Brain tumour is a term that encompasses a wide range of tumours arising from the brain, cranial nerves (nerves leaving the brain) and the linings around the brain. They can be benign or malignant and can be primary (arising within the head) or metastatic (spreading to the brain from elsewhere in the body).
Being diagnosed with a brain tumour is a very stressful event for a patient and thus, it is important to discuss the situation with a surgeon in a timely fashion. This allows the patient to get accurate information and to develop an appropriate treatment strategy.
The management of brain tumours is complex and depends on, amongst other things:
- Likely type of tumour
- Location of the tumour (is it in or near functionally important brain - can the lesion be removed without causing significant neurological injury)
- Neurological status of the patient
- Age and medical condition of the patient
- Disease burden elsewhere in the body (if the lesion is metastatic)
Having ascertained this information Dr Heppner will discuss with you the options for treatment of your particular condition and any risks that may be involved with this.
A multidisciplinary approach involving the input of radiation oncologists and medical oncologists is often beneficial when managing brain tumours and Dr Heppner has a close working relationship with a number of experts in these fields in the Auckland area.
Dr Heppner completed a Fellowship in Complex Spine Surgery and performs everything from simple decompressive operations through to fusion surgery over the entire length of the spine. Dr Heppner’s particular interest is in cervical spine surgery, craniocervical junction surgery (surgery at the junction between the skull and spine) and intradural spinal surgery. This is typically for tumours and other lesions around the spinal cord and exiting nerve roots).
Dr Heppner has a close working relationship with a number of Orthopaedic Spinal Surgeons and operates with them on conjoint cases in both the Public and Private sectors frequently. If he feels your case may benefit from a combined approach he will discuss this option with you.
Hydrocephalus is the condition where there is an imbalance between the production and absorption of cerebrospinal fluid (CSF). Depending on the cause of the hydrocephalus, the condition can present anywhere from birth through to old age. Dr Heppner has extensive experience in performing shunt procedures as these are a key component of his paediatric work at Starship Children’s Hospital. He also has extensive experience in Neuro-Endoscopy during which a telescope is placed into the ventricles (CSF chambers within the brain) and new pathways opened up to allow for CSF circulation. Dr Heppner also manages the related condition of idiopathic intracranial hypertension (benign intracranial hypertension; or pseudo tumour cerebrae) and normal pressure hydrocephalus.
Chiari malformation is a condition here the lowest part of the cerebellum herniates out of the skull and into the upper spinal canal. This can present with a range of symptoms from headache through to neurological impairment of the arms and legs due to the formation of a syrinx (cavity within the spinal cord). Most symptomatic malformations are treated with a foramen magnum decompression (posterior fossa decompression) and this is highly successful in the majority of cases. Occasionally, in more “complex” cases there may be evidence of instability necessitating fusion of the skull to the upper cervical spine (occipitocervical fusion). Assessment of a patient with Chiari Malformation involves a detailed history and examination followed by review of the MRI scan (+/- CT Scan). After this, an appropriate treatment plan can be made.
For certain patients with medically intractable epilepsy ( epilepsy that is not controlled by medication), surgery can be highly effective in abolishing or at least ameliorating seizures. Dr Heppner is involved with the epilepsy surgery programme at Auckland City and Starship Hospitals. Typically patients are worked up and investigated by a neurologist with an interest in epilepsy. If a lesion or area of the brain is identified from which the seizures are emanating, and if the area is amenable to resection at an acceptable risk, these patients are often cured of their epilepsy by surgical resection. Dr Heppner routinely performs operations such as temporal lobectomy and lesionectomy (resection of cavernomas, cortical dysplasia, tumors, etc) for epilepsy control.
A wide range of neurosurgical conditions can occur in children. These include congenital anomalies, hydrocephalus, craniofacial conditions (in particular premature fusion of the skull growth plates), tumours and epilepsy. Dr Heppner has extensive experience in managing these conditions and is involved in the multi-discplinary paediatric oncology, craniofacial and epilepsy programs at Starship Hospital.
Trigeminal neuralgia is a condition characterised by severe, shock like facial pain. It is often triggered by touch, chewing or talking. The severity of pain often waxes and wanes and it is typically well controlled (at least initially) by medication such as Carbamazepine (Tegretol).
Trigeminal neuralgia is usually caused by an artery compressing the origin of the 5th (Trigeminal) cranial nerve as it exits the brain. If the pain is not controlled by medication, there are a number of surgical options which can be very effective. They range from simple ballon compression of the nerve through to micro surgically moving the offending artery. The most appropriate operation depends on a number of factors including age and other past medical history.
Dr Heppner does not operate on aneurysms, arteriovenous malformations or arteriovenous fistulas. He would be happy to recommend other neurosurgeons with particular expertise in these areas. He does, however, operate on cavernous malformation, especially if they are associated with epilepsy.BACK TO HOME PAGE