- Cerebral (Brain) and Spinal tumours
- Cerebral Aneurysms, arteriovenous malformations (AVM), Intracerebral haemorrhages (haemorrhagic strokes) and other cerebrovascular pathologies
- Degenerative spine disease
- Headaches and Facial pains
- Neurological infections, brain abscesses, etc
- Neurotrauma
- Brain tumor resections
- Aneurysm clipping, AVM resections, Intracerebral haemorrhage evacuations
- Degenerative spine disease management
- Neuroendoscopy
- Spinal related pain relief employing radiofrequency ablative techniques
- Member of the Royal College of Surgeons in Ireland ( 2009)
- Masters of Surgery ( Neurosurgery) (USM) (2013)
First of all cysts in the brainstem area may be due to causes that may be harmless or harmful to the patient and the first thing to identify is where in this area does the cyst lie, i.e. is it within the brainstem or outside the brainstem and what symptoms did the patient experience that made them see a doctor in the first place.
For this a detailed history and examination with a neurosurgeon or neurologist is important, followed by a good brainscan, typically an MRI. Cysts around a brainstem are harmless (e.g. arachnoid cyst) but may irritate the nerves around the brainstem causing symptoms. Often they can be left alone or operated to release pressure and therefore lessen the irritation to the nerves. If a cyst is found within the brainstem, an MRI will tell us what that cyst is caused by i.e. tumor being most common. Whether it is benign ( not harmful) or malignant depends on the tissue result obtained from surgery. The majority of tumors affecting the brainstem are benign ( more likely to be harmless) but because it is the brainstem that is involved, it makes surgery very risky, often outweighing the benefit.
Therefore the answer to the question "what should I do to treat cysts in the brainstem" the answer depends on the findings of the brain MRI. Brainstem function is extremely important
for human beings and surgery can be very risky in this part of the brain.
I am assuming you are at least of middle age as you have stated that you had a cardiac assessment carried out for these symptoms you mentioned. However in view of these "shakes" and problems on standing it is best for you to be seen by a neurologist and an endocrinologist. A neurologist is a doctor who specialises in nerve disorders. An endocrinologist is a doctor who specialises in hormone problems.
Longstanding giddiness (since 1984) may be due to a number of causes, and oral (tablets, taken by mouth) medications can be helpful once the cause has been determined properly.
Along with brain MRI scans, this may require an ENT / ophthalmological assessment also if the neurological assessment turns out to be normal.
How old are you and what sort of work do you do? Apart from age ( the older a person gets, the less sleep they tend to require and this is normal) and actual long standing pain conditions already existing different parts of the body that can disrupt sleep themselves, sleep issues are not uncommon and the cause can be attributed to breathing problems that occur during sleep, resulting in poor sleep patterns that make the person feel lethargic and restless and unable to concentrate the next day. A respiratory physician ( a doctor who specialises in lung and breathing disorders) will be able to diagnose these conditions using sleep studies. Very rarely, a stroke in the brainstem also cause breathing related issues which can disrupt sleep patterns. Finally psychological stress can additionally burden a person and this may manifest with poor sleep quality at night.
For humans, a specialised region in the inner ear is responsible for providing balance and it communicates with the cerebellum through the brainstem to achieve this. When you have vertigo spells, a problem may be occuring in these regions and this is common in older age group patients. Vertigo itself can be benign however it can be disruptive in everyday life and can be treated using oral medications. However you should see an ENT specialist ( a doctor who sees patients with ear/hearing/nose/throat problems) before starting them. Sometimes however, patients report imbalance when they close their eyes or additionally they develop shaking symptoms in their arms and seem to lack coordination. It is important to differentiate between these symptoms as the problem may instead involve the spinal cord or cerebellum rather than
just the inner ear only.
If a headache causes you much pain, affecting your walk and blurring your vision, you should get it checked immediately as it may be related to a brain problem. A visit to a neurosurgeon or neurologist is required.
Please get yourself checked once again by a neurosurgeon and an opthalmologist, and this time please also do a brain scan. High eye pressure is not good and may be revealing or lead to something else more distressing if not checked properly. A brain problem cannot be ruled out based on your history and you should be examined thoroughly along with an MRI brain scan if required.
Problems with facial nerves, called hemifacial spasm, need to be assessed using an MRI brain scan to see if there is anything irritating the nerve in the brain. Once an MRI is done and there is no condition within the brain that is causing the twitches, injections can be used to control the twitches, but complete cure is less likely. If something is found in the brain that is causing the twitches, surgery can help to address the problem.
Your daughter may need an MRI brain to discover what is causing her seizures. Once a problem has been found in her brain, we use medications first to fully control her seizures and when that is no longer helpful, surgery to address the brain problem may be considered. Her medications will still be continued after the surgery. Permanent cure without anymore future medications can be difficult but not impossible.
- MADOPAR 2X1 morning and evening
- SIFROL 0,375mg 1x1 morning
From what you have mentioned about your husband, yes it is quite likely that he has Parkinsons disease and the medications given are to help his symptoms and restless legs syndrome. It is advised that he continues his medicaions and follow-up with his neurologist. As I am a neurosurgeon I would not be of much help to a patient who has Parkinsons disease.