Diseases & Conditions Blog

Four major blood vessels supply your brain with blood to provide it with essential nutrients and oxygen, There are the two carotid arteries in the front of your neck and the two vertebral arteries running up protective bony canals in the neck section of your spine, These major arteries join to form the brain’s vascular system, a roughly circular arrangement at the base of your brain. Branches from the circle supply blood to all its parts. Areas that depend on only a single branch are especially vulnerable to any disturbance in the flow of blood.The following articles deal with the principal ways in which the brain can be affected by defects in this system. These disorders, such as stroke, which are caused by inadequate blood supply or by bleeding in the brain tissue from diseased arteries, are serious ailments often marked by dramatic life-threatening attacks. Professional care is urgently needed for anyone who has an attack of this kind.

Extradural hemorrhage occurs when blood vessels in the dura mater, the outermost of the three meninges, or membranous layers that cover the brain, rupture. Blood then flows outwards over the surface of the brain, between the dura mater and the skull. The problem usually results from a head injury that causes some of the blood vessels in the outer surface of the dura mater to burst . Because these vessels are large, a substantial amount of blood leaks into the space between the dura mater and the skull. The symptoms of an extradural hemorrhage are likely to appear within 24 hours of the injury (see also Subdural hemorrhage and hematoma, previous article). Even if the original injury seemed trivial when it happened, the symptoms are not. They include a sudden severe headache; nausea, often culminates in vomiting; and increasing drowsiness, all of which ultimately to unconsciousness and death

What are The Risks?

Head injuries are very common, but only about ten per cent of them require hospital admission, and only one to two percent cause extradural hemorrhage as a complication. This disorder creates an emergency situation, however, because pressure on the brain mounts as more and more blood floods into the narrow space between brain and skull.

What Should be Done?

If you or anyone in your presence shows symptoms of an extradural hemorrhage, get medical help fast, especially if there has been a blow to the head within the past several hours or the last day. Unless the person is treated promptly, there is a danger of permanent brain damage or even death. The person will be admitted to the hospital immediately for diagnostic tests and general treatment for head injury . If tests indicate the presence of extradural hemorrhage, surgery will be necessary to stop the bleeding. The operation involves removing a portion of skull bone to release leaked blood and permit the surgeon to repair ruptured blood vessels. When the operation is done promptly, it usually results in complete recovery from all problems.

An epidural abscess is a collection of pus in the space between the skull or spinal bones and the dura mater, which is the outermost of the three meninges, or membranes that cover the brain and spinal cord. The pus is usually due to a bacterial infection. As the pus collects it exerts pressure on the nerve tissue. In rare cases, toxins, or harmful chemicals that are produced by bacteria, may cause damage to the dura mater.

What are The Symptoms?

An abscess on the spinal cord can cause loss of muscular power in the legs and numbness of the entire lower part of the body. An abscess in the brain may have the same symptoms as a stroke, causing weakness down one side of the body or difficulty with speech. The onset of stroke like symptoms is seldom rapid; they usually appear gradually over several hours. In addition, you will probably have general symptoms caused by the infection, such as fever, confusion, and perhaps delirium or convulsions.

What are The Risks?

Epidural abscesses are extremely rare, because the infections that used to cause them can now be treated with antibiotics. Such infections include acute infection of the middle ear and sinusitis.

What Should be Done?

If you suspect that you have an abscess, consult your physician, who will probably consider the history of previous infection, and may order diagnostic tests. Among them may be blood tests to identify the invading bacteria, a skull X-ray, and perhaps an electroencephalogram (EEG). Arteriography, a CAT scan of the brain, and an examination of the spinal cord (myelography) may also be required for a diagnosis.

What is The Treatment?

To combat infection, your physician will probably prescribe an antibiotic. In some cases, however, this will not solve the problem, and surgery will be necessary. The surgeon makes an opening in the skull or in the vertebral bone through which pus can be removed. After such an operation, antibiotic treatment is continued. If the original cause of infection is also dealt with, you have a good chance of full recovery.

Meningitis is an inflammation of the meninges, which are membranous coverings of the brain and spinal cord. There are three meninges. First, there is the outside membrane, the dura mater, which adheres to your skull. Next is the middle layer, the arachnoid. Finally, there is the innermost membrane, the pia mater, which adheres to the brain. The cause of infection of these membranes is usually an invasion by either bacteria or viruses. There are a number of ways that infection can reach the meninges. For example, infectious agents may spread through the bloodstream from some other part of the body, such as the lungs, where there is an infection. They can also spread to the brain from an infected ear or infected sinuses, through the cavities in the bones of the skull. Or if you have a head injury involving a fractured skull, this provides an easy entry for infection. There are many forms and degrees of meningitis. Much depends on the type of bacterium or virus that causes the disease.

What areThe Symptoms?

Fever, headache, nausea and vomiting, a stiff neck, and photophobia (inability to tolerate bright light) usually develop over the course of a few hours. An occasional additional symptom is a deep red or purplish skin rash. If the infection continues to proceed unchecked, you become drowsy and you may eventually lose consciousness.

The symptoms of meningitis may be less obvious in infants and young children. For a full discussion on the differences, read the article on meningitis in babies and children.

What are The Risks?

Meningitis is an uncommon illness in this country. The most common form, a viral infection, spreads from person to person through the air. It therefore tends to occur in epidemics, as do many viral illnesses, often in winter when people are in close contact in doors. Bacterial meningitis may also occur in epidemics, but sporadic cases of this form are more commonly seen.

The sooner treatment of bacterial meningitis is started, the better the results. Untreated bacterial meningitis may well be fatal. With appropriate treatment, most people recover completely, but a few are left with permanent damage including deafness, blindness, and/or mental deterioration. Babies and elderly people are most in danger of either failing to recover or of being left with lasting residual damage. The reason for this may be that these people have relatively weak powers of resistance.

Viral meningitis tends to be a less severe illness than the bacterial type. In most cases there is full recovery with no after effects.

What Should be Done?

If you or anyone in your family develops symptoms of meningitis, particularly a combination of severe headache, stiff neck, and photophobia, consult your physician without delay. A tentative diagnosis of meningitis can be confirmed by an examination of a sample of cerebrospinal fluid, the liquid that bathes your central nervous system. This sample will be taken in a hospital. If the sample, which is obtained by a lumbar puncture , looks cloudy and contains pus cells, the meninges are probably infected. Further tests of the liquid sample should be able to identify the infectious agent, and this will help your physician to plan treatment aimed at combating the particular organism involved.

What is The Treatment?

You will have to remain in the hospital until the meningeal infection has cleared up. If the infection is bacterial, you will be given large doses of antibiotics, which may be dripped through a tube directly into a vein. This may be necessary for as long as two weeks. Since most viruses are not harmed by antibiotics, these drugs are not generally used for a case of viral meningitis. You can expect to be fully recovered in two to three weeks, depending on the severity of the attack.

While you are in the hospital, you will be made as comfortable as possible. Bed rest in a darkened room, plenty of liquids, and possibly drugs to lower your temperature and ease the pain of headaches will help your body overcome the infection.

Parkinson’s disease is caused by gradual deterioration in certain nerve centers inside the brain. The centers are those that control movement, particularly semi-automatic movements such as swinging your arms while walking. Deterioration of these nerve centers upsets the delicate balance between two body chemicals, dopamine and acetylcholine, which are essential for controlling the trans­mission of nerve impulses within this part of the nervous system. The resultant lack of control produces the symptoms of Parkinson’s disease.Nobody knows what causes the more common forms of the illness. In rare cases the nerve degeneration results from such factors as carbon monoxide poisoning or high levels of certain metals in body tissues. Sometimes Parkinson’s disease is the result of an earlier infection of the brain, such as encephalitis . High doses of certain drugs used in treating psychiatric conditions such as schizophrenia sometimes produce the symptoms of Parkinson’s disease.

What are The Symptoms?

One characteristic symptom is a type of tremor (sometimes incorrectly spoken of as “palsy,” which actually means paralysis). There is an involuntary, rhythmic shaking of the hands, the head, or both, often accompanied by a continuous rubbing together of thumb and forefinger. Such tremors are most severe when the affected part of the body is not consciously in use. Once you begin to consciously move the involved body part the tremor disappears or diminishes. If the disorder worsens, there is a gradual loss of most automatic physical movements such as the natural swinging of the arms that makes walking smooth, or the ability to write legibly or move your mouth and tongue so as to speak clearly. It becomes increasingly difficult to initiate new movements, or to change from one position to another. There is no pain, numbness, or tingling, simply a decreasing ability to move. Falls may be frequent because it is difficult to retain balance while walking. Simple activities such as rising from a chair can become hard to manage. Further symptoms include excessive salivation, abdominal cramps, and sometimes in the later stages of the disease, deterioration of memory and thought processes.

What are The Risks?

Most people who have Parkinson’s disease are elderly or in late middle age. Men are slightly more susceptible than women, and there is some evidence that Parkinson’s disease runs in families. Because the disease does not affect nerves that supply the heart or other vital organs, it is not directly life­threatening. A slowly progressing disability, however, can lead to mental depression.

What Should be Done?

There is no immediate cause for concern if, after age 50, you develop a mild tremor. Many people do so as they grow older. Consult your physician, however, if you have other symptoms of Parkinson’s disease, or if the tremor worsens. Special diagnostic tests are not always necessary. Your doctor may be able to make a diagnosis based on a general physical examination.

What is the Treatment?

Self-help: Encouragement and support from family and friends can be very helpful. Practical changes in the house, for example, bath­rail supports, special banisters along regular routes, and chairs with high arms will help you get around more easily and be more comfortable. Try to exercise regularly, and keep your spirits up by remaining or becoming as engaged in activities as possible.

Professional help: Modern drug treatment can do much to relieve the symptoms of Parkinson’s disease, particularly stiffness and immobility. In mild cases drugs are not usually prescribed, because they may have some troublesome side-effects. But your physician will probably want to see you about every six months to observe the progress of your condition. If drug treatment becomes necessary, medications that re-establish the balance of dopamine and acetylcholine within the affected area of the brain are usually prescribed. Some of these drugs tend to make the mouth unpleasantly dry, but that may seem more like a benefit than a side- effect if excessive salivation is a symptom of the disease in your case. New drugs are constantly being developed, but none has yet proved to be completely effective against the tremor that occurs in the disease. If tremors become a serious problem, it is sometimes possible to operate on the portion of the brain that is responsible for the problem, especially in younger people.

What are the Long-Term Prospects?

As yet no treatment has been found that slows down the progression of Parkinson’s disease, but the relief from symptoms that the various treatments give has kept many people with this disease in reasonable health.