Neurosurgery: diseases — симптомы, диагностика и лечение

A herniated disc is the release of the internal contents of the disc beyond its outer ring. The diagnosis sounds alarming, and most patients immediately think about surgery. In reality, the picture is different: a significant proportion of hernias exist asymptomatically, and of those that cause pain, the majority resolve conservatively within 6-12 weeks. Moreover, large hernias and sequesters often decrease or completely resolve on their own - the body “digests” them. Surgery is necessary for a minority, but there are a few situations where delay is unacceptable.

A brain cyst is a cavity with fluid located in the brain tissue, between its membranes or in the ventricles. Most often, cysts are found accidentally during an MRI performed for another reason. Most of them—arachnoid cysts and pineal cysts—are congenital or age-related, do not grow, do not cause symptoms, and do not require treatment. Less common are cysts formed at the site of a stroke or injury, colloid cyst of the third ventricle, parasitic cysts and cystic tumors. The danger of a cyst is determined not by the fact of its presence, but by its size, location, effect on the outflow of cerebrospinal fluid and the nature of the contents. Therefore, the finding should be assessed by a neurologist or neurosurgeon, if necessary with MRI with contrast.

A brain tumor is the growth of abnormal cells in the brain tissue or its membranes. Primary tumors arise in the brain itself, the meninges, the pituitary gland, or the cranial nerves; secondary - metastases of cancer of other organs; in adults they are more common. Tumors can be benign, such as most meningiomas, or malignant, such as glioblastoma. However, even a benign tumor can be dangerous due to the pressure on vital structures in the limited space of the skull. Symptoms depend on the location and rate of growth: increasing headache, epileptic seizures, weakness, speech and vision disorders, personality changes. The main diagnostic method is MRI with contrast, and the type of tumor is determined by histological examination. Treatment is selected by a team of neurosurgeon, oncologist and radiotherapist.

Hydrocephalus is an excessive accumulation of cerebrospinal fluid in the ventricles of the brain, leading to their expansion and compression of brain tissue. The disease is usually associated with babies and enlarged heads, but there is a second, much more often overlooked form - normal pressure hydrocephalus in the elderly. Its manifestations - gait disturbance, urinary incontinence and memory loss - are almost always attributed to age and dementia, whereas this is one of the few reversible causes: after surgery, the condition can improve significantly.