As the name implies, brain and nerve surgery deals with the surgical diseases of the central nervous system. So, all surgical procedures necessary for the congenital anomalies of the central nervous system (brain and spinal cord) are performed by brain surgeons. All birth abnormalities, hydrocephalus, brain and spinal cord tumors that can be seen in everyone from newborn to adults are operated by us brain surgeons.
Childhood diseases that concern brain and nerve surgery are mainly studied in two big groups:
- Congenital abnormalities
- Craniosynostosis : Misshapen head
- Childhood brain and spinal cord tumor: This topic is presented as a separate page on our website because we perform these operations frequently.
Spina bifida is the most frequent birth defect of the central nervous system. It can be seen in various forms. We can see a simple closure defect in the spine (no intervention is done in this situation and the patients can live a normal life), or we can encounter more complicated problems where the spinal cord is in a sac in the back or neck (meningocele) or a part of the brain is in a sac outside the skull (encephalocele). In order to avoid these fatal situations, routine examinations during pregnancy have vital importance (these situations can be detected in the first three months of the pregnancy and the pregnancy can be terminated). Children born with these problems may necessitate a series of very difficult and long-term operations. Surgeries to remove and close the sac and to insert a shunt for the hydrocephalus to develop later are performed. However, it is frequent that the leg movement or bladder or bowel control of the child does not improve despite all interventions. These operations are performed to keep the child alive and the disabilities that the child is born with usually continue. In addition, there may be situations where the spinal cord ends below where it is supposed to end (tethered cord). Bedwetting and being unable to gain bladder or bowel control can be seen in this disease. When intervened early, these functions can be improved. Children with abnormal tuft of hair or red spots in the back region should be examined. All these defects can be revealed and diagnosed with MRI in detail.
Abnormal tuft of hair in the lumbar region
All of us have a fluid with water clarity and viscosity that surrounds and circulates around our brain and spinal cord, called the cerebrospinal fluid. This fluid is produced approximately 450 milliliters per day and is absorbed at the same amount. When there is a problem in the circulation of the fluid, it accumulates in the head and causes “hydrocephalus”. This can be due to certain diseases in the mother’s womb during pregnancy or it can be due to infectious diseases after birth or in early childhood. Excessive growth in head circumference measurements, vomiting, uneasiness, visual problems, tense fontanel, setting-sun eye (as seen in the photo below) and growth retardation can be encountered. For treatment a “shunt” in inserted. Shunt is device that drains the excessive fluid in the brain to the abdominal cavity. It is put in through a 2-cm incision to the head and the abdomen. The device is not visible from outside. It runs automatically by itself, it doesn’t have a battery. The fluid that drains into the abdomen is produced by the body itself, so it does not cause any discomfort. The device usually stays in for a lifetime. The patient can carry on his/her normal life with the device and it does not cause anything that negatively affects their lives. However, sometimes there can be problems like shunt blockage or shunt infections. In this case, the device is replaced.
SETTING-SUN EYES A CHILD WITH ADVANCED HYDROCEPHALUS