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Dr. Timothy Lee Kam Yiu , Senior Consultant Neurosurgeon

Articles

Head Injury and Brain Tumour

1. Head Injury

Head injuries can be divided into 2 groups: Severe head Injury and Minor head Injury

SEVERE HEAD INJURY:

This group of patients is often in a coma (not opening eyes, not talking or not obeying command). The primary objective of treatment is to minimize the secondary damages and to allow the brain to recover itself. The common causes of secondary damages are: bleeding (extradural, subdural, intracerebral or intraventricular), brain swelling, low blood pressure or low oxygen. Therefore the blood clot may need to be removed. Drugs may be needed to reduce the swelling. Recovery often takes a long time. Sometimes too much water may accumulate in the brain requiring operation.

MINOR HEAD INJURY:

Sometimes after a minor knock injury patients may experience headache, giddiness, poor concentration or poor short term memory. This may invariably settle with time, sometimes taking several weeks or months. Piracetam may help.

CHRONIC SUBDURAL HAEMATOMA

In old patients, sometimes blood clot develops several weeks after injury. The symptoms are often weakness of limbs, unsteady walking, speech problem or drowsiness. These are often diagnosed as stroke until a scan has been done. The treatment is simple and effective. One or two holes drilled in the head often cure the problem. Nevertheless, because of the underlying problem of aging shrunken brain, there is a small chance of recurrence (5-10%). Patients often return back to their conditions before the bleeding occurs.

2. Brain Tumour

Brain tumours can be divided into 2 groups:

1. Benign / non-cancerous Tumours

2. Cancerous Tumours

1. Benign / non-cancerous Tumours

A. Meningioma:

The tumour grows from covering of the brain (meninges). Usually it grows slowly but occasionally it can grow faster than expected (case). It may produce symptoms such as:

1. Headache, this type of headache sometimes occurs at night or early morning waking the patients up

2. Epilepsy

3. Weakness or numbness or blurred vision, depending on the location of the tumour. Complete removal of the tumour gives long term cure.

B. Pituitary Adenoma:

This tumourarises from the pituitary gland, a hormone gland that controls most of the hormones of the body. It may produce the following symptoms:

1. Over secretion of hormones including prolactin (in females, breast discharge irregular or lack of menstruation, infertility; in male, lack of sex drive or impotence), growth hormone (in adult, big hands feet and head, night sweat, in children, excessive height) and ACTH (weight gain, moon face and hypertension)

2. Under – secretive of hormones (excessive tiredness and excessive urine)

3. Blurring of vision and occasionally double vision

4. Headache

Assessment often includes assessment of hormonal status and vision.

If the tumour secrets prolactin (prolactinoma), often surgery is not needed. Treatment with Drugs, bromocryptine or carbagoline is often sufficient.


Date Posted : 2011-01-04 17:01:04