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STROKE Description
Stroke is a general term for a sudden neurological event which results in the new onset of neurological symptoms. The term is derived from the same definition as a "stroke of lightning", referring to something that occurs suddenly and without warning. This commonly used term can refer to more than one nervous system disease. For example, it can refer to either sudden hemorrhage or cerebral infarction. However, the most common meaning of the term is to refer to cerebral infarction, due to cerebral ischemia. Common types: y y y Cerebral Ischemia or Cerebral Infarction Transient Ischemic Attack (TIA) Hemorrhagic

Causes
Strokes are ultimately caused by a thrombus or embolus that blocks blood flow to the brain. Blood clots (thrombus clots) usually occur in areas of the arteries that have been damaged by atherosclerosis from a buildup of plaques. Embolus type blood clots are often caused by atrial fibrillation - an irregular pattern of heart beat that leads to blood clot formation and poor blood flow.

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Treatment
y y y Drugs Given During a Stroke Surgery (Carotid endarterectomy, Angioplasty and catheter embolectomy.) Drugs Given After a Stroke

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HEADACHE Description
There are many different causes of headache. Headache is an extremely common symptom, experienced in one form or another by most people at one or more time in their life. The vast majority of headaches experienced by most people are benign tension headaches which are a nuisance but harmless, not associated with any serious underlying nervous system diseases. However, fortunately relatively rarely, some types of headache can be associated with severe, potentially life-threatening neurologic disease, such as meningitis, aneurysms and brain tumors, to name a few. While all of these causes of headache have pain in the head as a common symptom, all vary somewhat in other associated symptoms that can set them apart from each other. Read on to learn more about the different types, how they differ and their implications for your health. Common Types: y y y y y y Tension Headache Migraine Headache Cluster Headache Meningitis Headache Cerebral Aneurysm and Subarachnoid Hemorrhage Brain Tumor Headache

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Causes

Physical or Emotional stress placed on the body. Physical stress that may cause headaches include difficult and prolonged manual labor, or sitting at a desk or computer for long periods of time Emotional stress may also cause tension headaches by causing the muscles surrounding the skull to contract.

Treatment

Tension headaches are sometimes helped by measures to relax the tight muscles. These include massage, hot showers and heating pads on the back of the neck or cold packs. Biofeedback and muscle-relaxation training may be helpful.

Chronic tension headaches, prescription analgesics aren't always useful. They tend to lose their effectiveness, encourage dependency, and cause "rebound" headaches when they wear off. A less addictive and often more effective alternative is a tricyclic antideressant, such as Amitriptyline (Elavil) or Imipramine (Tofranil), which can affect the pain pathways in the brain. Cluster headaches seldom last more than an hour or two, but those hours - usually in the middle of the night - can be miserable. The attacks can occur daily, for weeks at a time, and then disappear for long stretches. These headaches don't usually last long enough to be treated effectively. Some sufferers need prescription narcotics.

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EPILEPSY Description
Epilepsy is a condition characterized by recurring seizures in an individual. Seizures are an abnormal overactivity of the cells of the brain which can affect variable regions of the central nervous system, primarily in the forebrain. The effects of seizures depend on their location in the brain and their extent. The classic appearance of seizure with physical convulsions in a patient is a common manifestation of seizures but not all types of seizures include convulsions. There are many causes of seizures. In general, any injury to the brain can lead to seizures, including trauma, tumors, vascular lesions, hemorrhage and developmental anomalies. Below are many links to pages describing many of the various types of seizures and causes of this disease. Common Types: y y y y y Temporal Lobe Epilepsies Cortical Dysplasia Hemimegalencephaly Hereditary FormsSturge-Weber Syndrome Febrile Seizures

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y y y

Rasmussen's Encephalitis Post-Traumatic Seizures Abdominal Seizures

Causes
Anything that disturbs the normal pattern of activity in the brain can trigger epilepsy. The cause can be illness, brain damage, or abnormal development of the brain. No cause can be determined for about three-quarters of the cases of epilepsy.

Treatment
The majority of epileptic seizures are controlled through drug therapy, particularly anticonvulsant drugs. The type of treatment prescribed will depend on several factors including the frequency and severity of the seizures as well as the person's age, overall health, and medical history. An accurate diagnosis of the type of epilepsy is also critical to choosing the best treatment. Drug Therapy Older, classic medications used to treat epilepsy include:
y y y y y

Dilantin or Phenytek Phenobarbital Tegretol or Carbatrol Mysoline Zarontin

y y y

Depakene Depakote, Depakote ER Valium and similar tranquilizers such as Tranxene and Klonopin

Newer drugs to treat epilepsy include:

y y y y y

Felbatol Gabitril Keppra Lamictal Lyrica

y y y y

Neurontin Topamax Trileptal Zonegran

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BRAIN TUMOR Description

A brain tumor is an abnormal growth that involves the brain itself or its surrounding structures. This distinction helps us to divide nervous system tumors into two general classes: y Intra-axial tumors: These are tumors which grow within the substance of the brain itself y Extra-axial tumors: These are tumors that originate outside of the actual tissues of the brain, but can involve the brain because of their close proximity to it. In addition, pineal region tumors, originating from the area of the pineal gland, while technically part of the brain are often considered separately. Tumors vary in location as well as other characteristics such as their typical presenting symptoms, their speed of growth and aggressiveness (whether they are benign or malignant) and their typical locations.

Causes
No one knows the exact causes of brain tumors. Doctors can seldom explain why one person develops a brain tumor and another does not. However, it is clear that brain tumors are not contagious. No one can "catch" the disease from another person.

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The following risk factors are associated with an increased chance of developing a primary brain tumor:
y

Being male - In general, brain tumors are more common in males than females. However, meningiomas are more common in females.

Race - Brain tumors occur more often among white people than among people of other races.

Age - Most brain tumors are detected in people who are 70 years old or older. However, brain tumors are the second most common cancer in children. (Leukemia is the most common childhood cancer.) Brain tumors are more common in children younger than 8 years old than in older children.

Family history - People with family members who have gliomas may be more likely to develop this disease.

Being exposed to radiation or certain chemicals at work.

Treatment
Surgery is the usual treatment for most brain tumors. Surgery to open the skull is called a craniotomy. It is performed under general anesthesia. Before surgery begins, the scalp is shaved. The surgeon then makes an incision in the scalp and uses a special type of saw to remove a piece of bone from the skull. After removing part or all of the tumor, the surgeon covers the opening in the skull with that piece of bone or with a piece of metal or fabric. The surgeon then closes the incision in the scalp. Radiation therapy (also called radiotherapy) uses high-energy rays to kill tumor cells. The radiation may come from x-rays, gamma rays, or protons. A large machine aims radiation at the tumor and the tissue close to it. Sometimes the radiation may be directed to the entire brain or to the spinal cord. Chemotherapy, the use of drugs to kill cancer cells, is sometimes used to treat brain tumors. The drugs may be given by mouth or by injection. Either way, the drugs enter the bloodstream and travel throughout the body. The drugs are usually given in cycles so that a recovery period follows each treatment period.

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TRAUMATIC BRAIN INJURY (TBI) Description

Traumatic brain injury (TBI) is one of the most common causes of death and disability in the world. Brain trauma can lead to a number of different consequences. It can result from both blunt trauma, as in the case of a motor vehicle accident, and penetrating trauma, such as in the case of gun-shot or stab wounds. Types of Injury: There is a great deal of confusion amongst layman about the description of various traumatic head injuries. For example, the term "concussion" gets used very frequently, often without knowing the true meaning of the diagnosis. Here we have several traumarelated diagnoses with links to more information about each so that you can understand what each means and implies: y Concussion: A very misunderstood and misused term, learn more about what concussion really means here. y y y y Traumatic Coma Cerebral Contusion Diffuse Axonal Injury Epidural Hematoma

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y y y

Intraparenchymal Hemorrhage Traumatic Subarachnoid Hemorrhage Subdural Hematoma

Causes
1. Open Head Injury 2. Closed Head Injury 3. Deceleration Injuries (Diffuse Axonal Injury) 4. Chemical / Toxic 5. Hypoxia (Lack of Oxygen) 6. Tumors 7. Infections 8. Stroke

Treatment
Medications: There are several types of medications used to treat brain injury. Some of these include:
y

Diuretics are used to decrease the amount of water in the patient's body. This makes less water available to the brain for swelling.

Anticonvulsants are used to prevent seizures. Seizures occur as a result of extra electrical activity in the brain. There are several types of seizures. The most common type causes the patient to have jerking movements of the arms and legs followed by sleep.

Surgery: There are three types of surgery used with brain injury:
y

Craniotomy - The skull is opened to relieve the causes of increased pressure inside the skull. Causes may be fractured bones, blood clots, or swollen brain tissue.

y y

Burr holes - A small opening is made into the skull to remove blood clots. Bone flap removal - A piece of bone is removed from the skull to relieve pressure caused by swollen brain tissue

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SPINAL DISEASE

Description
Spinal disease is any pathology which affects the spinal column and/or the spinal cord and spinal nerves which are contained therein. Spine disease is a large area of study because of the large number of diseases which can affect the spinal system, from purely skeletal disorders to primary nervous system disorders. All types of spine disease can present with either or both spinal symptoms and neurological symptoms associated with injury or compression of the spinal cord or spinal nerves. Spine disease is very common, with many people undergoing spinal surgery every day. y Degenerative spine disease is a general term for any pathology of the spine that occurs over time due to both normal aging and wear and tear of the vertebral column. This includes many pathologies, such as herniated disc disease, spinal stenosis, and spinal instability. y Traumatic spine disease refers to any disease of the spine which occurs as the result of a traumatic injury such as a fall or motor vehicle accident. y Spinal Tumors are tumors that involve the spinal cord or vertebral column. They can either be primary, originating in the spinal column, or secondary, spreading to the spine from other sites in the body, such as in the case of a metastatic cancer. y Spinal Dysraphisms are abnormalities in the the spinal cord, mostly due to abnormalities in the development of the spinal cord and/or vertebral column.

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Causes
y y y y y

Infections Injuries Tumors Conditions, such as ankylosing spondylitis and scoliosis Bone changes that come with age, such as spinal stenosis and herniated disks

Spinal diseases often cause pain when bone changes put pressure on the spinal cord or nerves. They can also limit movement. Treatments differ by disease, but sometimes they include back braces and surgery.

Treatment
y y y y y y y y

Artificial Disc Replacement Back Surgery: When Is It a Good Idea? Epidural Injections Laparoscopic Spine Surgery Lumbar (Open) Microscopic Discectomy Lumbar Zygapophysial (Facet) Joint Injections Spinal Fusion Vertebroplasty for Spine Fracture Pain

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MULTIPLE SCLEROSIS Description

Multiple Sclerosis (MS) is a disease of the central nervous system which leads to recurring attacks of neurological symptoms. The deterioration in function is related to something termed "demyelination". Nerve cells connect to other nerve cells at a distance by way of a long wire-like extension of the cell called an axon. The axon carries an electrical signal along its length to transmit messages from one cell to the next. These can be quite long, carrying nervous system impulses up to feet at a time through the spinal cord and brain. Most of these long axons are myelinated, wrapped in an insulating substance called myelin. The myelin helps the electrical impulses conduct quickly and efficiently down the length of the axon. In MS, the myelin sheath around some axons in the central nervous system becomes damaged. This damage makes conduction along these axons faulty, slowing or stopping completely, leading to symptoms. These areas of demyelination, called MS plaques, are patchy and can occur almost anywhere in the brain or spinal cord at various times. The specific symptoms that occur depend on the specific location of the demyelination within the nervous system. The pattern and time course of these occurrences varies depending on the type of multiple sclerosis.

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Causes
MS is caused by damage to the myelin sheath, the protective covering that surrounds nerve cells. When this nerve covering is damaged, nerve impulses are slowed down or stopped.

Treatment
There is no known cure for multiple sclerosis at this time. However, there are therapies that may slow the disease. The goal of treatment is to control symptoms and help you maintain a normal quality of life. Medications used to slow the progression of multiple sclerosis are taken on a long-term basis, they include:
y

Interferons (Avonex, Betaseron, or Rebif), glatiramer acetate (Copaxone), mitoxantrone (Novantrone), and natalizumab (Tysabri) are approved for treating MS

Methotrexate, azathioprine

(Imuran),

intravenous

immunoglobulin (IVIg) and

cyclophosphamide (Cytoxan) may also be used if the above drugs are not working well

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CEREBROVASCULAR DISEASE Description

Cerebrovascular disease refers to disorders of the blood vessels that supply blood flow to the brain. While many of these disorders can cause what is generally referred to as "stroke", they vary quite a bit in their presentation and specific disease characteristics. For this reason, "stroke" can be a confusing term and is often misused. The term "stroke" originally meant a neurological condition which occurs suddenly, like a stroke of lightning. However, this can refer to many different underlying causes. The most common cause of "stroke" is what is called cerebral infarction which is damage to a part of the brain because of a blockage of the normal blood flow. The brain needs blood and therefore it will fail to function normally when an infraction occurs. However, other forms of "stroke" include hemorrhage, or bleeding, into or around the brain. These forms of "stroke" can be quite different in their symptoms and underlying pathology that caused the bleeding.

Causes
When a blood vessel carrying blood to the brain is blocked by a clot and a hemorrhagic stroke occurs due to leakage of blood into the brain. Brain cells may die if they do not receive blood and oxygen for a long a time.

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Treatment I. Medications
Blood platelet inhibitors such as Aspirin, Dipyridamole, Ticlopidine, Clopidogrel and Sulfinpyrazone are effective in reducing the risk for stroke. These drugs have been effective in treating patients with a history of stroke or patients at risk for a stroke event.

II.

Surgical Procedures
Carotid Endarterectomy: In this procedure an incision is made into the carotid artery and the plaque removed with the help of a dissecting tool thus enabling normal blood flow. Then the artery is repaired with sutures or a graft

III.

Non-Surgical Procedures
Carotid Angioplasty and Stenting: In this procedure, a balloon tipped catheter is inserted into the artery and the balloon inflated to press against the plaque so as to flatten the plaque and reopen the artery. A tiny, slender metal mesh tube (stent) is fitted inside the carotid artery to improve the blood flow in the arteries blocked by plaque. The stent helps in preventing the artery from collapsing or closing up after the procedure is complete.

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HYDROCEPHALUS Description
Hydrocephalus is an abnormality of the normal dynamics of the cerebrospinal fluid (CSF). The CSF is a water-like fluid that surrounds the brain and spinal cord. Normally, it is produced, flows throughout the open spaces in and around the central nervous system (the ventricles and subarachnoid space) and is then re-absorbed. However, some conditions can lead to the accumulation of this fluid or other abnormalities in its flow which can damage the brain and lead to significant symptoms. In general, hydrocephalic conditions are separated into two categories: y Communicating or Non-Obstructive Hydro: In patients who do not have a visible (on imaging studies) obstruction of the flow of cerebrospinal fluid. y Non-Communicating or Obstructive Hydro: In patients who do have a visible obstruction of the flow of cerebrospinal fluid.

Causes
The causes of hydrocephalus are still not well understood. Hydrocephalus may result from inherited genetic abnormalities (such as the genetic defect that causes aqueductal stenosis) or developmental disorders (such as those associated with neural tube defects including spina bifida and encephalocele). Other possible causes include complications of premature birth such as intraventricular hemorrhage, diseases such as meningitis,

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tumors, traumatic head injury, or subarachnoid hemorrhage, which block the exit of CSF from the ventricles to the cisterns or eliminate the passageway for CSF into the cisterns.

Treatment
Hydrocephalus is most often treated by surgically inserting a shunt system. This system diverts the flow of CSF from the CNS to another area of the body where it can be absorbed as part of the normal circulatory process.

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CNS INFECTION Description

A CNS infection is an infection which involves the central nervous system in some way. Meningitis is one of the most common and well known types, involving the meninges, the coverings of the brain and spinal cord. Other types of infections involve the brain or spinal cord directly. For example, a cerebral abscess is a bacterial brain infection and encephalitis is typically a viral infection of the brain. In general, an infection is a disease caused by the invasion of a disease-causing micro-organism or virus. The growth of the bacteria, virus or other invading organism in the human tissues causes damage and inflammation by a variety of mechanisms. y Meningitis

Meningitis is one of the most common forms of infection affecting the nervous system. It is characterized by infection of the membranes covering the brain and spinal cord, centered in the cerebrospinal fluid that surrounds the nervous system. y y y y Encephalitis Brain Abscess Cerebritis Subdural Emphysema

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Causes
There are four main causes of infections of the central nervous system (CNS): bacterial, viral, fungal and protozoal.

Treatment
A two-pronged approach is taken to treat CNS infections. First, antibiotic therapy against an array of potential infectious bacteria is begun. The second stage involves surgery to drain the infected site. Although some CNS infections have been resolved with antibiotics alone, the more aggressive approach is often preferred. Surgery allows immediate relief of pressure on the brain or spinal cord, as well as an opportunity to collect infectious material for bacterial identification. Once the bacterial species is identified, drug therapy can be altered to a more specific antibiotic. However, surgery may not be an option in some cases, such as when there are numerous sites of infection or when infection is located in an inaccessible area of the brain.

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ARNOLD CHIARI MALFORMATION Description

Arnold Chiari Malformation is a malformation of the brain which can lead to neurological symptoms. There are various forms of the malformation, discussed below, and can be both congenital (present at birth) and acquired. Although the various subtypes of Arnold-Chiari vary in their causes and specific patho-anatomy, the common feature which defines them is the decent of the cerebellar tonsils below the foramen magnum. The cerebellar tonsils are the most inferior portion of the cerebellum, a part of the hind brain which is important for motor coordination. Normally, these tonsils are wholly inside the skull. In the case of Arnold-Chiari, the tonsils are low-lying, below their normal level. The foramen magnum is the opening at the base of the skull, through which the brain stem passes to become the spinal cord. Whereas the normal cerebellar tonsils sit above the level of this opening, in Arnold-Chiari the tonsils lay below the level of the foramen magnum and can crowd this opening, compressing the brain stem, nerves and fluid pathways in the area. Common symptoms of this malformation vary depending on the type. The types are listed below with links to further information about the symptoms, diagnosis and treatment of each.

Causes
y y y y

exposure to hazardous chemicals/substances lack of proper vitamins and nutrients in the diet infection prescription or illegal drug and alcohol consumption

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Treatment
Once symptomatic onset occurs, a common treatment is decompression surgery,[16] in which a neurosurgeon usually removes the lamina of the first and sometimes the second or even third cervical vertebrae and part of the occipital bone of the skull to relieve pressure. The flow of spinal fluid may be accompanied by a shunt. Since this surgery usually involves the opening of the dura mater and the expansion of the space beneath, a dural graft is usually applied to cover the expanded posterior fossa.

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ALZHEIMER DISEASE Description

Alzheimer disease (AD) is the most common cause of dementia in western civilization. It affects more women than men, and the clinical course generally lasts approximately five years. The younger the individual is at the onset of the disease, the more severe the deficits for the patient. One famous contemporary who suffers from the disease is former U.S. President Ronald Reagan.

Causes
Scientists don t yet fully understand what causes AD, but it is clear that it develops because of a complex series of events that take place in the brain over a long period of time. It is likely that the causes include genetic, environmental, and lifestyle factors. Because people differ in their genetic make-up and lifestyle, the importance of these factors for preventing or delaying AD differs from person to person.

Treatment
There is currently no cure for Alzheimer's, but scientific research is bringing us closer to a cure every day. Outstanding progress has already been made in unraveling the mysteries of Alzheimer's disease, including what causes it and what happens in the brain as the disease progresses. New understandings about these processes have already provided critical information about how doctors might prevent, delay, stop or even reverse the nerve cell damage that leads to the devastating symptoms of Alzheimer's. All around the world, scientists

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and pharmaceutical companies are now racing to develop treatments that address the underlying disease processes, some of which (or a combination of which) might effectively solve the Alzheimer's puzzle.

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TOURETTE SYNDROME

Description
This syndrome begins in childhood and manifests itself through various forms of tics. These tics include frequent, irregular movements of the head, neck, or shoulders. They also may be more complex motor behaviors such as snorting, sniffing, and involuntary vocalization. As the syndrome progresses repetitive behaviors such as touching others, obsessive compulsive symptoms, and explosive involuntary cursing can be more common. Aggressive behavior and improper sexual impulses are the rarest and most severe expressions of the syndrome. Most often the child is hyperactive and has been given some form of CNS stimulant.

Causes
The cause of Tourette syndrome is not known, but it is believed to have a genetic component. A total absence of the protein dynorphin in the striatal fibers of the globus pallidus is found in some patients. Other studies have shown a deficit in the uptake or release of dopamine and serotonin at synapses.

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Treatment
Tourette syndrome require no medication for tic suppression. However, effective medications are available for those whose symptoms interfere with functioning. Neuroleptics are the most consistently useful medications for tic suppression; a number are available but some are more effective than others (for example, haloperidol and pimozide).

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CHOROID PLEXUS PAPILLOMA

Description
These tumors form most commonly in the fourth ventricle and mainly affect children during the first year of life. If untreated they result in hydrocephalus and symptoms of headache, lethargy, stupor and weakness of the legs. The tumor takes the form of a giant choroid plexus and has a cellular epithelium that is closely related to the ependyma. This form of tumor is often accompanied by hemorrhage which increases the complications of treatment. A shunt is the most immediate form of treatment if the patient is in a condition where surgical removal of the tumor cannot be performed right away. The shunt removes the excess CSF thereby reducing the damaging affects of pressure. Another problem that can occur with the choroid plexus is that a cyst(s) can form within it.

Causes
The cause, or causes, of CPTs are not known. In early 2001, ongoing investigations attempted to determine if environmental factors, genetic factors, viruses, or other factors caused primary brain tumors. Primary brain tumors are not contagious.

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Treatment
y y y y y y y Brain surgery oncology neurology medical imaging drug radiation therapy anesthesiology.

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Broca Aphasia

Description
Aphasia is defined by Websters Dictionary as a "loss or impairment of the power to use or comprehend words usually resulting from brain damage." In most people the Broca's area is in the lower part of the left frontal lobe. It is one of the main language areas in the cerebral cortex because it controls the motor aspects of speech. Persons with a Broca aphasia can usually understand what words mean, but have trouble performing the motor or output aspects of speech. Thus, other names for this disorder are 'expressive' and 'motor' aphasia. Depending on the severity of the lesion to Broca's area, the symptoms can range from the mildest type (cortical dysarthria) with intact comprehension and the ability to communicate through writing to a complete loss of speaking out loud.

Causes
Aphasia is caused by damage to one or more of the language areas of the brain. Many times, the cause of the brain injury is a stroke. A stroke occurs when blood is unable to reach a part of the brain. Brain cells die when they do not receive their normal supply of blood, which carries oxygen and important nutrients. Other causes of brain injury are severe blows to the head, brain tumors, brain infections, and other conditions that affect the brain.

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Treatment
y y y y y

Singing and Melodic Intonation Therapy Constraint Induced Therapy Pharmacotherapy Transcranial magnetic stimulation Communication In some instances an individual will completely recover from aphasia without treatment. When treatment is necessary, the most common treatment is therapy designed to improve an individual's ability to communicate by helping the person to use remaining abilities, to restore language abilities as much as possible, to compensate for language problems, and to learn other methods of communicating.

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NERVOUS SYSTEM