HJAR Jul/Aug 2022

HEALTHCARE JOURNAL OF ARKANSAS I  JUL / AUG 2022 59 Ali Krisht, MD CHI St. Vincent Arkansas Neuroscience Institute FROM minimally invasive surgeries and dramatically reduced recovery times to advanced imaging and diagnostics, the field of neurosurgery has seen no shortage of incredible improvements over the last 50 years. One of the most impressive developments has been the advancement in our understanding and treatment of brain tumors. There was a time when a brain tumor diagnosis may have felt like a death sentence for some patients, but we’ve come a long way in the last half-century. It starts with the improved ability to identify and locate the tumor and all of its defining characteristics. With the use of a high-definition CT scan or MRI technology today, we can identify exactly where a tumor is located within the brain, map its path, and see how it relates to the functional areas surrounding it. We can even study the connections of the brain that pass in the vicinity of the tumor, a valu- able capability when planning any poten- tial operation to avoid the cables that could cause weakness or loss of brain function in a patient. All of these advancements lead to a more accurate assessment for patients and allow us to rate tumors on a spectrum from lower grade to higher grade and also benign or cancerous. The ability to accurately and precisely di- agnose brain tumors has revolutionized the way we treat patients as neurosurgeons and provides better outcomes for the patients. This allows us to be safer and more proac- tive in our treatment strategy for particularly aggressive brain tumors. Tumors that de- velop in tricky areas such as the base of the skull were once seen as inoperable, but now they can be safely removed with little to no side effects for our patients. There are different kinds of tumors that can develop in the brain. The first kind of tumor can develop in the head, while the second kind can develop from the actual brain tissue. Aggressive tumors often arise from a layer of cells in the brain called the glia. Historically, patients diagnosed with this type of tumor would be told that they only have a fewmonths left to live, but now, with our technology and a deeper understanding of the anatomy, neurosurgeons can map better surgical pathways and treatment options that help patients live much longer lives than they would have decades ago. Sometimes brain tumors are found incidentally while patients are undergoing imaging for other ailments. When they are discovered and deemed benign and are not causing any symptoms, they can be treated conservatively without intervention. Many tumors cause debilitating symptoms for patients, though, depending on the type of brain tumor they have been diagnosed with. Symptoms can vary from slurred speech, forgetfulness, seizures, weakness on one side of the body, double vision or visual impairment, problems walking and with balance and even deficits with other senses. At the CHI St. Vincent Arkansas Neuroscience Institute, we are in a position to not only utilize all of these advancements in our understanding and treatment of brain tumors, but also to share these advanced techniques with other neurosurgeons from around the world who come to train with us. We follow our patients very closely and network with other oncologists from across the state. If a tumor is trying to come back, we will know before the patient even starts to show symptoms. Closely monitoring each and every patient provides our team with a chance to respond early, change medications, or schedule another surgery, radiation, or chemotherapy treatment. With aggressive tumors, a proactive approach is ultimately what pays off. The impact of all of these advancements in the field of neurosurgery cannot be overstated. While tumors often go through a wide spectrum of behavior, there is no tumor in our clinic or our program that goes untreated. Anyone who is told their brain tumor is inoperable or nothing can be done, I would suggest looking for another opinion. In the right place and with a team with the right expertise, many more things can be done, and we don’t give up on patients. We’ve come a long way in the last 50 years, and I look forward to seeing howmuchmore progress we can make for our patients in the next half-century. n Ali Krisht, MD, is an internationally recognized neuro- surgeon and director of the CHI St.Vincent Arkansas Neuroscience Institute, a comprehensive neurosur- gery program incorporating all aspects of treatment for the spectrum of neurological disorders.