Neurosurgery treats diseases that affect the central nervous system (brain and spinal cord) and its envelopes (skull and spine) and the peripheral nervous system (plexuses and nerves).
These diseases can be congenital, genetic or acquired – intracranial tumor, aneurysm, AVM (arteriovenous malformation), cavernoma, hydrocephalus, idiopathic intracranial hypertension (pseudotumor cerebri), cysts, degenerative diseases of the spine (herniated disc, narrow lumbar or cervical canal scoliosis, for example), traumatic brain injury, spinal cord trauma, chronic pain, epilepsy and movement disorders (spasticity, Parkinson, dystonia).
Sequelae such as sinking and skull deformities, mental changes (coma, persistent vegetative state, minimal state of consciousness, epilepsy, changes in reasoning, attention and memory), quadriplegia, paraplegia, language disorder, changes in swallowing and chronic pain can be treated by a multidisciplinary team with support from neurosurgical procedures.
Through skull tomography examination with 3D reconstruction, the skull can be evaluated and neurosurgical cranioplasty planned to correct the aesthetic and functional defect. Post-traumatic brain injury hydrocephalus can be recognized and treated with neurosurgery, providing improved quality of life.
Spinal diseases (post-spinal trauma or degenerative pathologies such as disc herniation, spondylolisthesis, narrow canal, scoliosis, spinal cord tumors, fractures and vertebral deformities due to osteoporosis) can be treated by neurosurgery to decompress the nervous system or for bone fixation and stabilization.
Electrical or magnetic stimulation of the spinal cord, transcranial and deep brain stimulation (DBS) and vagus nerve stimulation (VNS) are neurosurgical procedures that can be used in post-traumatic rehabilitation or in diseases of abnormal movements such as Parkinson's and Epilepsy.
Normal pressure hydrocephalus (NPH) is a type of reversible dementia, which affects people over 60 years of age and can easily be confused with Alzheimer's or Parkinson's. It is currently estimated that more than 120,000 Brazilians have NPH, but the majority do not know the diagnosis.
The symptoms of NPH are noticeable changes:
Hydrocephalus can be treated and the best clinical results, with recovery of health and quality of life, are obtained when hydrocephalus is diagnosed and treated quickly.
Imaging tests, such as head tomography and brain magnetic resonance imaging, confirm the diagnosis of NPH.
The Tap Test, the infusion test and external lumbar drainage for 72 hours are predictive tests for therapeutic success. After the test, hydrocephalus (NPH) can then be confirmed and if the clinical picture is compatible, the patient must undergo neurosurgery to promote recovery of their mental and motor skills, in addition to control of urination and evacuation.
There are two current neurosurgical options for treating hydrocephalus:
Idiopathic intracranial hypertension, also known as benign intracranial hypertension or pseudotumor cerebri, is a hydrodynamic disorder more common in obese women of childbearing age. It is a neurological disease with an incidence of 1 in 100 thousand individuals.
Symptoms of idiopathic intracranial hypertension may be constant headache, nausea, vomiting, dizziness, tinnitus and visual changes (double vision, visual blurring, partial loss of vision). If left untreated, it can lead to permanent blindness.
The diagnosis of idiopathic intracranial hypertension can be confirmed with the following tests: head tomography, magnetic resonance imaging of the brain, lumbar puncture of the cerebrospinal fluid with pressure measurement, fundus examination and visual campimetry.
Non-invasive measurement of intracranial pressure is a non-invasive and painless test that provides important information about the morphology of intracranial pressure waves and brain compliance. This exam can be done for diagnosis and patient monitoring.
Treatment of idiopathic intracranial hypertension is through reducing body weight, medications to reduce the production of cerebrospinal fluid and neurosurgery to relieve intracranial pressure (ventriculoperitoneal shunt, lumboperitoneal shunt, bitemporal decompressive craniectomy) or decompression of the optic nerve sheath.
