The Telegraph
Since 1st March, 1999
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This week: neurosurgery

severe headache

Recently, my mother had a sudden onset of a severe headache. A CT scan showed bleeding in the brain. A doctor says it is probably due to a rupture of an aneurysm and it needs immediate surgery. Will you please explain what aneurysm is' Is surgery the only way to treat this problem'

An aneurysm is an abnormal widening or dilation of a blood vessel caused by a swelling on its wall. The widened vessel is prone to rupture and severe bleeding any moment. This can lead to death or disability. A doctor can prevent the rupture by two techniques. The first one involves putting a clip across the neck of the aneurysm through an operation, guided by a microscope. The second technique, which does not involve an operation, uses a thin tube (microcatheter) to deliver coils to the site of the enlarged blood vessel which closes the aneurysm from inside. Itís up to the neurosurgeon to decide which technique to adopt. In any case, the treatment has to be done as soon as possible. Or else, her problems will worsen.

tingling in fingers

My wife has been suffering from a tingling sensation in her fingers, accompanied with a nagging pain in the wrists. She has even been complaining of a strange numbness in the fingers. When we met a neurologist he asked her to get several nerve tests. Whatís wrong with her'

Most probably she has got what is known as carpal tunnel syndrome. It is cused by the compression of a nerve in the wrist. Since this particular nerve supplies sensation to the fingers and strength to the muscles underneath them, the patient often experiences a tingling sensation, numbness and pain when the nerve gets compressed. The pain and numbness can be so severe that the patient may actually wake up from sleep in the middle of the night. She may also face severe problems while performing domestic chores like cooking, which require bending of the wrists. Sometimes this condition may be caused by diabetes, underactive thyroid gland, rheumatoid arthritis and so on. Certain medications like those used for birth control can also cause the problem. If the thyroid problem gets fixed, or the birth control pill is stopped, the symptoms often disappear. The treatment for this ailment includes rest, or using a wrist-splint during sleep. In some cases, a relatively minor operation under local anaesthesia relieves the pressure on the nerve.

epilepsy surgery

My 20-year-old son has been suffering from convulsions off and on. Weíve consulted several neurologists. The prescribed medication only offered her a temporary relief. I have heard that there is a type of surgery which cures epilepsy. Is it true'

Surgery for epilepsy is possible these days. Usually when medical treatment fails, we evaluate a patient to see whether he or she is a candidate for surgery. A number of investigations are necessary for this evaluation. The tests will also help a surgeon pinpoint the focus of epilepsy in the brain and decide the mode of operation.

bulging head

My son is eight months old. His head has been gradually bulging and now it has become quite large for his age. Our child specialist says itís hydrocephalous and has referred him to a neurosurgeon. He didnít explain much about the problem. Weíre scared. Can you please enlighten me'

Hydrocephalous results from an excessive accumulation of fluid (cerebro-spinal fluid) in the brain. It can be diagnosed through clinical examination, ultrasonography and CT scan of the brain. In some cases MRI scan may be necessary. The common treatment for this ailment involves diverting the fluid to somewhere else in the body, using a tubular device called a shunt. Shunt operations are relatively safe and can be preformed under an endocope. However, they only manage the problem; they do not cure it. The success of the procedure depends on the extent of the symptoms and timeliness of the diagnosis.

We invite readersí queries on health problems. Eminent doctors will respond to them in this column every week. Mail your letters to:
KnowHOW, The Telegraph, 6, Prafulla Sarkar Street, Calcutta 700 001
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