Neuroscience

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Neurological Disorders

Brain Tumor
More than 40,000 new brain tumors are found each year, and the incidence is on the rise. A malignant brain tumor seems particularly cruel because, unlike some other types of cancer, there are no known behavioral changes to reduce one's risk for it. Also, even benign tumors can pose serious dangers when in the brain.

In surgery, reaching the tumor without damaging healthy brain tissue is a critical concern. The "StealthStation" system used at Greenwich Hospital allows the neurosurgeon to make a smaller incision, which promotes faster healing, and perform operations more quickly and in a less invasive manner than would otherwise be possible.

Stealth provides crucial information for pre-operative planning. It also assists during the operation by tracking the movement and location of surgical instruments in relation to delicate structures within the brain.

The system begins with CT (computerized tomography) or MRI (magnetic resonance imaging) data. That information is digitally transformed into a three-dimensional model of the patient's head, which is displayed on a high-resolution computer monitor.

Stereotactic radiosurgery, which is performed in the Bendheim Cancer Center at Greenwich Hospital, requires close collaboration among the neurosurgeon, radiation oncologist and radiation physicist. It is particularly helpful with small tumors.

In this non-invasive technique, there is no incision. Instead, radiation is delivered with precise accuracy to a tiny target area--the tumor--without damaging the healthy tissues through which it must travel. This is done by beaming the radiation along different pathways so that the dose received by healthy tissues is insignificant while that delivered to the tumor is much higher. Though the treatment can be done quickly, hours of planning are required to map the radiation delivery routes.

For more information about cancer services at Greenwich Hospital, click here.

Multiple Sclerosis
Multiple sclerosis is a chronic disease of the central nervous system that is most often diagnosed when people are 20 to 40 years old. Living with MS can be difficult because the disease is progressive and unpredictable.

With this disorder, the insulating material covering nerve fibers disintegrates for reasons not yet clearly understood. This causes numbness or weakness, problems related to vision or eye movement and unsteadiness or poor coordination. These symptoms can be mild or severe.

Magnetic resonance imaging at Greenwich Hospital is helpful in diagnosing MS. However, because there is no test that can determine with 100 certainty that a person has MS, neurologists must instead rely on the course of symptoms a patient experiences. Other tests may be done to rule out conditions that can cause similar symptoms.

MS usually begins with an acute period in which symptoms first appear. Then they recede, perhaps not to be seen again for years. The disease typically recurs in time, however, and often becomes more severe. Treatment can include medication and, if necessary, physical or occupational therapy.

Parkinson's Disease
First described by Englishman James Parkinson in 1817, this is a progressive degeneration of nerve cells in the part of the brain that controls muscle movements. The cause is not known.

Parkinson's disease often begins with subtle symptoms...a mild trembling of the hand, for instance, that could easily be attributed to fatigue or frazzled nerves. In time, symptoms become more pronounced.

People with Parkinson's disease have inadequate amounts of a chemical called dopamine because it is produced by the nerve cells destroyed by the disease. A natural chemical called Levodopa can help nerve cells manufacture dopamine. It delays symptoms, but it is not a cure. Current research will further our understanding of Parkinson's disease and how to treat it.

Back Pain
Pain in the back, neck or legs may result from problems related to the spine and the peripheral nerves that branch out from it. These problems may develop as a result of injuries, the wear and tear of daily life...even surgeries performed years ago.

Pain in the legs often comes from pressure on nerves. Back pain may be caused by instability of the spine or abnormalities in the way it moves. Spinal tumors, another possible source of pain, are relatively rare, occurring only about one-fourth as often as brain tumors.

When surgery involving the spine or brain is performed at Greenwich Hospital, a procedure called intra-operative monitoring is conducted to minimize the risk of nerve damage.

Electrodes are attached to the patient. Then amplifiers and a computer are used to monitor electrical signals sent through the spinal cord and nerves to ensure that nerves at risk continue to transmit normally. This can be done even when the patient is anesthetized.

Alzheimer's Disease
Alzheimer's disease is not a normal result of aging. Only about five percent of older people are afflicted with this or a related dementia. It isn't curable, and we don't yet know what causes it, but there are ways to ease the burden it places upon patients and their families.

The condition rarely makes an appearance before age 65, and its development is generally slow. Early signs include a gradual loss of memory for recent events and reluctance or inability to learn new information. As the disease progresses, the patient may become increasingly confused, quarrelsome and difficult to manage.

Treatment for the Alzheimer's patient almost always includes care for the caregiver, whose task is often both physically and emotionally draining.

No single test exists for diagnosis and no treatment is available to reverse the course of Alzheimer's disease, but some drugs do modify some of the behaviors associated with it.

Epilepsy
This is the second most prevalent neurological disorder in the United States. (The first is stroke.) Epilepsy is not an isolated disease with a single cause, but rather a set of symptoms triggered by a disturbed pattern of nerve cell activity in the brain. Normal nerve cells generate electrical impulses up to 80 times a second. In the person with epilepsy, the corresponding number may be five or six times higher.

Abnormal electrical activity in the brain may produce seizures. These may range from very subtle experiences in which the chief symptoms are a slight fluttering of the hand or twitching of the eyelids to a complete loss of consciousness followed by convulsions.