Assist brain functionEncyclopedia Entry for Brain :Brain abscess. Brain abscesses commonly occur when bacteria or fungi infect part of the brain. As a result, swelling and irritation (inflammation) develop. Infected brain cells, white blood cells, live and dead bacteria, or fungi collect in an area of the brain. Tissue forms around this area and creates a mass, or abscess. The germs that cause a brain abscess can reach the brain through the blood. Or, they enter the brain directly, such as during brain surgery. In rare cases, a brain abscess develops from an infection in the sinuses. The source of the infection is often not found. However, the most common source is a lung infection. Less often, a heart infection is the cause. The following raise your chance of developing a brain abscess: A weakened immune system (such as in people with HIV/AIDS ) Chronic disease, such as cancer Drugs that suppress the immune system (corticosteroids or chemotherapy ) Congenital heart disease.Symptoms may develop slowly, over a period of several weeks, or they may develop suddenly. They may include: Changes in mental status , such as confusion, slow response or thinking, unable to focus, or sleepiness Decreased ability to feel sensation Fever and chills Headache, seizures , or stiff neck Language problems Loss of muscle function, typically on one side Vision changes Vomiting Weakness.A brain and nervous system (neurological) exam will usually show signs of increased pressure inside the skull and problems with brain function. Tests to diagnose a brain abscess may include: Blood cultures Chest x-ray Complete blood count ( CBC ) Head CT scan Electroencephalogram ( EEG ) MRI of head Testing for the presence of antibodies to certain germs A needle biopsy is usually performed to identify the cause of the infection.A brain abscess is a medical emergency. Pressure inside the skull may become high enough to be life threatening. You will need to stay in the hospital until the condition is stable. Some people may need life support. Medicine, not surgery, is recommended if you have: A small abscess (less than 2 cm) An abscess deep in the brain An abscess and meningitis Several abscesses (rare) Shunts in the brain for hydrocephalus (in some cases, the shunt may need to be removed temporarily or replaced) An infection called toxoplasmosis in a person with HIV/AIDS You may be prescribed several different types of antibiotics to make sure treatment works. Antifungal medicines may also be prescribed if the infection is likely caused by a fungus. Surgery is needed if : Increased pressure in the brain continues or gets worse The brain abscess does not get smaller after medicine The brain abscess contains gas (produced by some types of bacteria) The brain abscess might break open (rupture) The brain abscess is large (more than 2 cm) Surgery consists of opening the skull, exposing the brain, and draining the abscess. Laboratory tests are often done to examine the fluid. This helps identify the cause of the infection, so that the right antibiotics or antifungal medicine can be prescribed. Needle aspiration guided by CT or MRI scan may be needed for a deep abscess. During this procedure, medicines may be injected directly into the mass. Certain diuretics (water pills) and steroids may also be used to reduce the swelling of the brain.If untreated, a brain abscess is almost always deadly. With treatment, the death rate is about 10% to 30%. The earlier treatment is received, the better. Some people may have long-term nervous system problems after surgery.Complications may include: Brain damage Meningitis that is severe and life threatening Return (recurrence) of infection Seizures.Go to a hospital emergency room or call the local emergency number (such as 911) if you have symptoms of a brain abscess.You can reduce the risk of developing a brain abscess by getting treated for infections or health problems that can cause them. Some people, including those with certain heart disorders, may receive antibiotics before dental or other procedures to help reduce the risk of infection.Abscess - brain; Cerebral abscess; CNS abscess.Brain surgery - discharge.Amebic brain abscess Amebic brain abscess Brain Brain.Tunkel AR. Brain abscess.Encyclopedia Entry for Brain :Brain aneurysm repair - discharge. If you had bleeding before, during, or after surgery you may have some short- or long-term problems. These may be mild or severe. For many people, these problems get better over time. If you had either type of surgery you may: Feel sad, angry, or very nervous. This is normal. Have had a seizure and will take medicine to prevent another one. Have headaches that may continue for a while. This is common. What to expect after craniotomy and placement of a clip: It will take 3 to 6 weeks to fully recover. If you had bleeding from your aneurysm this may take longer. You may feel tired for up to 12 or more weeks. If you had a stroke or brain injury from the bleeding, you may have permanent problems such as trouble with speech or thinking, muscle weakness, or numbness. Problems with your memory are common, but these may improve. You may feel dizzy or confused, or your speech may not be normal after the surgery. If you did not have any bleeding, these problems should get better. What to expect after endovascular repair: You may have pain in your groin area. You may have some bruising around and below the incision. You may be able to start daily activities, such as driving a car, within 1 or 2 weeks if you did not have any bleeding. Ask your health care provider which daily activities are safe for you to do.Make plans to have help at home while you recover. Follow a healthy lifestyle, such as: If you have high blood pressure, keep it under control. Be sure to take the medicines your provider prescribed for you. DO NOT smoke. Ask your provider if it is OK for you to drink alcohol. Ask your provider when it is OK to start sexual activity. Take your seizure medicine if any was prescribed for you. Your doctor may refer you to a speech, physical, or occupational therapist to help you recover from any brain damage. If the doctor put a catheter in through your groin (endovascular surgery), it is okay to walk short distances on a flat surface. Limit going up and down stairs to around 2 times a day for 2 to 3 days. DO NOT do yard work, drive, or play sports until your doctor says it is OK to do so. Your provider will tell you when your dressing should be changed. DO NOT take a bath or swim for 1 week. If you have a small amount of bleeding from the incision, lie down and put pressure where it bleeds for 30 minutes. Be sure you understand any instructions about taking medicines such as blood thinners (anticoagulants), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen.Call your doctor if you have: A severe headache or a headache that gets worse and you feel dizzy A stiff neck Nausea and vomiting Eye pain Problems with your eyesight (from blindness to peripheral vision problems to double vision) Speech problems Problems thinking or understanding Problems noticing things around you Changes in your behavior Feel weak or lose consciousness Loss of balance or coordination or loss of muscle use Weakness or numbness of an arm, leg, or your face. Also, call your doctor if you have: Bleeding at the incision site that does not go away after you apply pressure An arm or leg that changes color, becomes cool to touch, or becomes numb Redness, pain, or yellow or green discharge in or around the incision site A fever higher than 101 F (38.3 C) or chills.Make sure to follow-up with your surgeon's office within 2 weeks of being discharged from the hospital. Ask your doctor if you need long-term follow-up and tests, including CT scans or MRIs of your head. If you had a cerebral spinal fluid (CSF) shunt placed after aneurysm surgery, you will need regular follow-ups to make sure it functions well.Aneurysm repair - cerebral - discharge; Cerebral aneurysm repair - discharge; Coiling - discharge; Saccular aneurysm repair - discharge; Berry aneurysm repair - discharge; Fusiform aneurysm repair - discharge; Dissecting aneurysm repair - discharge; Endovascular aneurysm repair - discharge; Aneurysm clipping - discharge.Bowles E. Cerebral aneurysm and aneurysmal subarachnoid hemorrhage. Nurs Stand. 2014;28(34):52-59. PMID: 24749614 www.ncbi.nlm.nih.gov/pubmed/24749614. Connolly ES Jr, Rabinstein AA, Carhuapoma JR, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2012;43(6):1711-1737. PMID: 22556195 www.ncbi.nlm.nih.gov/pubmed/22556195. Szeder V, Tateshima S, Duckwiler GR. Intracranial aneurysms and subarachnoid hemorrhage.Encyclopedia Entry for Brain :Brain aneurysm repair. There are two common methods used to repair an aneurysm: Clipping is done during an open craniotomy. Endovascular repair (surgery), most often using a coil or coiling and stenting (mesh tubes), is a less invasive and more common way to treat aneurysms. During aneurysm clipping: You are given general anesthesia and a breathing tube. Your scalp, skull, and the coverings of the brain are opened. A metal clip is placed at the base (neck) of the aneurysm to prevent it from breaking open (bursting). During endovascular repair (surgery) of an aneurysm: You may have general anesthesia and a breathing tube. Or, you may be given medicine to relax you, but not enough to put you to sleep. A catheter is guided through a small cut in your groin to an artery and then to the blood vessel in your brain where the aneurysm is located. Contrast material is injected through the catheter. This allows the surgeon to view the arteries and the aneurysm on a monitor in the operating room. Thin metal wires are put into the aneurysm. They then coil into a mesh ball. For this reason, the procedure is also called coiling. Blood clots that form around this coil prevent the aneurysm from breaking open and bleeding. Sometimes stents (mesh tubes) are also put in to hold the coils in place and make sure the blood vessel stays open. During and right after the procedure, you may be given a blood thinner, such as heparin, clopidogrel, or aspirin. These medicines prevent dangerous blood clots from forming in the stent. .If an aneurysm in the brain breaks open (ruptures), it is an emergency that needs medical treatment in the hospital. Often a rupture is treated with surgery, especially endovascular surgery. A person may have an unruptured aneurysm without any symptoms. This kind of aneurysm may be found when an MRI or CT scan of the brain is done for another reason. Not all aneurysms need to be treated right away. Aneurysms that have never bled especially if they are very small (less than 3 mm at their largest point) do not need to be treated right away. These very small aneurysms are less likely to rupture. Your surgeon will help you decide whether it is safer to have surgery to block off the aneurysm before it can break open or to monitor the aneurysm with repeated imaging until surgery becomes necessary. Some small aneurysms will never need surgery. .Risks of anesthesia and surgery in general are: Reactions to medicines Breathing problems Bleeding, blood clots, or infections Risks of brain surgery are: Blood clot or bleeding in or around the brain Brain swelling Infection in the brain or parts around the brain, such as the skull or scalp Seizures Stroke Surgery on any one area of the brain may cause problems that may be mild or severe. They may last a short while or they may not go away. Signs of brain and nervous system (neurological) problems include: Behavior changes Confusion , memory problems Loss of balance or coordination Numbness Problems noticing things around you Speech problems Vision problems (from blindness to problems with side vision) Muscle weakness.This procedure is often done as an emergency. If it is not an emergency: Tell your health care provider what medicines or herbs you are taking and if you have been drinking a lot of alcohol. Ask your provider which medicines you should still take on the morning of the surgery. Try to stop smoking. Follow instructions on not eating and drinking before the surgery. Take the medicines your provider told you to take with a small sip of water. Arrive at the hospital on time.A hospital stay for endovascular repair of an aneurysm may be as short as 1 to 2 days if there was no bleeding before surgery. The hospital stay after craniotomy and aneurysm clipping is usually 4 to 6 days. If there is bleeding or other problems, the hospital stay can be 1 to 2 weeks, or longer. You will probably have imaging tests of the blood vessels ( angiogram ) in the brain before you are sent home. Follow instructions on caring for yourself at home. Ask your doctor if it will be safe for you to have imaging tests such as angiogram, CT angiogram, or MRI scans of the head in the future.After successful surgery for a bleeding aneurysm, it is uncommon for it to bleed again. The outlook also depends on whether brain damage occurred from bleeding before, during, or after surgery. Most of the time, surgery can prevent a brain aneurysm that has not caused symptoms from becoming larger and breaking open. You may have more than one aneurysm or the aneurysm that was coiled might grow back. After coiling repair, you will need to be seen by your provider every year.Aneurysm repair - cerebral; Cerebral aneurysm repair; Coiling; Saccular aneurysm repair; Berry aneurysm repair; Fusiform aneurysm repair; Dissecting aneurysm repair; Endovascular aneurysm repair - brain; Subarachnoid hemorrhage - aneurysm.Brain aneurysm repair - discharge Brain surgery - discharge Caring for muscle spasticity or spasms Communicating with someone with aphasia Communicating with someone with dysarthria Dementia and driving Dementia - behavior and sleep problems Dementia - daily care Dementia - keeping safe in the home Epilepsy in children - discharge Stroke - discharge Swallowing problems.American Stroke Association website. What you should know about cerebral aneurysms. www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/HemorrhagicBleeds/What-You-Should-Know-About-Cerebral-Aneurysms_UCM_310103_Article.jsp#.W6EejmhKhQI. Updated November 14, 2016. Accessed May 23, 2018. Le Roux PD, Winn HR. Surgical decision making for the treatment of intracranial aneurysms.Encyclopedia Entry for Brain :Brain herniation. Brain herniation occurs when something inside the skull produces pressure that moves brain tissues. This is most often the result of brain swelling from a head injury, stroke , or brain tumor. Brain herniation can be a side effect of tumors in the brain, including: Metastatic brain tumor Primary brain tumor Herniation of the brain can also be caused by other factors that lead to increased pressure inside the skull, including: Collection of pus and other material in the brain, usually from a bacterial or fungal infection ( abscess ) Bleeding in the brain (hemorrhage) Buildup of fluid inside the skull that leads to brain swelling ( hydrocephalus ) Strokes that cause brain swelling Swelling after radiation therapy Defect in brain structure, such as a condition called Chiari malformation Brain herniation can occur: Between areas inside the skull, such as those separated by a rigid membrane like the tentorium or falx Through a natural opening at the base of the skull called the foramen magnum Through openings created during brain surgery.Signs and symptoms may include: High blood pressure Irregular or slow pulse Headache Weakness Cardiac arrest (no pulse) Loss of consciousness, coma Loss of all brainstem reflexes (blinking, gagging, and pupils reacting to light) Respiratory arrest (no breathing) Wide (dilated) pupils and no movement in one or both eyes.A brain and nervous system (neurological) exam shows changes in alertness (consciousness). Depending on the severity of the herniation and the part of the brain that is being pressed on, there will be problems with one or more brain-related reflexes and nerve functions. Tests may include: X-ray of the skull and neck CT scan of the head MRI scan of the head Blood tests if an abscess is suspected.Brain herniation is a medical emergency. The goal of treatment is to save the person's life. To help reverse or prevent a brain herniation, the medical team will treat increased swelling and pressure in the brain. Treatment may involve: Placing a drain into the brain to help remove cerebrospinal fluid (CSF) Medicines to reduce swelling, especially if there is a brain tumor Medicines that remove fluid from the body, such as mannitol or other diuretics, which reduce pressure inside the skull Placing a tube in the airway ( endotracheal intubation ) and increasing the breathing rate to reduce the levels of carbon dioxide (CO 2 ) in the blood Removing blood or blood clots if they are raising pressure inside the skull and causing herniation Removing part of the skull to give the brain more room.People who have a brain herniation have a serious brain injury. They may already have a low chance of recovery due to the injury that caused the herniation. When herniation occurs, it further lowers the chance of recovery. The outlook varies depending on where in the brain the herniation occurs. Without treatment, death is likely. There can be damage to parts of the brain that control breathing and blood flow. This can rapidly lead to death or brain death.Complications may include: Brain death Permanent and significant neurologic problems.Call your local emergency number (such as 911) or take the person to a hospital emergency room if they develop decreased alertness or other symptoms, especially if there has been a head injury or if the person has a brain tumor or blood vessel problem.Prompt treatment of increased intracranial pressure and related disorders may reduce the risk for brain herniation.Herniation syndrome; Transtentorial herniation; Uncal herniation; Subfalcine herniation; Tonsillar herniation; Herniation - brain.Brain injury - discharge.Brain Brain Brain hernia Brain hernia.Case CS, Shoamanesh A. Intracerebral hemorrhage.Encyclopedia Entry for Brain :Brain injury - discharge. First, health care providers provided treatment to prevent any further damage to the brain, and to help the heart, lungs, and other important parts of the body. After the person became stable, treatment was done to help them recover from the brain injury. The person may have stayed in a special unit that helps people with brain injuries.People with a serious brain injury improve at their own pace. Some skills, such as movement or speech, may go back and forth between getting better and then worse. But usually there is improvement.People may display inappropriate behavior after a brain injury. It is OK to point out when behavior is not appropriate. Explain the reason and suggest a different behavior. Offer praise when the person calms down or changes their behavior. Sometimes suggesting a new activity or a new place to go is the best option. It is important for family members and others to stay calm. Try to ignore angry behavior. DO NOT make a face or show anger or judgment. The providers will teach you when to decide to step in and when to ignore certain behavior.At home, the person who had the brain injury may need to practice everyday activities. It may help to create a routine. This means certain activities are done at the same time each day. The providers will help you decide how independent the person can be and when you can leave them alone. Make sure your home is safe so injuries do not happen. This includes making the bathroom safe, for either a child or an adult , and protecting against falls. Family and caregivers may need to help the person with the following: Exercising the elbows, shoulders, and other joints, to keep them loose Watching for joint tightening (contractures) Making sure splints are used in the correct way Making sure arms and legs are in a good position when sitting or lying Caring for muscle spasticity or spasms If the person is using a wheelchair, they will need follow-up visits with their provider to make sure it fits well. The person also needs to change positions in the wheelchair several times an hour during the day, to help prevent skin ulcers. Learn to make your home safer if the person with the brain injury wanders in or from the home.Some people with brain injuries forget about eating. If so, help them learn to add extra calories. Talk with the provider if the person is a child. Children need to get enough calories and nutrition to grow. Ask the provider if you need the advice of a dietitian. If the person with the brain injury has problems with swallowing, help them follow any special diet that makes eating safer. Ask the provider what the signs of swallowing problems are. Learn tips to make feeding and swallowing easier and safer.Tips for making clothing easier to put on and take off: DO NOT give the person too many choices. Velcro is much easier than buttons and zippers. If the clothing has buttons or zippers, they should be in the front. Use pullover clothes when possible and slip on shoes. Tips for talking to the person with a brain injury (if they have problems understanding): Keep distractions and noise down. Move to a quieter room. Use simple words and sentences, speak slowly. Keep your voice lower. Repeat if needed. Use familiar names and places. Tell them when you are going to change the subject. If possible, make eye contact before touching or speaking to them. Ask questions so the person can answer 'yes' or 'no.' When possible, give clear choices. Use props or visual prompts when possible. DO NOT give the person too many options. When giving instructions: Break down instructions into small and simple steps. Allow time for the person to understand. If the person becomes frustrated, take a break or consider redirecting them to another activity. Try using other methods of communicating: You may want to use pointing, hand gestures, or drawings. Develop a book with pictures of words or photographs to use when communicating about common topics or people.Have a routine. Once the person finds a bowel routine that works, help them stick with it. Pick a regular time, such as after a meal or a warm bath. Be patient. It may take 15 to 45 minutes for the person to have bowel movements. Try having the person gently rub their stomach to help stool move through their colon. The person may have problems starting to urinate or emptying all of the urine out of their bladder. The bladder may empty too often or at the wrong time. The bladder may become too full, and they may leak urine out of the overfilled bladder. Some men and women may need to use a urinary catheter. This is a thin tube that is inserted into the bladder. Learn how to care for the catheter.Call the person's provider if they have: Problems taking drugs for muscle spasms Problems moving their joints (joint contracture) Problems moving around or it is getting harder for them to transfer out of a bed or chair Skin sores or redness Pain that is becoming worse Choking or coughing when eating Signs of a bladder infection (fever, burning with urination, or frequent urination) Behavior issues that are hard to manage.Head injury - discharge; Head trauma - discharge; Contusion - discharge; Shaken baby syndrome - discharge.Brain Injury Association of America. Family and caregivers. Biausa.org. www.biausa.org/brain-injury-family-caregivers.htm#Manage the Home. Accessed December 8, 2016. Dobkin BH. Neurologic rehabilitation.Encyclopedia Entry for Brain :Brain natriuretic peptide test. A blood sample is needed. The blood is taken from a vein ( venipuncture ). This test is most often done in the emergency room or hospital. Results take up to 15 minutes. In some hospitals, a finger prick test with rapid results is available.When the needle is inserted to draw blood, you may feel a little pain. Most people feel only a prick or a stinging sensation. Afterward there may be some throbbing or bruising.You may need this test if you have signs of heart failure. Symptoms include shortness of breath and swelling of your legs or abdomen. The test helps make sure the problems are due to your heart and not your lungs, kidneys, or liver. It is unclear if repeated BNP tests are helpful in guiding treatment in those already diagnosed with heart failure.In general, results of less than 100 picograms/milliliter (pg/mL) are a sign a person does not have heart failure. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your health care provider about the meaning of your specific test results.BNP levels go up when the heart cannot pump the way it should. A result greater than 100 pg/mL is abnormal. The higher the number, the more likely heart failure is present and the more severe it is. Sometimes other conditions can cause high BNP levels. These include: Kidney failure Pulmonary embolism Pulmonary hypertension Severe infection (sepsis) Lung problems.Risks associated with having blood drawn are slight but may include: Excessive bleeding Fainting or feeling lightheaded Hematoma (blood accumulating under the skin) Infection (a slight risk any time the skin is broken).A related test, called the N-terminal pro-BNP test, is done in the same way. It provides similar information, but the normal range is different.Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;128(16):e240-e327. PMID: 23741058 www.ncbi.nlm.nih.gov/pubmed/23741058. Zile MR, Little WC. Heart failure with a preserved ejection fraction.Encyclopedia Entry for Brain :Brain PET scan. A PET scan requires a small amount of radioactive material (tracer). This tracer is given through a vein (IV), usually on the inside of your elbow. Or you breathe in the radioactive material as a gas. The tracer travels through your blood and collects in organs and tissues. The tracer helps your health care provider to see certain areas or diseases more clearly. You wait nearby as the tracer is absorbed by your body. This usually takes about 1 hour. Then, you lie on a narrow table, which slides into a large tunnel-shaped scanner. The PET scanner detects signals from the tracer. A computer changes the results into 3-D pictures. The images are displayed on a monitor for your provider to read. You must lie still during test so that the machine can produce clear images of your brain. You may be asked to read or name letters if your memory is being tested. The test takes between 30 minutes and 2 hours.You may be asked not to eat anything for 4 to 6 hours before the scan. You will be able to drink water. Tell your provider if: You are afraid of close spaces (have claustrophobia). You may be given a medicine to help you feel sleepy and less anxious. You are pregnant or think you might be pregnant. You have any allergies to injected dye (contrast). You have taken insulin for diabetes. You will need special preparation. Always tell your provider about the medicines you are taking, including those bought without a prescription. Sometimes, medicines interfere with the test results.You may feel a sharp sting when the needle containing the tracer is placed into your vein. A PET scan causes no pain. The table may be hard or cold, but you can request a blanket or pillow. An intercom in the room allows you to speak to someone at any time. There is no recovery time, unless you were given a medicine to relax.A PET scan can show the size, shape, and function of the brain, so your doctor can make sure it is working as well as it should. It is most often used when other tests, such as MRI scan or CT scan, do not provide enough information. This test can be used to: Diagnose cancer Prepare for epilepsy surgery Help diagnose dementia if other tests and exams do not provide enough information Tell the difference between Parkinson disease and other movement disorders Several PET scans may be taken to determine how well you are responding to treatment for cancer or another illness.There are no problems detected in the size, shape, or function of the brain. There are no areas in which the tracer has abnormally collected.Abnormal results may be due to: Alzheimer disease or dementia Brain tumor Epilepsy , and may identify where the seizures start in your brain Movement disorders (such as Parkinson disease ).The amount of radiation used in a PET scan is low. It is about the same amount of radiation as in most CT scans. Also, the radiation does not last for long in your body. Women who are pregnant or are breastfeeding should let their provider know before having this test. Infants and babies developing in the womb are more sensitive to the effects of radiation because their organs are still growing. It is possible, though very unlikely, to have an allergic reaction to the radioactive substance. Some people have pain, redness, or swelling at the injection site.It is possible to have false results on a PET scan. Blood sugar or insulin levels may affect the test results in people with diabetes. PET scans may be done along with a CT scan. This combination scan is called a PET/CT.Brain positron emission tomography; PET scan - brain.Chernecky CC, Berger BJ. Positron emission tomography (PET) - diagnostic.Encyclopedia Entry for Brain :Brain radiation - discharge. Two weeks after radiation treatment starts, you might notice changes in your skin. Most of these symptoms go away after your treatments have stopped. Your skin and mouth may turn red. Your skin might start to peel or get dark. Your skin may itch. Your hair will begin to fall out about 2 weeks after radiation treatment starts. It may not grow back.When you have radiation treatment, color markings are drawn on your skin. DO NOT remove them. These show where to aim the radiation. If they come off, DO NOT redraw them. Tell your provider instead. To care for your hair: For the first 2 weeks of treatment, wash your hair once a week with a gentle shampoo, such as a baby shampoo. After 2 weeks, use only warm water on your hair and scalp, without shampoo. Dry gently with a towel. DO NOT use a hair dryer. If you wear a wig or toupee: Be sure the lining does not bother your scalp. Wear it only a few hours a day, during the time you are getting radiation treatments and right after treatment has ended. Ask your provider when you can start to wear it more. To care for your skin in the treatment area: Wash the treatment area gently with lukewarm water only. Don't scrub your skin. Don't use soaps. Pat dry instead of rubbing dry. Don't use lotions, ointments, makeup, perfumed powders, or other perfumed products on this area. Ask your provider what is OK to use. Keep the area being treated out of direct sunlight. Wear a hat or scarf. Ask your provider if you should use sunscreen. Don't scratch or rub your skin. Ask your doctor for medicine if your scalp gets very dry and flaky, or if it gets red or tanned. Tell your provider if you have any breaks or openings in your skin. Don't put heating pads or ice bags on the treatment area. Keep the treatment area in the open air as much as possible. But stay away from very hot or cold temperatures. Don't swim during treatment. Ask your provider when you can start swimming after treatment.You need to eat enough protein and calories to keep your weight and strength up. Ask your provider about liquid food supplements that may help you get enough calories. Avoid sugary snacks and drinks that may cause tooth decay. You will likely feel tired after a few days. If so: Don't try to do too much. You probably will not be able to do everything you are used to. Get more sleep at night. Rest during the day when you can. Take a few weeks off work, or work less. You may be taking a medicine called dexamethasone (Decadron) while you are getting radiation to the brain. It may make you hungrier, cause leg swelling or cramps, cause problems sleeping (insomnia), or cause changes in your mood. These side effects will go away after you start taking less of the medicine, or when you stop taking it.Your provider may check your blood counts regularly.Radiation - brain - discharge; Cancer - brain radiation; Lymphoma - brain radiation; Leukemia - brain radiation.Doroshow JH. Approach to the patient with cancer.Encyclopedia Entry for Brain :Brain surgery - discharge. You'll probably notice itchiness, pain, burning, and numbness along your incision. You may hear a clicking sound where the bone is slowly reattaching. Complete healing of the bone may take 6 to 12 months. You may have a small amount of fluid under the skin near your incision. The swelling may be worse in the morning when you wake up. You may have headaches. You may notice this more with deep breathing, coughing, or being active. You may have less energy when you get home. This may last for several months. Your doctor may have prescribed medicines for you to take at home. These may include antibiotics and medicines to prevent seizures. Ask your doctor how long you should expect to take these medicines. Follow instructions on how to take these medicines. If you had a brain aneurysm , you may also have other symptoms or problems.Take only the pain relievers your provider recommends. Aspirin, ibuprofen (Motrin), and some other medicines you may buy at the store may cause bleeding. Eat the foods you normally do, unless your provider tells you to follow a special diet. Slowly increase your activity. It will take time to get all of your energy back. Start with walking. Use hand railings when you are on stairways. DO NOT lift more than 20 pounds (9 kg) for the first 2 months. Try not to bend over from your waist. It puts pressure on your head. Bend with your knees instead. Ask your provider when you may begin driving and return to having sex. Get enough rest. Sleep more at night, and take naps during the day. Also, take short rest periods during the day.Keep the incision clean and dry: Wear a shower cap when you shower or bathe until your surgeon takes out any stitches or staples. Afterward, gently wash your incision, rinse well, and pat dry. Always change the bandage if it gets wet or dirty. You may wear a loose hat or turban on your head. DO NOT use a wig for 3 to 4 weeks. DO NOT put any creams or lotions on or around your incision. DO NOT use hair products with harsh chemicals (coloring, bleach, perms, or straighteners) for 3 to 4 weeks. You may place ice wrapped in a towel on the incision to help reduce swelling or pain. Never sleep on an ice pack. Sleep with your head raised on several pillows. This helps reduce swelling.Call your doctor if you have: Fever of 101 F (38.3 C) or higher, or chills Redness, swelling, discharge, pain, or bleeding from the incision or the incision comes open Headache that does not go away and is not relieved by medicines the doctor gave you Vision changes (double vision, blind spots in your vision) Problems thinking straight, confusion, or more sleepiness than usual Weakness in your arms or legs that you did not have before New problems walking or keeping your balance A hard time waking up Seizure Fluid or blood dripping into your throat New or worsening problem speaking Shortness of breath, chest pain, or are coughing up more mucus Swelling around your wound or underneath your scalp that does not go away within 2 weeks or is getting worse Side effects to a medicine. DO NOT stop taking a medicine without talking to your doctor first.Craniotomy - discharge; Neurosurgery - discharge; Craniectomy - discharge; Stereotactic craniotomy - discharge; Stereotactic brain biopsy - discharge; Endoscopic craniotomy - discharge.Ortega-Barnett J, Mohanty A, Desai SK, Patterson JT. Neurosurgery.Encyclopedia Entry for Brain :Brain surgery. Before surgery, the hair on part of the scalp is shaved and the area is cleaned. The doctor makes a surgical cut through the scalp. The location of this cut depends on where the problem in the brain is located. The surgeon creates a hole in the skull and removes a bone flap. If possible, the surgeon will make a smaller hole and insert a tube with a light and camera on the end. This is called an endoscope. The surgery will be done with tools placed through the endoscope. MRI or CT scan can help guide the doctor to the proper place in the brain. During surgery, your surgeon may: Clip off an aneurysm to prevent blood flow Remove a tumor or a piece of tumor for a biopsy Remove abnormal brain tissue Drain blood or an infection Free a nerve The bone flap is usually replaced after surgery, using small metal plates, sutures, or wires. The bone flap may not be put back if your surgery involved a tumor or an infection, or if the brain was swollen. (This is called a craniectomy.) The time it takes for the surgery depends on the problem being treated.Brain surgery may be done if you have: Brain tumor Bleeding (hemorrhage) in the brain Blood clots ( hematomas ) in the brain Weaknesses in blood vessels ( brain aneurysm repair ) Abnormal blood vessels in the brain (arteriovenous malformations; AVM) Damage to tissues covering the brain (dura) Infections in the brain ( brain abscesses ) Severe nerve or face pain (such as trigeminal neuralgia , or tic douloureux) Skull fracture Pressure in the brain after an injury or stroke Epilepsy Certain brain diseases (such as Parkinson disease) that may be helped with an implanted electronic device Hydrocephalus (brain swelling).Risks for anesthesia and surgery in general are: Reactions to medicines Problems breathing Bleeding, blood clots, infection Possible risks of brain surgery are: Problems with speech, memory, muscle weakness , balance, vision, coordination, and other functions. These problems may last a short while or they may not go away. Blood clot or bleeding in the brain Seizures Stroke Coma Infection in the brain, wound, or skull Brain swelling.Your doctor will examine you, and may order laboratory and imaging tests. Tell your doctor or nurse: If you could be pregnant What drugs you are taking, even drugs, supplements, vitamins, or herbs you bought without a prescription If you have been drinking a lot of alcohol If you take aspirin or anti-inflammatory drugs such as ibuprofen If you have allergies or reactions to medications or iodine During the days before the surgery: You may be asked to stop taking aspirin, ibuprofen, warfarin (Coumadin), and any other blood thinning medicines. Ask your doctor which drugs you should still take on the day of the surgery. Try to stop smoking. Smoking can slow healing after your operation. Ask your doctor for help. Your doctor or nurse may ask you to wash your hair with a special shampoo the night before surgery. On the day of the surgery: You will likely be asked not to drink or eat anything for 8 to 12 hours before the surgery. Take the drugs your doctor told you to take with a small sip of water. Arrive at the hospital on time.After surgery, you will be closely monitored by your health care team to make sure your brain is working properly. The doctor or nurse may ask you questions, shine a light in your eyes, and ask you to do simple tasks. You may need oxygen for a few days. The head of your bed will be kept raised to help reduce swelling of your face or head. The swelling is normal after surgery. Medicines will be given to relieve pain. You will usually stay in the hospital for 3 to 7 days. You may need physical therapy (rehabilitation). After you go home, follow any self-care instructions you're given.How well you do after brain surgery depends on the condition being treated, your general health, which part of the brain is involved, and the specific type of surgery.Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy.Brain aneurysm repair - discharge Brain surgery - discharge Caring for muscle spasticity or spasms Communicating with someone with aphasia Communicating with someone with dysarthria Epilepsy in children - discharge Epilepsy or seizures - discharge Epilepsy - what to ask your doctor - adult Epilepsy - what to ask your doctor - child Stroke - discharge Swallowing problems.Before and after hematoma repair Before and after hematoma repair Craniotomy - series Craniotomy - series.Ortega-Barnett J, Mohanty A, Desai SK, Patterson JT. Neurosurgery.Encyclopedia Entry for Brain :Brain tumor - children. The cause of primary brain tumors is unknown. Primary brain tumors may be: Not cancerous (benign) Invasive (spread to nearby areas) Cancerous (malignant) Brain tumors are classified based on: The exact site of the tumor The type of tissue involved Whether it is cancerous Brain tumors can directly destroy brain cells. They can also indirectly damage cells by pushing on other parts of the brain. This leads to swelling and increased pressure inside the skull. Tumors can occur at any age. Many tumors are more common at a certain age. In general, brain tumors in children are very rare. COMMON TUMOR TYPES Astrocytomas are usually noncancerous, slow-growing tumors. They commonly develop in children ages 5 to 8. Also called low-grade gliomas, these are the most common brain tumors in children. Medulloblastomas are the most common type of childhood brain cancer. Most medulloblastomas occur before age 10. Ependymomas are a type of childhood brain tumor that can be benign (noncancerous) or malignant (cancerous). The location and type of ependymoma determine the type of therapy needed to control the tumor. Brainstem gliomas are very rare tumors that occur almost only in children. The average age at which they develop is about 6. The tumor may grow very large before causing symptoms.Symptoms may be subtle and only gradually become worse, or they may occur very quickly. Headaches are often the most common symptom. But only very rarely do children with headaches have a tumor. Headache patterns that may occur with brain tumors include: Headaches that are worse when waking up in the morning and go away within a few hours Headaches that get worse with coughing or exercise, or with a change in body position Headaches that occur while sleeping and with at least one other symptom such as vomiting or confusion Sometimes, the only symptoms of brain tumors are mental changes, which may include: Changes in personality and behavior Unable to concentrate Increased sleep Memory loss Problems with reasoning Other possible symptoms are: Gradual loss of movement or feeling in an arm or leg Hearing loss with or without dizziness Speech difficulty Unexpected vision problem (especially if it occurs with a headache), including vision loss (usually of peripheral vision) in one or both eyes, or double vision Problems with balance Weakness or numbness.The health care provider will perform a physical exam. Infants may have the following physical signs: Bulging fontanelle Enlarged eyes No red reflex in the eye Positive Babinski reflex Separated sutures Older children with brain tumors may have the following physical signs or symptoms: Headache Vomiting Vision changes Change how the child walks (gait) Weakness of a specific body part Head tilt The following tests may be used to detect a brain tumor and identify its location: CT scan of the head MRI of the brain Examination of the cerebral spinal fluid (CSF).Treatment depends on the size and type of tumor and the child's general health. The goals of treatment may be to cure the tumor, relieve symptoms, and improve brain function or the child's comfort. Surgery is needed for most primary brain tumors. Some tumors may be completely removed. In cases where the tumor cannot be removed, surgery may help reduce pressure and relieve symptoms. Chemotherapy or radiation therapy may be used for certain tumors. The following are treatments for specific types of tumors: Astrocytoma: Surgery to remove the tumor is the main treatment. Chemotherapy or radiation therapy may also be necessary. Brainstem gliomas: Surgery may not be possible because of the tumor's location deep in the brain. Radiation is used to shrink the tumor and prolong life. Sometimes targeted chemotherapy can be used. Ependymomas: Treatment includes surgery. Radiation and chemotherapy may be necessary. Medulloblastomas: Surgery alone does not cure this type of tumor. Chemotherapy with or without radiation is often used in combination with surgery. Medicines used to treat children with primary brain tumors include: Corticosteroids to reduce brain swelling Diuretics (water pills) to reduce brain swelling and pressure Anticonvulsants to reduce or prevent seizures Pain medicines Chemotherapy to help shrink the tumor or prevent the tumor from growing back Comfort measures, safety measures, physical therapy, occupational therapy, and other such steps may be required to improve quality of life.You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you and your child feel less alone.How well a child does depends on many things, including the type of tumor. In general, about 3 out of 4 children survive at least 5 years after being diagnosed. Long-term brain and nervous system problems may result from the tumor itself or from treatment. Children may have problems with attention, focus, or memory. They may also have problems processing information, planning, insight, or initiative or desire to do things. Children younger than age 7, especially younger than age 3, seem to be at greatest risk of these complications. Parents need to make sure that children receive support services at home and at school.Call a provider if a child develops headaches that do not go away or other symptoms of a brain tumor. Go to the emergency room if a child develops any of the following: Physical weakness Change in behavior Severe headache of unknown cause Seizure of unknown cause Vision changes Speech changes.Glioblastoma multiforme - children; Ependymoma - children; Glioma - children; Astrocytoma - children; Medulloblastoma - children; Neuroglioma - children; Oligodendroglioma - children; Meningioma - children; Cancer - brain tumor (children).Brain radiation - discharge Brain surgery - discharge Chemotherapy - what to ask your doctor Radiation therapy - questions to ask your doctor.Brain Brain Primary brain tumor Primary brain tumor.Ater JL, Kuttesch JF. Brain tumors in childhood.Encyclopedia Entry for Brain :Brain tumor - primary - adults. Primary brain tumors include any tumor that starts in the brain. Primary brain tumors can start from brain cells, the membranes around the brain (meninges), nerves, or glands. Tumors can directly destroy brain cells. They can also damage cells by producing inflammation, placing pressure on other parts of the brain, and increasing pressure within the skull. The cause of primary brain tumors is unknown. There are many risk factors that could play a role: Radiation therapy used to treat brain cancers increases the risk of brain tumors up to 20 or 30 years later. Some inherited conditions increase the risk of brain tumors, including neurofibromatosis, Von Hippel-Lindau syndrome, Li-Fraumeni syndrome, and Turcot syndrome. Lymphomas that begin in the brain in people with a weakened immune system are sometimes linked to infection by the Epstein-Barr virus. These have not proven to be risk factors: Exposure to radiation at work, or to power lines, cell phones, cordless phones, or wireless devices Head injuries Smoking Hormone therapy SPECIFIC TUMOR TYPES Brain tumors are classified depending on: Location of the tumor Type of tissue involved Whether they are noncancerous (benign) or cancerous (malignant) Other factors Sometimes, tumors that start out less aggressive can change their biologic behavior and become more aggressive. Tumors can occur at any age, but many types are most common in a certain age group. In adults, gliomas and meningiomas are the most common. Gliomas come from glial cells such as astrocytes, oligodendrocytes, and ependymal cells. Gliomas are divided into three types: Astrocytic tumors include astrocytomas (can be noncancerous), anaplastic astrocytomas, and glioblastomas. Oligodendroglial tumors. Some primary brain tumors are made up of both astrocytic and oligodendrocytic tumors. These are called mixed gliomas. Glioblastomas are the most aggressive type of primary brain tumor. Meningiomas and schwannomas are two other types of brain tumors. These tumors: Occur most often between ages 40 and 70. Are usually noncancerous, but can still cause serious complications and death from their size or location. Some are cancerous and aggressive. Other primary brain tumors in adults are rare. These include: Ependymomas Craniopharyngiomas Pituitary tumors Primary (central nervous system - CNS) lymphoma Pineal gland tumors Primary germ cell tumors of the brain.Some tumors do not cause symptoms until they are very large. Other tumors have symptoms that develop slowly. Symptoms depend on the tumor's size, location, how far it has spread, and whether there is brain swelling. The most common symptoms are: Changes in the person's mental function Headaches Seizures (especially in older adults) Weakness in one part of the body Headaches caused by brain tumors may: Be worse when the person wakes up in the morning, and clear up in a few hours Occur during sleep Occur with vomiting, confusion, double vision, weakness, or numbness Get worse with coughing or exercise, or with a change in body position Other symptoms can include: Change in alertness (including sleepiness, unconsciousness, and coma) Changes in hearing, taste, or smell Changes that affect touch and the ability to feel pain, pressure, different temperatures, or other stimuli Confusion or memory loss Difficulty swallowing Difficulty writing or reading Dizziness or abnormal sensation of movement (vertigo) Eye problems such as eyelid drooping, pupils of different sizes, uncontrollable eye movement, vision difficulties (including decreased vision, double vision, or total loss of vision) Hand tremor Lack of control over the bladder or bowels Loss of balance or coordination, clumsiness, trouble walking Muscle weakness in the face, arm, or leg (usually on just one side) Numbness or tingling on one side of the body Personality, mood, behavior, or emotional changes Trouble speaking or understanding others who are speaking Other symptoms that may occur with a pituitary tumor : Abnormal nipple discharge Absent menstruation (periods) Breast development in men Enlarged hands, feet Excessive body hair Facial changes Low blood pressure Obesity Sensitivity to heat or cold.The following tests may confirm the presence of a brain tumor and find its location: CT scan of the head EEG (to measure the electrical activity of the brain) Examination of tissue removed from the tumor during surgery or CT-guided biopsy (may confirm the type of tumor) Examination of the cerebral spinal fluid (CSF) (may show cancerous cells) MRI of the head.Treatment can involve surgery, radiation therapy, and chemotherapy. Brain tumors are best treated by a team that includes: Neuro-oncologist Neurosurgeon Medical oncologist Radiation oncologist Other health care providers, such as neurologists and social workers Early treatment often improves the chance of a good outcome. Treatment depends on the size and type of tumor and your general health. Goals of treatment may be to cure the tumor, relieve symptoms, and improve brain function or comfort. Surgery is often needed for most primary brain tumors. Some tumors may be completely removed. Those that are deep inside the brain or that enter brain tissue may be debulked instead of removed. Debulking is a procedure to reduce the tumor's size. Tumors can be hard to remove completely by surgery alone. This is because the tumor invades surrounding brain tissue much like roots from a plant spread through soil. When the tumor cannot be removed, surgery may still help reduce pressure and relieve symptoms. Radiation therapy is used for certain tumors. Chemotherapy may be used with surgery or radiation treatment. Other medicines used to treat primary brain tumors in children may include: Medicines to reduce brain swelling and pressure Anticonvulsants to reduce seizures Pain medicines Comfort measures, safety measures, physical therapy, and occupational therapy may be needed to improve quality of life. Counseling, support groups, and similar measures can help people cope with the disorder. You may consider enrolling in a clinical trial after talking with your treatment team.Complications that may result from brain tumors include: Brain herniation (often fatal) Loss of ability to interact or function Permanent, worsening, and severe loss of brain function Return of tumor growth Side effects of medicines, including chemotherapy Side effects of radiation treatments.Call your provider if you develop any new, persistent headaches or other symptoms of a brain tumor. Call your provider or go to the emergency room if you start having seizures, or suddenly develop stupor (reduced alertness), vision changes, or speech changes.Glioblastoma multiforme - adults; Ependymoma - adults; Glioma - adults; Astrocytoma - adults; Medulloblastoma - adults; Neuroglioma - adults; Oligodendroglioma - adults; Lymphoma - adults; Vestibular schwannoma (acoustic neuroma) - adults; Meningioma - adults; Cancer - brain tumor (adults).Brain radiation - discharge Brain surgery - discharge Chemotherapy - what to ask your doctor Radiation therapy - questions to ask your doctor Stereotactic radiosurgery - discharge.Brain tumor Brain tumor.Dorsey JF, Hollander AB, Alonso-Basanta M, et al. Cancer of the central nervous system.