Dr. K Kartik Revanappa

The neurones in the brain are constantly reorganising their connections both functionally and physically according to the environment, your thinking and behaviour. This ability is known as neuroplasticity. Through neuroplasticity the nerve cells of brain can compensate for injury to some parts of the brain and enable a person to recover from stroke, birth abnormalities. It is also beneficial in treating utism, ADD, learning disabilities and helps manage obsessive compulsive disorders.

Here are seven things you should know about neuroplasticity.

1. Change depends on the attentiveness of the brain: Neuroplasticity changes can only happen if the brain is alert and active. When the brain is active it releases neurochemicals that are necessary for the neurone connections to change. If a person is distracted to inattentive, these changes cannot happen.
2. The more the effort; the bigger the change: Neuroplasticity changes depend on how motivated the person is to change or learn new tasks. For this reason, when it comes to using neuroplasticity for physiotherapy, it is essential to first deal with any depression or anxiety issues the patient might be having before attempting to rehabilitate them.
3. It helps strengthen neural connections: Repetition of actions is one of the key elements of neuroplasticity in physiotherapy. Through this, the strength of neurone connections is strengthened to include sensory information, movement and cognitive patterns.
4. It improves cell to cell connections: This is crucial to a patient’s rehabilitation as it increases reliability and makes a person more independent. In turn, this makes behaviour patterns more reliable.
5. It helps predict actions: A task can usually be broken down into a series of smaller tasks. For example, feeding oneself can be broken down into steps that begin with lifting a spoon and filling it with food to finally putting the spoon into your mouth. Hence, along with completing an action, the brain must also know what to do next. Neuroplasticity helps improve this associative flow and allows the brain to predict the next step.
6. Changes can be temporary or permanent: Initial changes due to neuroplasticity are temporary ad only if the brain determines the experience to be desired is this change made permanent. This is why when treating mobility issues, patients are not always able to repeat tasks in the same way.
7. Memory guides the learning: When making new neural connections through neuroplasticity, the brain is taught to discard unsuccessful attempts and only remember the experience of the successful attempts. From here, adjustments are made to improve the connection. In case you have a concern or query you can always consult an expert & get answers to your questions!

A stroke may be called a brain attack. It may happen to any person at any time. A stroke occurs when blood supply to the brain is cut off. The brain cells become oxygen deprived due to the stroke and eventually die. Dead brain cells result in brain dysfunction due to which patients lose control over muscle and memory.

Strokes can be mild to life threatening and requires immediate medical attention. Stroke requires advanced care and should be treated by extensively qualified and experienced medical experts. 

Neurosurgery satisfies all the required clauses for treatment of stroke and accounts for being one of the best ways for management of stroke. Renowned hospitals have a dedicated neurosurgical wing and a team of neurological specialists who know how to deal with stroke the best.

Vascular Neurology
This form of neurology focuses on patients who have undergone a stroke or have experienced symptoms of stroke. A multidisciplinary approach is taken for the prevention of recurrent cerebrovascular conditions.

Types of stroke

1. Ischemic stroke: This kind of stroke occurs when there is a blockage in a blood vessel, which supplies blood to the brain. This form of stroke is the more common. The underlying cause of this stroke is known as atherosclerosis, which is a condition where fatty deposits occur in the walls of the blood vessels and cause blockage in them.
2. Hemorrhagic stroke: This type of stroke occurs when a blood vessel gets weak and ruptures into the brain. This is caused by two types of weak blood vessels known as aneurysm and arteriovenous malformation.
3. Transient ischemic attack: This type of stroke is also known as a mini stroke. These attacks occur because of blood clots. The blockage caused is temporary or transient in nature.

Treatment of Ischemic stroke

1. Tissue Plasminogen Activator: This is one of the best ways to treat ischemic strokes. This medicine is given to the patient intravenously. It dissolves the blood clot and improves blood flow to the area of the brain which is affected. The medicine should be given within three to four hours after stroke symptoms appear.
2. Endovascular procedure: This is a process by which the blood clot is removed using a catheter, which gets inserted into the area of the blocked blood vessel. It helps in restoring blood flow to that area. 

Treatment of Hemorrhagic stroke

1. Endovascular procedure: Several endovascular techniques and methods are used so that the weakening of blood vessels is reduced and less bleeding is caused.
2. Surgical treatment: Different modes of neurosurgery may be undertaken to stop bleeding and for relieving pressure within the skull. In case you have a concern or query you can always consult an expert & get answers to your questions!

The symptoms caused due to herniated disc can be very severe and can also cause a bit of disability. The disc of the spine is like a cushion and separates the set of bones on the backside. The discs are shock absorbers of the spine and are mainly composed of 2 parts, a soft jelly centre called the nucleus and a tough outer covering called the annulus.

Effects of Herniated Disk
A herniated or cracked disc is a severe condition and it seems to happen most commonly in the lower back.  It happens when a fraction of the soft centre gets pushed through the destabilized area due to degeneration, trauma or by putting pressure on the spinal cord. 

Nerves are located precisely at the back of every disc and are responsible for controlling everything in our body. While a disc gets herniated, the external covering of the disc tears and creates a bulge. The soft jelly gets shifted from the centre of the disk to the region where the damage has occurred on the disc. Most commonly, the bulge occurs in areas where the nerve is located and it causes strain on the affected nerve. It has been observed that individuals do not feel any painful sensations even if their disc gets damaged.

When is Surgery Recommended for Herniated Disc?
Surgery for herniated disc is recommended only after options like steroid injections, pain relievers, exercise and non-steroid anti-inflammatory drugs do not work. If the pain persists even after these options, then it becomes important to go for surgery. There are certain risks involved in this surgery like infection, bleeding or nerve damage. 

There are chances that the disc may get ruptured again if it is not removed. If you are a patient suffering from degenerative disc disease, then there are chances that problem occurs in other discs. It is very important that a patient maintains healthy weight to prevent any further complications.

The main factor that increases the risk of herniated disc is excess body weight, which causes a lot of stress on the lower back. A few people become heir to a tendency of developing this condition. Even individuals with physically demanding jobs are prone to this condition. 

Activities like bending sideways, pushing, twisting, repetitive lifting can increase the risk of a herniated disk. At times, emergency surgery is also required to avoid paralysis in a patient. In case you have a concern or query you can always consult an expert & get answers to your questions!

Sciatica is a neurological condition that mainly arises due to problems in the sciatic nerve. The sciatic nerve is believed to be the largest nerve originating from the spinal nerves L4 to S3. It extends downward from the lower spine into the back of each leg (thighs) right down to the foot. The sciatic nerve acts as a connecting link between the spinal cord and the foot and the leg muscles. People with sciatica often experience a tingling sensation along with a shooting pain radiates downwards from the lower back (mostly the lumbar region) to the back of one of the legs. Some may also experience the sciatic pain down both the legs (rare).

Types of Sciatic Pain:

Sciatica that affects a person can be of two types depending on the severity of the associated symptoms

• Acute sciatic pain: In this case, a person experiences a sudden radiating pain which often heals by itself within a week or two. More than often, the pain is triggered by an injury to the spinal joints, nerves, or the disc.
• Chronic sciatic pain: This is a more serious condition where the pain may linger for long, often more than three months. The chronic sciatic pain may affect a person with severe Arthritis and nerve injury and damage.

Symptoms associated with Sciatica:

• One of the characteristic symptoms of Sciatica is a shooting pain that radiates from the lower back (often the lumbar) to the back of one (or both) of the legs.
• In some, the sciatic pain may result in weakness and a tingling sensation down the affected leg.
• A person with sciatica may find it difficult to move his/her foot and legs (restricts their movement).
• Some people may experience a shooting pain even while they are in a sitting position. In some others, the pain may be at its worst when a person is in a standing position.
• Sciatica can also trigger a hip pain.

What triggers sciatica and the associated symptoms?

• The disc is a protective shield that prevents any damage or injury to the vertebrae. A degenerative disc problem can interfere with the normal functioning of the disc triggering sciatica.
• Spondylolisthesis: In Spondylolisthesis, also known as a Slip Disc, a bone (mostly in the lumbar region) slips over the bone which is located just below it. People with prolonged and untreated spondylolisthesis are often known to suffer from sciatica.
• The sciatic pain can also affect a woman during her pregnancy.
• Lumbar spinal stenosis: This condition is is characterized by the spinal canal narrowing down in the lumbar region. Lumbar spinal stenosis exerts pressure on the sciatic nerve, giving rise to sciatica.
• A muscular strain or spasm in the buttocks can also be a contributing factor.

Proper management and prevention for sciatica are possible. One should be alert and consult a doctor in case they experience the associated symptoms or any discomfort. In case you have a concern or query you can always consult an expert & get answers to your questions!

Sciatica refers to the pain one experiences due to the irritation or compression of nerve roots contributing to formation of Sciatic nerve. The sciatic nerve is the longest and widest nerve in the body, running from the lower back, down to the back of each leg. The pain can occur in the lower back and spread to the hips, buttocks and leg. Sciatica generally affects one side of the body. There are numerous causes of irritation of the sciatic nerve and sciatica.

Some of them are:

1. Spinal Stenosis: The narrowing of the spinal canal caused by natural wear and tear of the vertebrae (individual bones in the spine protecting underlying nerves) of the spine is known as spinal stenosis. The narrowing may put pressure on the roots of the sciatic nerve, causing pain.
2. Herniated Disc: A disc is made up of cartilage and acts as a cushion between vertebrae, allowing flexibility of the spine. A herniated or slipped disc occurs when a disc is temporarily pushed out of place, putting pressure on the sciatic nerve.
3. Spondylolisthesis: It is a condition where one of the lower vertebrae slips forward over another. This also causes a collapse of the disc space between both, causing the nerve to get pinched. This may cause sciatica.
4. Piriformis Syndrome: Piriformis is a muscle found deep inside the buttocks, which connects the lower spine to the upper thighbone, running directly over the sciatic nerve. Spasming of this muscle can pressurize the sciatic nerve, triggering symptoms of sciatica.
5. Sacroilitis: Sacroillac joints are the place where the lower spine meets the pelvis and inflammation of one or both of these joints causes sacroilitis. This can give rise to symptoms of sciatica as it causes pain in the lower back, buttocks and legs.
6. Spinal tumors: Very rarely, tumors growing inside or along the spine may put pressure on the sciatic nerve.
7. Infection or injury: Muscle inflammation, infections, fractures or any other spinal injury may lead to irritation or compression of the sciatic nerve.
8. Pregnancy: Pregnant women may suffer from sciatica due to weight gain, expansion of the uterus or increased fluid retention or other changes occurring in the body, which put pressure on the sciatic nerve.
9. Other causes: Osteoarthritis and fractures caused by osteoporosis may also affect the sciatic nerve, producing symptoms of sciatica.

In case you have a concern or query you can always consult an expert & get answers to your questions!

There is no trustworthy evidence regarding what causes brain tumors, but there are a few risk factors that have been substantiated through research. Children and young people who receive radiation around the head are susceptible to developing tumors in the brain once they grow up. Also, people with a certain kind of rare genetic condition like neurofibromatosis may develop a brain tumor though such cases are very few in number. Age is also an important factor as people aged over 65 years are diagnosed with brain tumors at quadruple times higher than children and younger people.

Types of Brain Tumours-

A primary brain tumor originates in the brain, and they may or may not be cancerous. Some tumors can be benign, which do not spread in the surrounding tissues and are not very malicious. However, that does not signify that they will not cause any harm over time. Sometimes these tumors can be severe and cause a threat to the life of the sufferer. The National Cancer Institute reports that approximately there were 23, 380 fresh cases of brain tumors in 2014.

Identifying the Symptoms of Brain Tumors...

The symptoms of the brain tumor are dependent on various factors such as the size, type as well as the exact location of the tumor. These symptoms are triggered when any tumor is pressed or clashed against a nerve or disturbs a part of the brain. Symptoms are also felt when any tumor particle blocks the fluid flowing around the brain or when there is a swelling in the brain owing to the build-up of fluid.

Common symptoms include- headaches that get worse in the morning, nausea along with vomiting, an alteration in the speech, hearing and imbalances in walking and movement, mood swings, change in personality and ability to concentrate or remember things and seizures or convulsions.

Treatment for Brain Tumor-

Surgery is normally the most usual treatment for brain tumors, and the patient is given anaesthesia, and the scalp is shaved before the surgery. Then, craniotomy is performed to open the skull, and the surgeon removes a bone piece out of the skull. Then the tumor is removed as much as possible. The bone is then restored back, and the incision on the scalp is closed. Sometimes surgery is not viable in case the tumor has developed in the brain stem or some other complex parts.

Neurosurgeons can surgically remove some tumors completely (called resection or complete removal). If the tumor is near sensitive areas of the brain, neurosurgeons will only be able to remove part of it (called partial removal). Even partial removals can relieve symptoms and facilitate or increase the effectiveness of other treatments.

The role of surgery in treating brain tumors

Surgery can provide:

1. The complete removal of some brain tumors
2. A sample to enable doctors to diagnosis the tumor and recommend the most appropriate treatment
3. Better quality of life:
4. Reduced symptoms and improved ability to function (e.g., to think, speak or see better)
5. Less pressure within the skull from the tumor
6. A longer life

In case you have a concern or query you can always consult an expert & get answers to your questions!

Gone are the days when back pain affected a person only in their old age. Nowadays, almost every second person suffers from some kind of a backache. From sedentary lifestyle to certain diseases and ailments, the back pain can result from the amalgamation of various factors, making the condition painful (mild to chronic) and uncomfortable to the hilt. In this article, we will mainly stress upon the factors responsible for a back pain.

Underlying factors that often triggers a back pain

More than often, prolonged and chronic back pain interferes with the daily activities of a person, thereby jeopardizing their lives. For a proper treatment and management, one should first identify the factors responsible for the back pain. Some of the common and critical triggers include

Medical conditions:

• Sciatica: Sciatica is a neurological disorder whereby an inflammation or injury of the sciatic nerve (considered the largest nerve in the body) triggers numbness and a shooting pain that moves downwards, often from the lower back (the lumbar region) through the buttocks and hips into the back of one leg. Sometimes, a person may experience a pain down both the legs.
• Osteoarthritis of the spine: This is a painful degenerative disorder of the spine that mainly affects the neck and the lower back. Here, the cartilage of the discs and joints (lower back and neck) are damaged causing pain and weakness. In some people, the pain is so severe that it limits their motion to a great extent.
• Lumbar spinal stenosis: Stenosis of the lumbar spine results in severe back pain, especially in the lower half (lumbar area), triggered by narrowing down of the spinal canal.
• Osteoporosis of the spine: This is a bone disorder where the bones become so porous, thin and weak that they start to crack and break (including those of the spine), a condition known as vertebral compression fractures. These fractures are a common cause of weakness and back pain.
• Shingles: This is a viral infection (varicella-zoster virus) characterized by the appearance of a rash which is often painful. Shingles can occur in any part of the body including the spine. The viral infection in the spine is what triggers the back pain.
• Spinal Cancer, muscle spasm or ligament tear and strain on the back can give rise to back pain.
• Back pain can also be an outcome of rupture or disorder of the discs that act as a defensive shield between the spinal vertebrae.

Lifestyle practices:

1. Leading a sedentary life can be dangerous, often causing back pain.
2. People who are overweight or obese (especially the lower half) are known to suffer from a back pain.
3. In many people, rigorous exercise and physical activities can be a major contributing factor, triggering a back pain.
4. Women who wear high heels are more susceptible to developing a back pain.
5. In addition to these, bad posture, stress, a poor quality mattress can equally contribute to back pain.
6. Do not neglect the condition if the pain persists for more than a week. Get medical assistance to avoid further deterioration and complication. If you wish to discuss about any specific problem, you can ask a free question.

Stress has become an integral and inevitable part of life. From personal life to professional commitments, the trigger can be anything. While there can be many common and harmful effects of stress, one that deserves a special mention is a headache. Almost 90% of the people worldwide get a Tension Headache (a term often used for a headache associated with stress).

In case, when headache is due to tension,  the head feels tight and heavy. Further, a person may experience pressure mainly around the forehand and also at the back side of the head, moving down to the neck. However, it is important that one does not confuse a tension headache with a migraine. The two are as different as chalk and cheese. A tension headache can be chronic or episodic. A person with a chronic tension headache may suffer from the condition frequently. On the other hand, if a person gets a tension headache for less than 15 days a month, the headache is said to be episodic. The condition is more severe and painful in a chronic tension headache.

What causes a tension headache?
While stress (physical, mental and emotional) is the major contributing factor, the following triggers may also play a pivotal role in a tension headache.

• Severe anxiety and depression.
• Lack of a proper rest and sound sleep.
• Extreme fatigue (physical or mental) or hunger can also result in a tension headache.
• A person with iron deficiency may also suffer from a tension headache.

Managing a stress related headache
Managing and eliminating stress can go a long way to prevent a tension headache. The following activities are sure to make the situation better

1. Sleep well to keep stress at bay: Sleep can work wonders to reduce stress and the associated headache. Maintain a healthy sleep cycle. Work is important, but compromising on your sleep is foolish. It is important that you sleep for not less than 6-8 hours daily.
2. A healthy diet for a stress-free life: A healthy diet can play a significant role to reduce stress, thereby enhancing your moods. Enrich your diet with dark green leafy vegetables, dark chocolates, nuts, probiotics, berries (especially blueberries), seeds (sesame, pumpkin, and sunflower), foods rich in omega-3 fatty acids. Foods rich in vitamins, magnesium, and potassium are known to be great mood enhancers. Try and avoid processed foods as well as foods rich in fats and complex carbohydrates as much as you can.
3. Meditation can help: People under stress can benefit immensely from meditations, exercise, and physical activities. Exercise is known to trigger the release of endorphins or feel good hormones. Endorphins can lift up your mood and spirits to a great extent.
4. Family time: Spending time with your family and loved ones can also help to reduce stress.

Stress and headache can both be managed and taken care of if you follow a healthy lifestyle. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.

Pain causes a lot of discomfort in the body no matter whether the pain is in the back, legs or in the head. Almost all people experience lower-back pain at some point in their lives, which can be extremely painful and can cause considerable annoyance. The first medical specialty that comes to mind for relief of lower-back pain is Orthopedics. The other two specialists that play a vital role in treating lower-back pain are the neurosurgeons and the physiatrists.

Pain in the Back
It is very difficult for the body to source the pain when it is deep and this pain could be due to infection, disease or injuries in the back, stomach and heart. It is even possible that the pain radiates to different places in the body. Often back pain is accompanied by body changes like redness, fever, neurological problems, heat, and changes in body functions and for that diagnosis of the back pain may be very severe. Patients suffering from lower-back pain and with symptoms that comprise of weakness in the foot or other symptoms of a neurologic insufficiency must definitely see a neurosurgeon.

Back pain that occurs due to reversible problems is known to vanish in a few hours or in a day. However, if it continues longer and is accompanied by body changes, then there are chances that the condition can become worse. Visiting a doctor becomes a must for back pain if any of such characteristics are witnessed. It is always better to get evaluated by a physician.

When to Consult a Doctor Immediately

1. Back pain that is followed by a shock like a car accident.
2. The pain in the back worsens and is constant
3. Back pain continues for more than 4-6 days
4. The pain does not improve even after taking typical remedies such as taking pain relievers or after resting.
5. Severe pain in the back in the night and that is alleviated by rest
6. The back pain is accompanied by abdominal pain
7. Numbness in the upper thighs, buttocks, groin or in the genital area
8. Weakness or tingling sensation in the arm or legs

Role of a Neurosurgeon
The neurosurgeon provides non-surgical as well surgical care depending upon the nature of the illness or the injury, and he does not just operate. The neurosurgeons are experts and offer treatment to patients suffering from any injury or disease in the spine, brain or peripheral nerves that deal with arms, hands, feet and legs. But there are many other neurosurgeons that confine their practice to treating back pain. If you wish to discuss about any specific problem, you can ask a free question.