The Cerebral and Vertebral Neurosurgery Unit of the Ruber Hospital on Juan Bravo Street in Madrid, under the direction of Dr. Hugo Santos, has been treating tumoral pathology of the nervous system since 1987. This Unit has experienced the advances of modern neurosurgery, applying the most avant-garde techniques, both for diagnosis, treatment and rehabilitation in a single team, which allows a comprehensive care of the patient.
The central nervous system (brain and spinal cord) can be affected by tumor processes, both benign and malignant.
The existence of brain pathology and one of its most frequent consequences, such as epilepsy, have haunted mankind since ancient times. The trepanations found in skulls in pre-Columbian times in Mexico and other American lands, make us think that in some cases the trepanned ones survived such surgery. It is still in doubt whether in these cases the reason for performing them was therapeutic or simply magic or sorcery.
In the diagnostic differentiation of brain and spinal cord tumor lesions, it should be assessed whether they are primitive tumors of the nervous system or lesions secondary to tumor processes in other parts of the body (metastasis). It should also be taken into account whether they arise from the brain parenchyma itself or if the origin is in structures that are closely related to them (nerve roots, meninges, arterial or venous vessels and bone). Much of the prognosis after treatment depends on this singularity. As in other types of tumors, there is predominance in age and sex groups. In tumors that are primitive of the brain or spinal cord parenchyma, those of glial extirpation, or commonly called astrocytomas, in their different degrees, among others, stand out.
Types of lesions of the nervous system
Among the lesions that affect the nervous system but have their origin in structures adjacent to it, such as the meninges, meningiomas stand out. Neurinomas are lesions that originate from nerve roots. There are lesions of vascular origin that can affect by mass effect or bleeding, such as cavernous angiomas.
There are also tumor lesions that, although not strictly cerebral, can affect structures of the nervous system, as is the case of pituitary adenomas, when they affect the optic nerves.
What symptoms are caused by lesions of the nervous system?
Tumor processes should be suspected when there are alterations such as headaches, dizziness, sensory or motor alterations or alterations of some other function such as hearing or neuralgia type pains, such as those usually produced in the face by lesions called “posterior fossa”.
What diagnostic tests are performed to determine if the patient has a lesion in the nervous system?
Clinical examination is the fundamental basis for diagnosis, to which imaging tests must be added to locate the location of the lesion and thus have an approximate diagnosis. Currently, we have advanced diagnostic imaging systems, such as MRI, brain CT, digital cerebral arteriography. Electroencephalogram and a combination of studies such as PET-CT are also extremely useful.
What is the treatment for nervous system lesions?
When the time comes to indicate surgical treatment, in a Unit such as ours we have adequate equipment to carry out the surgical procedures. In this section, special mention should be made of the availability of equipment to carry out minimally invasive, micro-endoscopic surgeries complemented with the participation of neurophysiologists to monitor brain functions even when the patient is under anesthesia. On some occasions, very specialized anesthetic techniques can be applied to perform surgery on awake patients, without pain during the surgery.
The guidance to estimate which is the best site to approach a lesion is determined by both the navigated MRI and intraoperative brain navigation equipment.
The patient, when deciding who will be the neurosurgical team that will attend him, must be sure that in addition to having all the technological advances available, there is an experienced neurosurgical team, as well as adequate hospital facilities to successfully carry out his treatment.
At the Ruber Hospital on Juan Bravo Street, we have the most advanced technology to solve tumor processes, both at brain and spinal cord level. It has a highly specialized diagnostic imaging department. The operating rooms are of the so-called “intelligent” type. The intensive care unit, like us, has extensive experience for the assessment and postoperative treatment of the patient. On the floors, with experienced nurses and assistants, we all form a team that is hard to match.