Cranial Conditions & Brain Treatments We Offer
Cranial conditions affect the brain, skull base, blood vessels, and nerves of the face. Some grow slowly and cause subtle changes over time. Others, like bleeding from a ruptured aneurysm or serious brain trauma, can be life-threatening and need urgent care.
Dr. Sanjay Ghosh is a board-certified neurosurgeon in Mission Valley, San Diego, with fellowship training in skull base surgery and extensive experience treating brain tumors, cranial base disorders, and complex trauma.
This page gives an overview of the cranial conditions and advanced treatments offered in our practice and links to more detailed information. If you already know your diagnosis, you can click your condition below. If you are still looking for answers, these summaries can help you understand what may be going on and when to seek care.
Brain & Skull Base Tumors
Acoustic Neuroma (Vestibular Schwannoma)
An acoustic neuroma is a benign (noncancerous) tumor that grows on the balance and hearing nerve between the inner ear and the brain. It often causes one-sided hearing loss, ringing in the ear (tinnitus), and balance problems as it slowly enlarges. Treatment may include careful monitoring, radiation (such as Gamma Knife or CyberKnife), or surgery, depending on tumor size, growth, age, and symptoms.
Brain Tumors (General)
“Brain tumor” is a broad term for abnormal growths of cells in or around the brain. Tumors may be benign or malignant (cancerous), but even benign tumors can cause serious problems if they press on critical brain areas. Symptoms can include headaches, seizures, weakness, changes in speech, vision, balance, or personality.
Dr. Ghosh cares for many types of primary and metastatic brain tumors and works closely with multidisciplinary teams to decide whether surgery, radiosurgery, radiation, medication, or a combination is the best option.
Glioma
A glioma is a tumor that starts in glial cells, which support the nerve cells in the brain. Gliomas range from slower-growing tumors to very aggressive forms like glioblastoma. Common symptoms include headaches, seizures, weakness, or changes in thinking, speech, or personality, depending on where the tumor sits. Treatment often includes a mix of surgery, radiation, and chemotherapy.
Meningioma
A meningioma is a tumor that grows from the meninges, the protective layers surrounding the brain and spinal cord. It is the most common type of primary brain tumor, and most meningiomas are benign and slow-growing. Many cause no symptoms for years; others can lead to headaches, seizures, weakness, or vision and hearing changes by putting pressure on nearby brain tissue or nerves.
Because of his skull base fellowship training, Dr. Ghosh is experienced in removing deep-seated and complex meningiomas that sit near critical nerves and blood vessels.
Pituitary Adenoma
A pituitary adenoma is a benign tumor of the pituitary gland, a pea-sized gland at the base of the brain that controls many hormones. These tumors can cause symptoms by changing hormone levels (such as weight changes, menstrual changes, or milk leakage) or by pressing on nearby structures, especially the optic nerves, causing vision problems.
Treatment depends on size and hormone activity and may include observation, medication, surgery, and/or radiosurgery.
Ependymoma
An ependymoma is a rare tumor of the brain or spinal cord that arises from ependymal cells lining the fluid-filled spaces (ventricles) and central canal. These tumors can block normal cerebrospinal fluid flow and increase pressure in the brain, causing headaches, nausea, balance problems, or neurologic changes.
Treatment usually involves surgery to remove as much tumor as safely possible, followed by radiation in selected cases.
Vascular Conditions
Cerebral Aneurysms
A cerebral (brain) aneurysm is a bulge or ballooning in a weakened area of a brain artery. Most unruptured aneurysms cause no symptoms and are found by chance on imaging. However, if an aneurysm leaks or ruptures, it can cause sudden, severe bleeding around the brain (subarachnoid hemorrhage), often described as “the worst headache of my life,” and can be life-threatening.
Management may include monitoring, endovascular procedures, or open surgery depending on aneurysm size, shape, location, and each patient’s overall risk.
Cranial Nerve & Facial Movement Disorders
Trigeminal Neuralgia
Trigeminal neuralgia is a chronic facial pain condition that causes sudden, severe, electric shock-like pain on one side of the face. Even light touch—such as brushing your teeth, talking, or a breeze on the cheek—can trigger attacks. It is usually caused by irritation or compression of the trigeminal nerve, which carries sensation from the face to the brain.
First-line treatment is typically medication, but when medications are not effective or tolerated, Dr. Ghosh offers surgical and radiosurgical options, including procedures that relieve pressure on the nerve or target it with focused radiation (such as Gamma Knife).
Hemifacial Spasm
Hemifacial spasm causes repetitive, involuntary twitching of the muscles on one side of the face. Over time, the spasms can spread from the eyelid to the cheek and mouth and can be socially and functionally disabling. Many cases are due to a blood vessel pressing on the facial nerve near the brainstem.
Initial treatment often involves Botox® injections to relax the affected muscles. For longer-term relief, some patients may benefit from microvascular decompression surgery, which moves the offending blood vessel away from the nerve.
Brain Trauma & Injury
Brain Trauma / Traumatic Brain Injury (TBI)
Brain trauma (traumatic brain injury, or TBI) is caused by an external force—such as a blow or jolt to the head, a fall, a car crash, or an object penetrating the skull. Mild TBIs (concussions) may cause temporary symptoms like headache, dizziness, or confusion. More severe injuries can lead to prolonged unconsciousness, bleeding, swelling, and long-term problems with thinking, mood, movement, or behavior.
As Director of Neurosurgery at SENTA Clinic and neurotrauma leader at Scripps hospitals, Dr. Ghosh cares for patients with acute brain trauma and its long-term effects, working with critical care, rehabilitation, and other specialists to optimize recovery.
Advanced Radiosurgery Options
Some cranial conditions can be treated with stereotactic radiosurgery (SRS)—a highly focused form of radiation that targets small areas with precision while minimizing exposure to surrounding brain tissue. Despite the word “surgery,” these are non-incisional treatments.
Gamma Knife Surgery
Gamma Knife surgery is a type of stereotactic radiosurgery that uses many beams of gamma rays to deliver a high dose of radiation to a precisely defined target in the brain. It is commonly used for small brain tumors, arteriovenous malformations (AVMs), and trigeminal neuralgia, among other conditions. Patients typically go home the same day, and there is no scalpel incision.
CyberKnife Radiosurgery
CyberKnife is a robotic radiosurgery system that delivers highly focused X-ray beams from many angles, tracking even small movements of the target. It can treat both benign and malignant brain tumors, metastases, and some functional disorders in just a few outpatient sessions, without incisions or hospital stays.
Dr. Ghosh has substantial experience using both Gamma Knife and CyberKnife to treat complex cranial conditions and will discuss whether radiosurgery, open surgery, or a combined approach is best for your specific case.
When to See a Cranial Neurosurgeon
You should seek prompt evaluation if you or a loved one has:
- New or worsening severe headache, especially if sudden or “the worst ever”
- Seizures or unexplained loss of consciousness
- New weakness, numbness, or trouble speaking
- Changes in vision, hearing, balance, or personality
- Sudden facial pain or face twitching that does not go away
- A known brain tumor, aneurysm, or cranial nerve disorder and new or changing symptoms
Early diagnosis can expand your treatment options and may improve outcomes.
Dr. Sanjay Ghosh and his team in Mission Valley, San Diego, provide comprehensive evaluation and individualized care for cranial conditions, from monitoring small, slow-growing tumors to performing complex skull base surgery and radiosurgery.
If you’re concerned about a brain or cranial nerve condition, we’re here to help you understand your diagnosis and next steps.