Welcome to the UAB Neurosurgery web page that is aimed specifically at patients and our families. While UAB Neurosurgeons are proud to be accomplished and recognized as scientists and educators, our first and foremost priority is to our patients. Our mission statement incorporates the principle that we will provide world class care characterized by professionalism, clinical excellence and compassion. We strive to be of service to patients and families with neurosurgical needs within the state of Alabama, the region and the greater United States.
This portion of the web page is designed to assist patients and families in understanding the full range of diseases treated and services provided within the Division of Neurosurgery at UAB. These diseases and services are most succinctly summarized in a table that can be accessed via the pull down menu at the left of this page entitled "Diseases, Treatments and Services" but are described further below. A large number of internet links from this page will allow interested persons to access other web pages that comprehensively explain the full range of programs, services and multi-disciplinary centers that make UAB care unique in its quality and comprehensiveness.
Grade 1 and 2 -Astrocytoma and Pilocytic Astrocytoma
Grade 3 - Anaplastic Astrocytoma
Grade 4 - Glioblastoma multiforme
Metastatic Brain Tumors
Lung, Breast, Skin
Gliomas are tumors of the cells that support the neurons of the brain. The seriousness or prognosis of a glioma is typically related to the grade of the tumor. The grade is determined when a pathologist (a physician trained to examine and evaluate tissue samples) studies a specimen of the tumor that is obtained either via a surgical resection or biopsy. As such some form of surgical intervention is virtually always necessary to treat gliomas. Advanced technology such as frameless navigation systems pre-operative functional imaging (MEG and functional MRI) are available at UAB and are frequently employed to optimize the extent of tumor removal that can be performed safely. Many gliomas require additional therapy beyond surgery which may include radiation therapy and/or chemotherapy. Optimal care is obtained through a comprehensive Neuro-Oncology team which consists of experts from Oncology, Radiation Therapy and Neuosurgery. Only a limited number of medical centers in the nation have Neuro-Oncology programs that could rival those available at UAB.
A metastatic tumor occurs when there is a cancerous tumor elsewhere in the body which may spread to the brain via the blood stream. Surgery or Gamma Knife Treatment is usually recommended.
Skull Base Tumors
Acoustic Neuromas (Vestibular Schwannomas)
Meningiomas are tumors of the covering layers of the brain. As such they are often around the outside of the brain rather than deep within it. Surgical removal is often warranted but not in every single case. Factors such as the size and location of the tumor and the age and medical condition of the patient are important factors that your neurosurgeon will consider and review with you prior to making any surgical recommendation.
Acoustic neuromas are benign tumors of the vestibular nerve. The vestibular nerve and the nerves that allow hearing and move the facial muscles all run together. A variety of treatments exist for acoustic neuromas including open microsurgery or Gamma Knife stereotactic radiosurgery.
The pituitary gland has a central role coordinating the relationship between the brain and the hormones of the body. As such some pituitary tumors may become symptomatic because of hormone abnormalities. This depends on which hormone is over secreted. Prolactin secreting tumors (Prolactinomas) may cause impotence in males and breast discharge in females. ACTH secreting tumors cause Cushing's Disease which can result in high blood pressure, abdominal fat collections, thinning of the hair and red streaks on the skin. Growth hormone secreting tumors cause acromegaly which is manifest as enlargement and coarsening of the hands, feet and facial features. Most pituitary tumors are not actively secreting hormones and as such are called non-secretory tumors. These tumors may cause symptoms by growing and causing headache or compressing nearby structures. Nerves important in vision pass immediately above the pituitary region and as such visual impairment can be a sign of a pituitary tumor. Rarely tumors can undergo spontaneous bleeding within them and expand rapidly causing severe headache and visual loss. This is called pituitary apoplexy and it represents an urgent need for surgery.
Pituitary tumors often require surgical intervention but surgery may often can be performed utilizing minimally invasive techniques such as trans-nasal endoscopy. Dr. Kristen Riley directs the pituitary disorders clinic in conjunction with colleagues in ENT, Endocrinology, Opthalmology and Radiation Therapy to provide excellent comprehensive care.
Brain Tumors in Children
Astrocytomas- Astrocytomas in children are usually low grade tumors and most frequently occur in the posterior fossa. This is the region in the back of the brain behind and below a line drawn from one ear to another across the back of the head. The cerebellum and the brain stem occupy this region and the three most common Pediatric Brain Tumors (Astrocytoma, Medulloblastoma and Ependymoma) characteristically arise in this location.
Surgery is virtually always required and serves several goals. First is removal of the offending mass. Regardless of the tumor type outcome is improved by removing the tumor. Low grade (pilocytic) astrocytomas of the cerebellum can often be completey removed
Pineal Region tumors/Germinomas
Brain and Spinal Injury
Head Injury Management at UAB
Few injuries or illnesses are as devastating to an individual and their family as a severe brain or spinal injury. The Neurosurgery service at UAB and the Children's Hospital of Alabama are committed to providing world class service to patients who have suffered these injuries and their families. This occurs on multiple levels. First, in approaching the acutely injured patient we take primary and complete responsibility for managing the variables that can absolutely minimize any component of secondary injury. Secondary injury refers to the cascade of biochemical and physiological changes that occur in a delayed fashion (beyond the moment of impact or injury). The cardinal parameters that are involved are the control of intracranial pressure and the assurance of perfusion pressure. Intracranial pressure refers to the pressure inside of the cranium (skull) that often rises as injured tissues swell and occupy more space. The elevation of pressure can make it more difficult for blood to perfuse the brain as well and it is from this principle that the commitment to maintaining cerebral perfusion pressure arises. All severely head injured patients are managed by the Neurosurgery service. We work cooperatively with our colleagues in Trauma, General, Cardio-thoracic, Pediatric and Orthopedic Surgery as well as Critical Care Intensivists to insure meticulous comprehensive care of the multiply injured patient however the primary management of issues related to brain injury are managed by the Neurosurgical service.
UAB Neurosurgery is one of the busiest neuro-trauma services in the nation. Over 400 patients are treated each year and the average daily census of head injured patients is 12-15. Once the acute situation is improved we work cooperatively with colleagues in Physical Medicine and Rehabilitation who run the UAB Head Injury Rehabilitation Program.
Vascular (Blood Vessel) Diseases of the Brain and Spinal Cord
Dural AV fistula
Pediatric neuro-vascular diseases
Diseases of the Spine
Trauma of the spine
Degenerative Diseases of the Spine
Pediatric Spinal Disorders
Tumors of the Spine
Spinal Cord Tumors
Parkinsons and Other Tremors
Spina Bifida and Neural Tube Defects