News | Dr. Guive Sharifi

News

/News

Brain surgery for seizures

Your doctor may recommend brain surgery to treat epilepsy if you have seizures that medications can’t control. You must have tried two or more medications without success to qualify. Brain surgery for epilepsy has a high success rate. It may significantly improve your quality of life.

Numerous types of surgery are available to treat it including:

  • resective surgery
  • multiple subpial transection
  • hemispherectomy
  • corpus callosotomy

Your doctor can help you understand the potential benefits and risks of surgical options.

Resective Surgery

Resective surgery is the most common type of surgery for treating epilepsy. If you have epilepsy, your doctor can use MRI to learn where seizures occur in your brain. Using resective surgery, they can surgically remove the part of your brain where seizures happen. They’ll likely remove an area roughly the size of a golf ball. They may also remove a brain lesion, a brain lobe, or a portion of a brain lobe.

The most common type of resective surgery is a temporal lobectomy. It’s the most successful form of surgery for epilepsy. It may reduce the number of seizures you have while limiting your risk of permanent brain damage.

Multiple subpial transection

A multiple subpial transection is a rare procedure. Surgeons only perform this surgery on people who have severe and frequent seizures. It involves cutting parts of your brain to prevent the spread of seizures. It may be more effective than resective surgery if your seizures don’t always start in the same part of your brain.

Hemispherectomy

In this procedure, a surgeon removes the outer layer of one entire side of your brain. It’s used when an entire side of your brain is damaged from seizures. The most common candidates for this type of surgery are younger children, babies born with brain damage, and older children with severe seizures.

The earlier in life you have this surgery, the better your long-term outcome will be.

Corpus callosotomy

Corpus callosotomy is different from other types of brain surgery for epilepsy because it can’t stop your seizures. Instead, its purpose is to decrease the severity of your seizures. By cutting the nerve fibers between the two sides of your brain, your surgeon can help stop seizures from spreading from one hemisphere to the other. By stopping the spread of seizures throughout your brain, they can help make your seizures less severe.

Corpus callosotomy is most often used in children who’ve bad seizures that start in one half of their brain and spread to the other.

Risks of brain surgery

Brain surgery offers potential benefits that may improve your quality of life, but it also involves serious risks. The risks may include:

  • infection
  • stroke
  • paralysis
  • speech problems
  • loss of vision
  • loss of motor skills
  • more seizures

What to expect after surgery

  • a hospital stay lasting three to four days after surgery
  • severe pain for a few days after surgery
  • moderate pain and swelling for several weeks
  • time off school or work for up to three months

You may need to continue taking antiseizure medications for at least a couple of years after your surgery.

Despite the lengthy recovery time, brain surgery can be worth it for people with epilepsy. Talk to your doctor if you think you might be a good candidate. They can help you understand the potential benefits and risks of surgery, as well as your long-term outlook.

Reference:

http://www.healthline.com/health/types-epilepsy-brain-surgery#outlook7

By |Sunday, June 18, 2017|News|0 Comments

Post scoliosis surgery care

These are general guidelines for recovery from scoliosis surgery.

At the Hospital: Immediately Following Scoliosis Surgery

Pain Management — Just after scoliosis surgery, most patients are given PCA (patient-controlled analgesia). PCA is a pump that delivers morphine or other narcotic at the press of a button by the patient. This controls pain very well for the first two to three days after surgery. Thereafter, PCA is stopped and oral pain medication is administered. At hospital discharge, a prescription for pain medication is provided. Adults may require medication at diminishing doses for weeks or months. Children are usually off medication within two weeks.

Drains — A drain prevents fluid accumulation at the incision site and is routine. Most patients have a drain in their back or side for two to three days after surgery. Drains in the side of the chest are termed ‘chest tubes’ and prevent air and fluid from accumulating around the lungs. Drains are removed when fluid drainage is small. Drain removal is not painful.

A urinary catheter (Foley) helps to keep the patient comfortable. It may be removed two or three days after surgery.

Walking — Physical therapists and nurses help the patient out of bed on the first or second day after surgery. Walking is guided by the physical therapist and is increased daily as tolerated.

Some patients may need a walker or cane early during recovery to help with balance and prevent a fall. keep their balance. Most children do not need walking aids at home.

Eating — Most patients will not begin to eat for two to three days after surgery. This is because the bowels slow down after surgery and patients have difficulty keeping food down.

Patients start on a diet slowly, first with sips of clear liquids, and move on to solid foods and a regular diet. Once home, it is important to eat well; small frequent meals are best to maintain body weight.
Hospital Discharge
Before release from the hospital, patients must:

  • Be eating a regular diet
  • Urinating normally
  • Walking, including up and down stairs
  • Have no fevers
  • Have minimal drainage at the incision site(s)

Some patients, especially adults, may benefit from a one- to three-week stay at an in-patient rehabilitation facility to improve walking and overall function.

At Home: Scoliosis Surgery Recovery
Helpful aids include an adjustable bed, shower chair, elevated toilet seat, and extended grasper are for  use at home after surgery.

Incision care — Patients may begin to shower one-week after surgery. Before showering, tape plastic wrap to cover the incision. Remove the tape and plastic wrap after each shower. This should be done for showers taken during the first week at home. Thereafter, shower without the plastic wrap covering the incision. For safety, it is important to be accompanied in the shower for the first two to three weeks.

If there is a dressing on the incision, change it once a day until there is no staining of the sterile gauze. Thereafter, a dressing is not needed.

Steri-Strips are usually placed across the incision(s) and will fall off on their own. Do not remove the Steri-Strips unless instructed to do so or if they are dangling.

Respiratory Function — Lung (pulmonary) function may slightly decline after scoliosis surgery. To improve breathing function steadily with time, it is helpful to perform respiratory exercises every one to two hours for the first three weeks after surgery. Respiratory exercises include deep breathing using the incentive spirometer provided at the hospital and frequent coughing. Lung function is routinely checked during regular office visits.

Activity Level — Patients are encouraged to walk. However, bending, lifting, and twisting are usually prohibited for several months or until the surgeon approves. Sports are not allowed for at least three months after surgery.

When activities are resumed, it is recommended to return gradually. Conditioning exercises such as swimming, bicycling, treadmill, or jogging are a good way to start.

After full healing, most patients will not have activity restrictions. However, certain sports activities such as gymnastics may not be practical. Activities that may be prohibited will be discussed by your surgeon and are dependent on the extent of your spinal fusion. Most patients do not feel restricted.

Medication — Usually, nonsteroidal medications, such as aspirin, Motrin, and ibuprofen are prohibited. Tylenol can be taken. Birth control pills are stopped prior to surgery as these may increase the risk of blood clot formation during the postoperative period in women.

Smoking — Smoking impairs bone from healing and hinders fusion. Patients must be committed to stop smoking two months before surgery and for a minimum of six months after surgery. Of course, it would be better just to give up the habit for a lifetime.

Transportation — Avoid frequent car rides and mass transit for six weeks after surgery. Patients can go home from the hospital by car with a pillow behind their back and seatbelt in use.

Reference:

https://www.spineuniverse.com/conditions/scoliosis/recovery-scoliosis-surgery

By |Tuesday, June 13, 2017|News|0 Comments

Seizure due to brain tumor surgery

Like any other invasive procedure, brain surgery is closely associated with many side effects. However, the likelihood of side effects increases significantly when it comes to the surgery of the brain as it is the master of all body controls. The intensity and duration of the side effects varies in accordance with the reason for the operation and the area of brain on which the operation was carried out. In some uncommon cases, people have to re-learn some or all basic skills such as reading and writing.

The malignant and benign tumors of the brain can cause substantial tissue damage. Thorough removal of all affected tissue is important to prevent the tumor from spreading further or from reccurring. Although this does save the patient’s life, removing tissue leads to complications.

Infections– Infection constitutes an unwanted effect related to brain surgery. If bacteria gain access to the brain during the procedure, chances of brain infection are high. For example, infection due to Staphylococcus Aureus can lead to meningeal inflammation. As a small hole is made in the skull, the patient stands a fair chance of acquiring a skull infection. A proper antibiotic regime is started immediately to prevent such after effects.

Bleeding– There is a possibility of post-operative intracranial bleeding in cases in which surgical eradication of a malignant or benign tumor has been carried out. This bleeding is known as a hemorrhage and it causes an increase in pressure. This spike in pressure either within or on the brain as well as the surrounding structures has the potential to reach alarmingly high levels, leading to either unconsciousness or death.

Some symptoms that suggest intracerebral bleeding include: nausea, sudden headache, vomiting and loss of sensation leading to numbness. Weakness is another important symptom. One must call for a doctor’s help immediately on noticing these symptoms.

Seizure– Seizures are caused by unusual electrical activity within the brain. Post neurosurgery, seizures are quite common and may occur either immediately, after a few months or even many years after the day of operation. If the seizure does occur soon after the completion of surgery, it is regarded as a “provoked” seizure. Some seizures are classified as ‘unprovoked’ if they continue to occur for a long time after the surgery. Patients belonging to the latter category are diagnosed as epileptic.

Seizures occur because after the removal of damaged or infected tissue, the brain makes new but different connections with the nerves. Such abnormal connections lead to unprovoked seizures which range in frequency. The good news is that many such seizures are treatable via effective anti-convulsant drugs.

Stroke– A stroke is defined as an emergency medical situation in which the blood flow in the brain experiences a sudden interruption. Blocked vessels may be a cause of stroke, especially after brain tumor removal surgery.

By |Thursday, June 8, 2017|Blog, News|0 Comments

Transsphenoidal Surgery Post Operative Instructions

How to care after Transsphenoidal Surgery?

Headaches & Pain

Pain following pituitary surgery is usually readily controlled by this medication.

Do not be afraid to take a pain pill if you are uncomfortable, especially when going to bed at night or awakening in the morning. Sleeping with your head elevated (on at least 2 pillows) helps decrease pain and swelling. Do not operate machinery or drive when taking narcotics.

If your headaches worsen or are unrelieved by pain medication or your neck feels stiff and painful call your Dr.

Fatigue

It normal to feel fatigued after surgery for 3 to 4 weeks. Pace yourself. Slowly increase your activity and remember to rest when you are tired.

Sinus Congestion

Don’t be discouraged if you can’t breathe through your nose at first. It typically takes 2 to 3 weeks before the inflammation and swelling inside the nose have subsided enough to provide a good nasal airway. If you think you have a sinus infection, call your Dr.

Nasal Drainage

You can expect some bloody mucus drainage from your nose. This drainage will be greatest the first 3 days after surgery. It is best not to blow your nose immediately after surgery, as this may cause bleeding. After 3 days, you may blow your nose gently. Clear fluid, like water dripping from a faucet, or a lot of bright red blood like a nosebleed is not normal.

What happens if my nose bleeds?

Spotting of red blood, or bloody mucous, is normal. Brisk bleeding, dripping from the nose that doesn’t stop after a few minutes of sitting up and squeezing your nostrils together is not. This happens rarely, and when it does, it is almost always a small vessel in the nose (not the tumor or brain). Control it with pressure and go to your local emergency room. They may have to pack your nose to stop it.

Cleaning Your Nose

The best way to clear your nose of mucus and dried blood is with saline (salt water) irrigations. Once the bottle has been filled, you lean over a sink and squeeze the bottle to irrigate each nostril with the saline solution. Use one bottle-full of salt water for each nostril. If done correctly, mucus will be flushed out of the front of the nose. Some mucus may even be rinsed to the back of the nose and flow out of the other nostril or the mouth. This procedure should be started the first day after surgery and repeated at least twice a day for one week. At first these irrigations may feel unusual, but soon you will find them to be comfortable and soothing.

Sneezing & Coughing

If you need to sneeze or cough during the two weeks after surgery, stay relaxed and let it happen! Don’t hold you breathe or pinch your nose! Avoid things that make you sneeze.

Fever

If your fever is higher than 101 degrees F, double your steroid dose until the fever subsides. If during the first 2 weeks after surgery your fever goes above 101 degrees F, call your Dr.

Showering

You may shower anytime. Cover the abdominal incision with plastic when you shower during the first week after surgery. You can get the incision wet after 7 days

Bending & Lifting

Heavy lifting, straining, and exercise that might cause bleeding should be avoided during the first two weeks. Don’t be surprised if you tire more easily than usual. Wait for about four weeks before resuming a strenuous exercise program

By |Saturday, May 27, 2017|News|0 Comments

Brain Tumors: Symptoms and Signs

General symptoms include:

  • Headaches, which may be severe and worsen with activity or in the early morning
  • Seizures. Motor seizures, also called convulsions, are sudden involuntary movements of a person’s muscles. People may experience different types of seizures, including myclonic and tonic-clonic (grand mal). Certain drugs can help prevent or control them. The differences between these types of seizures are listed below:
  • Personality or memory changes
  • Nausea or vomiting
  • Fatigue
  • Drowsiness
  • Sleep problems
  • Memory problems
  • Changes in ability to walk or perform daily activities

Symptoms that may be specific to the location of the tumor include:

  • Pressure or headache near the tumor
  • Loss of balance and difficulty with fine motor skills is linked with a tumor in the cerebellum.
  • Changes in judgment, including loss of initiative, sluggishness, and muscle weakness or paralysis is associated with a tumor in the frontal lobe of the cerebrum.
  • Partial or complete loss of vision is caused by a tumor in the occipital lobe or temporal lobe of the cerebrum.
  • Changes in speech, hearing, memory, or emotional state, such as aggressiveness and problems understanding or retrieving words can develop from a tumor in the frontal and temporal lobe of the cerebrum.
  • Altered perception of touch or pressure, arm or leg weakness on 1 side of the body, or confusion with left and right sides of the body are linked to a tumor in the frontal or parietal lobe of the cerebrum.
  • Inability to look upward can be caused by a pineal gland tumor.
  • Lactation, which is the secretion of breast milk and altered menstrual periods in women, and growth in hands and feet in adults are associated with a pituitary tumor.
  • Difficulty swallowing, facial weakness or numbness, or double vision is a symptom of a tumor in the brain stem.
  • Vision changes, including loss of part of the vision or double vision can be from a tumor in the temporal lobe, occipital lobe, or brain stem.
By |Tuesday, May 23, 2017|News|0 Comments