Brain Lesions Cancer

Everyone with eyes and a brain of their own knows that dementia is a very common and serious problem, robbing some people of their memories, quality to function independently and even their personalities. As a community-based neurologist, I see all too many cases of dementia, but the part that worries me the most is when patients, house members and even healing personnel assume that nothing can be done and don't even bother to rate for fundamental causes.

Brain Lesions Cancer

Although it is indubitably true that modern medicine lacks sufficient treatments for many causes of dementia, it's also true that still others can be cured or favorably modified. It would be a shame to assume that a case was untreatable and thereby miss something that could have been cured or good managed.

So how do dementia specialists or other doctors investigate cases of dementia? The healing detective-work begins with a standard history and corporeal examination.

Clues might come from the history of the patient's other healing problems, the medication list, use of alcohol or other drugs, or from other corporeal problems that industrialized concurrently with the dementia. Apart from the normal corporeal exam, the doctor also explores the patient's quality to pay attention, remember, calculate, draw pictures, reason, comprehend words and express himself or herself. Supplementary neurological examination assesses other aspects of brain function like vision, hearing, strength, coordination, sensation, walking and reflexes.

After compiling the results of the history and examination, the doctor can ordinarily judge the relative likelihoods of different fundamental causes for the dementia, but follows up these clinical judgments with Supplementary healing tests to nail down the most likely cause. The irreducible minimum of Supplementary testing includes a brain scan--either a Ct or an Mri--plus a panel of blood tests.

The brain scan might detect a brain tumor, previously unsuspected strokes, clotted blood compressing the brain or hydrocephalus (water on the brain) all of which can cause dementia and which can also be treated. The blood tests look for salt-and-water imbalances, abnormal blood-sugar levels, kidney impairment, liver impairment, immoderate calcium levels, thyroid disease, and deficiencies of vitamin B12 and folic acid. Each of these problems, if found, would certify specific treatment.

Other tests can be applied depending on the physician's judgment of their usefulness in individual cases. These might consist of an electroencephalogram (brain-wave test), lumbar puncture (spinal tap) or a Pet (positron emission tomographic) scan, which is a newer technique that shows the relative operation of brain cells in different parts of the brain. Supplementary blood-tests can screen for infections with human immunodeficiency virus (Hiv) or the bacteria related with Lyme disease or syphilis.

After all is said and done, what turns up? Unfortunately, about half the dementia cases evaluated in this way lead to a prognosis of Alzheimer's disease or similar degenerative brain disease for which there is no cure. Although treatments exist for these degenerative dementias, their benefits are modest.

It's the other half of the cases which narrate an spellbinding grab-bag of different fundamental causes and, for that matter, treatments.

Neurosurgery can be indicated for dementias caused by brain tumors, especially meningiomas which are slow-growing tumors that rejoinder poorly to chemotherapy or radiation therapy, but can be totally removed in surgical operations. Meningiomas are not cancerous, but because space inside the skull is limited, they cause problem by crowding the brain. Subdural hematomas and epidural hematomas are two other space-occupying abnormalities that crowd the brain. These are masses of clotted blood ordinarily caused by traumatic blows to the head. The injuries producing the bleeding are not all the time remembered or, if remembered, might have been dismissed as trivial at the time they occurred. These, too, can be totally removed by a neurosurgeon.

Normal pressure hydrocephalus is another cause of dementia responding to neurosurgery, but in this condition the surgeon doesn't take off a mass-lesion. Instead, the surgeon places a tube inside one of the brain's swollen fluid-chambers known as ventricles, allowing the immoderate fluid-accumulation to drain away through the tube and into another body-space where it causes no harm. normal pressure hydrocephalus can be identified not only by its dementia and enlarged ventricles, but by the concurrent nearnessy of a prominent walking impairment as well as urinary incontinence.

Non-surgical treatments can be helpful for other causes of dementia. Two conditions spellbinding a insufficiency or shortage of a biochemical are hypothyroidism and vitamin B12 deficiency. Seeing one of these is a blessing in disguise because they are indubitably fixed. In hypothyroidism, the thyroid gland in the neck secretes too little thyroid hormone. This is managed by manufacture up for the shortfall in pill form. In vitamin B12 deficiency, the problem is that this essential vitamin is not properly absorbed into the bloodstream via the gastrointestinal tract, so the insufficiency is treated by periodic injections of vitamin B12.

As people get older and gain more healing problems, their list of medications often grows longer. One or more of the medications they take might interfere with reasoning functioning. common offenders are medications for urinary incontinence, anxiety or insomnia. If a problem-medication is eliminated or substituted with another drug, the patient's reasoning prowess can improve.

Depression is a common cause of dementia in which the mood disorder itself interferes with concentration, memory and other reasoning performance. In many cases the reasoning impairments are more prominent than the mood disturbance, causing it to be overlooked. Depression is treated with medication, psychotherapy, or both.

Chronic infections with the Lyme and syphilis bacteria can be resolved with standard antibiotics. Occasionally a fungal infection is to blame, and can also be treated with specific medication. Treatments for Hiv are less good, but this disease still needs to be identified in order to gain the best inherent outcome.

Chronic alcohol abuse can damage the brain and cause dementia. In most cases the previously caused damage cannot be undone, but Supplementary damage can be prevented through medicine of the alcoholism. Wernicke's encephalopathy is an alcohol-associated cause of blurring for which injections of thiamine (vitamin B1) are urgently needed.

Strokes can also furnish dementia. Strokes are caused by disrupted circulation which damages parts of the brain. In most cases, the inpatient and house were aware of strokes when they occurred, but in other cases one or more strokes might have gone undetected at the time they occurred. Prior strokes cannot be undone, but recognition of the nearnessy of strokes can lead to preventive measures to decrease the likelihood of future strokes.

Apart from the conditions and diseases already mentioned, the list of inherent causes of dementia is longer still. In brief, not every cause of dementia can be cured or significantly improved, but without a thoughtful, thorough, healing evaluation the ones that can be treated could indubitably go undetected.

(C) 2005 by Gary Cordingley