting
• Slurred speech or loss of ability to speak
• Pupils of unequal size
• Impaired gait
• Dizziness

With more blood progressively flowing between the brain and the skull, more symptoms may develop such as

• Lethargy
• Unconsciousness
• Increasing headache
• Fluctuating drowsiness or confusion
• Mild weakness in limbs on one side of the body
• Coma

Treatment
A hematoma is especially serious because it may lead to permanent brain damage or even death if left untreated. Using a CT (computerized tomography) or MRI (magnetic resonance imagery) scan will help determine the diagnosis.

While a physician will often prescribe medications - depending on the type and severity of symptoms - to control edema (brain swelling) or prevent seizures, most hematomas require surgery. A craniotomy (an opening in the skull) is necessary to remove large hematomas or solid blood clots. In certain circumstances, the neurosurgeon will perform a trepanation (drilling a hole in the skull to remove the excess blood by suction). Most patients will fully recover and be able to resume normal activities within the first six months depending on the extent of the damage.
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Brain Tumor

When body cells lose the ability to control their growth, they divide too often and without any order. The extra cells form a mass of tissue called a tumor. Benign brain tumors have clear borders and do not contain cancer cells. Usually these can be removed and are not likely to recur, though there are some symptoms from sensitivity. Malignant brain tumors, on the other hand, contain cancer cells, interfere with vital functions and are life-threatening. They are likely to grow rapidly and crowd or invade the tissue around them (think of a plant with roots).

Tumors that begin in the brain tissue are known as primary brain tumors (identified by the type of tissue they grow in), whereas secondary or metastatic tumors are those that develop when cancer spreads to the brain or CNS from other organs. Doctors often refer to brain tumors by grade – from low (grade I) to high (grade IV), based on how the cells look under a microscope. Cells from higher-grade tumors are more abnormal-looking, malignant, and generally grow faster than cells from lower-grade tumors.

Symptoms
The symptoms of brain tumors depend mainly on their size and their location, but are often a result of:

• Damage to vital tissues
• Pressure on the brain as the tumor grows within the limited space in the skull
• Swelling and a buildup around the tumor or ventricles.

Treatment
Brain tumors are most commonly treated with chemotherapy (the use of drugs to kill cancer cells), radiation therapy (the external or internal use of high-powered rays to damage cancer cells and stop them from growing), stereotactic radiosurgery (a single especially-high dose of radiation) or surgery. With brain surgery, whenever possible, the surgeon attempts to remove the entire tumor. However, if the tumor cannot be completely removed without damaging vital brain tissues, the doctor cuts out as much of the tumor as possible. Even a partial removal will help relieve symptoms by reducing pressure on the brain and the amount of tumor that has to be treated again by radiation.

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Hydrocephalus

Hydrocephalus or “water head” is a condition characterized by an abnormal amount of cerebrospinal fluid (CSF) in the brain that causes the ventricles to expand dangerously.

Symptoms
Increased CSF volume results in elevated intracranial pressure, which often leads to brain damage, hemorrhaging or even death. The disorder can occur at birth or develop later in life, as the most typical cause is an obstruction of the normal spinal fluid passage from one fluid chamber to another.

Treatment
The most common form of treatment for hydrocephalus is a surgical placement of a shunt to divert the fluid from the brain.

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AVM

AVMs (arteriovenous malformations) are usually congenital (present from birth) and occur when brain or spinal cord arteries tangle and attach directly to veins without passing through capillaries (the smallest type of blood vessel). This can lead to a quicker rush of blood than normal - similar to a road with more traffic than planned. Over time, the surface develops wear-and-tear and may eventually break resulting in bleeding within the nervous system.

Symptoms
The symptoms from the bleeding in the brain appear progressively ranging from headaches and seizures, loss of bowel or bladder function, paralysis, to other neurological catastrophes like rupture or loss of brain function.

Treatment
AVMs are most commonly treated either by brain surgery (surgical resection), radiosurgery (directed radiation on the abnormal vessels to cause them to shrink) or embolization (placing catheters and injecting coils or liquid adhesives to block and reduce the AVM size).

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Cerebral Aneurysm