Neurological Conditions

Click on the condition for more information.

Acoustic Neuroma (Bilateral / Unilateral)

Acoustic Neuroma (also known as Vestibular Schwannoma), is a benign slow-growing tumor that develops from the vestibular nerve that travels from the inner ear to the brain. An acoustic neuroma can cause hearing loss, ringing in the ear (tinnitus), and loss of balance..

 

More symptoms can arise as the tumor enlarges and places pressure on the adjacent nerves. However, symptom severity is not always a direct reflection of tumor size: it is possible for even a small tumor to cause severe symptoms.

 

You may experience signs and symptoms such as:

 

● Hearing loss on the affected side

Acromegaly

Acromegaly is a hormonal disorder involving excessive production of growth hormone by the pituitary gland. Acromegaly typically occurs during adulthood, most often in middle age. Enlargement of the face, hands and feet are typical symptoms.

 

The physical changes that occur in acromegaly often develop gradually, making the condition difficult to recognize. However, if not treated in a timely manner, acromegaly may lead to serious illness and become life-threatening.

 

You may experience signs and symptoms such as:

 

● Enlargement of the hands

● Enlargementof the feet

● Enlargementof the head

● Protrusion of the lower jaw

● Protrusion of the brow

● Enlarged nose

● Thickening of the lips

● Widening of the space between teeth

● Sleep apnea

 

Aneurysms

A brain aneurysm is a focal area of weakness in the wall of a blood vessel within the brain. An aneurysm often looks like a blister arising from the side of a blood vessel. Aneurysms can rupture, causing hemorrhage (bleeding) into the brain, which can lead to a stroke. A ruptured aneurysm is often life threatening and requires immediate medical attention.

 

If an unruptured aneurysm is identified, medical treatment may be necessary to prevent future rupture.

If an aneurysm ruptures you may experience signs and symptoms such as:

 

● Sudden and severe headache (often described as the worst headache of one’s life)

● Nausea

● Vomiting

● Stiff neck

● Blurred or double vision

● Light sensitivity

● Seizure

● A drooping eyelid

● Loss of consciousness

● Confusion

 

An unruptured brain aneurysm may have no symptoms depending on the size. However, a large unruptured aneurysm may press on brain tissues and nerves.

 

If you have an unruptured brain aneurysm you may experience signs and symptoms such as:

 

● Pain above or behind an eye

● Double Vision

● Facial paralysis on one side

● A drooping eyelid

Arachnoid Cysts

Arachnoid cysts are cerebrospinal fluid-filled cysts in the nervous system. They can be located in the head or spine, and occasionally exert pressure on the brain or spinal cord.

Those with arachnoid cysts of the brain may experience a variety of symptoms such as:

 

● Headache

● Seizures

 

 

Those with arachnoid cysts in the spine may experience signs and symptoms such as:

 

● Compression of the spinal nerve roots

● Progressive back or neck pain

● Tingling or numbness in the hands, legs or feet

● Gait imbalance

 

Diagnosis usually involves an MRI that can helps distinguish these fluid-filled arachnoid cysts from other types of cysts.

 

Arteriovenous Malformations (AVM)

An AVM (arteriovenous malformation) is an abnormal connection between arteries and veins that predisposes the blood vessels to rupture. The cause of this condition is still unclear.

 

Many with this condition are unaware that they have an AVM until either they experience a seizure or symptoms from AVM rupture. AVM rupture causes hemorrhage in the brain or spine that may lead to a stroke. If this occurs it is important to seek medical treatment immediately.

 

Those with AVM may experience signs and symptoms such as:

 

● Seizures

● Headache

● An audible “whooshing” sound that can be detected with the use of a stethoscope

● Weakness or numbness

 

If hemorrhage in the brain occurs, signs and symptoms may include:

 

● Sudden, severe headache

● Weakness

● Numbness or paralysis

● Visual impairment

● Difficulty speaking

● Inability to understand others

● Severe unsteadiness

 

 

Carpal Tunnel Syndrome (CTS)

Carpal Tunnel Syndrome is a painful condition that arises from nerve impingement in the wrist.

 

Several factors can contribute to Carpal Tunnel Syndrome, the most common of which is overuse and strain of the wrist. Musicians, laborers and those whose jobs require the use of a keyboard for typing have a higher incidence of Carpal Tunnel Syndrome.

 

Carpal tunnel syndrome often begins with a dull ache in the wrist that extends into the hand or forearm. As the condition progresses the symptoms become more severe.

 

Those with Carpal Tunnel Syndrome may experience signs and symptoms such as:

 

● Tingling or numbness in all fingers except the pinky finger

● Aching of the hand

● Aching of the wrist

● Pain that radiates from the hand into the arm

● Weakness in the hands or fingers

Cavernous Malformation

A Cerebral Cavernous Malformation is an tangle of abnormal blood vessels in the brain. Because of their abnormally thin walls, the blood vessels in cavernous malformations are very weak and prone to leakage. Leakage causes hemorrhage (bleeding) in the area of the cavernous malformation.

 

Those with either Cavernous Malformations may experience signs and symptoms such as:

 

● Seizures

● Headaches

● Weakness in the arms or legs

● Visual impairment

● Long and short term memory issues

● Inability to focus

Chiari Malformation

Chiari Malformation is a condition in which brain tissue protrudes into the spinal canal. It can either occur when part of the skull is abnormally small or misshapen, or if the pressure in the brain is abnormally high.

 

Chiari Malformations can produce symptoms in childhood or adulthood.

 

Doctors categorize Chiari Malformation into four types, depending on the anatomy of the brain tissue that is displaced into the spinal canal, and whether developmental abnormalities of the brain or spine are present.

 

Many with this condition can present with no symptoms and only made aware of this condition after undergoing an MRI. However, others will present with a variety of symptoms.

 

Those with Chairi Malformation may experience signs and symptoms such as:

 

● Severe headaches, often brought on by coughing or sneezing

● Neck pain

● Problems with balance

● Difficulty with fine motor skills

● Numbness and tingling of the hands and feet

● Dizziness

● Difficulty swallowing

● Gagging or choking when swallowing

● Vision problems

● Slurred speech

 

Hydrocephalus

Hydrocephalus (also known as “water on the brain”) is a condition defined by the accumulation of cerebrospinal fluid (CSF) in the ventricles of the brain. The result is increased pressure on brain tissue and inside the skull. This occurs as a result of overproduction of CSF, or improper drainage of CSF.

 

This potentially life threatening condition is most common in infants but can also be seen in adults. This overaccumulation of CSF can damage brain tissue and lead to long term impairment. It is often most associated with the swelling or enlargement of the cranium.

 

Those suffering from Hydrocephalus may experience signs or symptoms including:
 
● An enlarged head
● A rapid swelling of the head
● Headache
● Fever
● A bulging in the fontanel
● Vomiting
● Urinary or bowel incontinence
● Fatigue or sleepiness
● Blurred or double vision
● Motor skill impairments
● Balance issues
● Poor coordination
● Irritability
● Poor feeding habits
● Loss of appetite
● Seizures
● Downward fixed eyes
● Muscle deficits
● Lack of response to physical touch
● Stunted growth

Trigeminal Neuralgia / Facial Pain

Trigeminal neuralgia is one of the most painful conditions any patient can suffer and is commonly referred to as “Suicide Disease”. The condition is characterized by extreme and excruciating facial pain that can last from a few seconds to a few minutes. This pain is usually intermittent and is elicited by minimal stimulation of the face. The Trigeminal nerve (also called the fifth cranial nerve or CN5), conducts sensation in the face .

 

The term “Suicide Disease” is derived from the overwhelming anxiety and depression experience by many patients with Trigeminal Neuralgia. Those plagued by this condition often live in fear of daily activities that may bring on bouts of pain, including eating, shaving, talking and sleep. Those with the condition often become reclusive. Malnutrition is also common in those with Trigeminal Neuralgia as eating often triggers painful episodes.

 

The condition has no defined cause but several theories exist. One of the most common theories is that this condition is caused by compression by blood vessels as the nerve travels from the brain to the face.

 

Those with Trigeminal Neuralgia can experience signs and symptoms including:

 

● Intermittent bursts of extreme lightning-like, stabbing facial pain
● Onset of pain while eating, shaving, talking or brushing teeth
● Dull aching between bouts of extreme pain
● Pain triggered by light touch or wind

 

Traditionally, pharmacological treatment is the initial therapy. However, as the pain evolves, patients often become resistant to prescription treatments and require either surgery or radiosurgery. Surgery may involve either percutaneous nerve ablation or open nerve decompression.

 

Dr. Kevin Yao has particular expertise in these surgical techniques as well as in the use of Gamma Knife Radiosurgery for Trigeminal Neuralgia. Gamma Knife radiosurgery requires no surgical incision and typically incurs minimal side effects. Dr. Yao served as Co-director of the Gamma Knife Center at Tufts-New England Medical Center and has successfully treated innumerable patients afflicted by this devastating disorder.