Study of the brain has fascinated specialists all over the globe since time immemorial. The brain being the most vital organ for survival and coordination is perhaps the most complex of them all too. This has led to a limited understanding of its working in spite of the available advanced technology. However, with the advent of techniques for diagnosis and treatment, therapeutic strategies are evolving. This is a major step towards rendering Neurosurgery safer than ever in the history of mankind.

Neurosurgery through the 20th Century-

During the beginning of the 20th century, Neurosurgery was considered as a specialty. The clinical-neurologist would draw conclusions related to lesions in the brain through neurological examination and clinical history. It enabled diagnosis of vascular lesions, spinal disorders, and brain tumors. During the second and third decades of the 20th century, vascular pathologies and brain tumors could be diagnosed indirectly through techniques like angiography, ventriculography, and pneumoencephalography. But since the operative techniques were too crude and the lack of skilled professionals were rampant, there were high rates of morbidity and mortality due to neurological conditions. Generally, after diagnosing the nature of brain lesion and its site, surgery was performed with inadequate maintenance and control of intracranial pressure and through not too sophisticated surgical instruments.

During the fifth and sixth decades of the 20th century, chemotherapy and radiation treatment came into the picture for treating malignant brain tumors, thereby reducing mortality to a good extent.

During the seventh decade of the 20th century, Computed Tomography (CT) scan provided a better understanding of the location of lesions in the brain which slightly substantiated the earlier techniques. Then, the procedures for cerebrospinal fluid diversion significantly improved management of intracranial pressure during surgery.

It was only during the last decade of the 20th century that the Neurology saw a giant progressive leap through the introduction of Magnetic Resonance Imaging (MRI) and powerful high magnification microscopes. Combined with Neuroanesthesia and Intracranial Pressure Management, this aided surgeons to work on a relaxed brain. This promoted safe removal of the brain tumor and better management of vascular lesions. Moreover, the understanding of micro-surgical anatomy improved drastically, leading to a boost in confidence levels of the micro-neurosurgeons performing the operation.

Neurosurgery in the 21st Century-

The 21st century is actually a revolutionary era that uses powerful computers in almost all the fields possible. Computer-based applications such as Neuro-imaging, Neuronavigation, Intra-operative Neuro-monitoring, and Neuro-modulation are now used in standard neurosurgical practice as a part of the routine. Extremely powerful CT scans and MRIs are used for diagnosis before surgery. The advent of nanotechnology and its application in Neurosurgery is doing great and has a promising future ahead based on the current study of scenarios. Moreover, there is a possibility of most of the Neurosurgical procedures becoming minimally invasive. Frameless Stereotaxy is another technique that helps in locating the exact position of the tumor, which further helps the neurosurgeon in navigating with great precision the very sensitive, high-risk areas of the brain. Such techniques, to a great extent, have lowered mortality and morbidity, lessened the rate of recovery, and chances of infection related to Neurosurgery.

Take Away-

A number of techniques for diagnosis and precise location of the tumor in the brain have made Neurosurgery much safer today, due to advancement in science and technology, than it ever had been in the history of mankind.

Advancements In Neurosurgery - Know How Safe It Is!

Snoring is something that not only spoils the sleep of your partner but leaves you embarrassed while travelling or any family gatherings. It is more popular among males but these days, women are also facing this issue. The problem only worsens with age and weight. On the other hand, the person suffering from Sleep Apnoea not only affects his and his partner's sleep but puts his life at risk.

Difference Between Sleep Apnoea And Snoring:

There is a huge difference between just Snorers and those suffering from Sleep Apnoea. Sleep Apnoea almost always results in frequent and loud snoring, while disturbing the breathing pattern. This leads the person suffering from Sleep Apnoea to feel tired even after long sleeping hours.

While Sleep Apnoea will almost always lead to loud snoring, snoring alone does not mean that one is suffering from Sleep Apnoea.



Causes And Symptoms

Snoring

  When a person sleeps, the throat muscles relax and the tongue bends backwards. This narrows down the throat to some extent.
  As the person keeps inhaling and exhaling, the throat muscles vibrate. These vibrations lead to snoring. The narrower the throat becomes, the more are the vibrations and the sound.
  The throat muscles tend to relax more with age. This is why snoring usually increases with age.
  If a person has obstructions in the form of Tonsils, Nasal polyps or Deviated nasal septum, the narrowing gets worse and leads to extensive snoring.
  If there is an inflammation in the throat or nose due to some infection or allergy, the throat may become narrower and result in loud snoring.
  In some people, sleeping positions like sleeping on the back or otherwise may abate snoring.
  Alcohol consumption during evening time may abate throat muscle relaxation and give rise to snoring.

Sleep Apnoea

  It is better described as episodes of pauses in breathing for more than 10 seconds at a time.
  The immediate cause of Sleep Apnoea is extensive narrowing or complete collapse of the upper airway.
  As breathing is paused temporarily, it causes a shortfall of Oxygen in blood. As it happens, the heart works harder to make up for it, even when the person is sleeping. This increases the risk of heart attack and stroke.
  It causes disturbance in the natural sleep cycle.

Treatment

Snoring

  Avoidance of risk factors like various allergies
  Correction of sleeping position with training

Sleep Apnoea

  The most common treatment is CPAP (Continuous Positive Airway Pressure). This is a mask like device worn on the nose before sleep. It keeps the upper airway open with a small positive pressure delivered.
  There is also the option of Uvulopalatopharyngoplasty. This is a surgical intervention to remove excess of soft palate tissue and open up the airway. The remaining tissue becomes stiff and thus minimize vibration.
  If there is a Tonsil or Deviated Nasal Septum or Nasal Polyp, it needs to be resected out in order to minimize obstruction to the airway.

Snoring and Sleep Apnoea are very common issues and can be treated by experienced doctors very easily.

Ways to diagnose snoring and sleep apnoea:

The doctors ask about the allergies you are suffering from, as well as your eating patterns, medicines and drinking and smoking habits. The doctor also examines your throat and nasal passages to ascertain if there are any kind of nasal, dental, mouth jaw, or throat deformities that are triggering your snoring. If your doctor will feel that you may be suffering from sleep apnoea, then your partner may be asked to keep a diary noting your sleeping and snoring patterns.

Polysomnography and CPAP Titration are some other ways through which the doctors diagnose sleep apnoea.

Polysomnography: Polysomnography, also called a sleep study, is a type of test that is conducted to diagnose sleep disorders. In this test, the doctors record the brain waves, the oxygen level in the blood, heart rate and breathing, as well as eye and leg movements of the patient.

CPAP Titration: A CPAP titration study is a type of in-lab sleep study that is carried out to calibrate continuous positive airway pressure (CPAP) therapy. It is a common treatment that is used to manage sleep-related breathing disorders including obstructive sleep apnea, central sleep apnea and hypoventilation and hypoxemia.

In case you find out that you are suffering from snoring or sleep apnoea, you should immediately visit a pulmonologist to get the proper treatment. 

Snoring And Sleep Apnoea - How To Get Rid Of Them?

Migraine is a type of headache which can occur in varied intensities; the pain resulting from a migraine is pulsating and throbbing. This sort of a headache is usually accompanied by extreme sensitivity to sounds and light as well as severe nausea. One feature that significantly differentiates between migraine and any other type of headache is that the headache resulting from migraines usually develops on any one side of the head.

Causes of Migraine

The exact cause behind migraine is yet to be fully understood. Migraines are thought to be a result of combination of genetic and environmental factors.In majority of cases, migraines tend to run in families . There are few well known trigger factors for migraine. These are   stress, exertion, gastric disturbances, eating heavy food stuff, taking alcoholic drinks, coffee intake, hormone changes in females.

Symptoms of Migraine

The most characteristic symptom of migraine is one sided headache mostly of violent, throbbing and pulsating in nature. The accompanying symptoms include nausea, vomiting, blurring of vision, flashes of light before eyes, double vision, light/sound sensitivity, confusion and weakness.

Homeopathy is not in the favour of using temporary treatments like popping a painkiller to alleviate the throbbing, pulsating and often intolerable pain caused from migraine. Homeopathy aims at going deep down into the root of the problem and entirely removes the tendency of any patient to be shot with migraine headaches every now and then. That is why homeopathic medications may take some time in showing results. They do not offer any temporary relief like most allopathic treatments do. On the other hand, homeopathic medicines offer a long term relief and can cure the migraine problem permanently.

Though homeopathic treatments vary from person to person, there are a few homeopathic medicines, which are very effective in relieving migraine headaches.

Belladona for throbbing migraine attack: Belladonna is one of the most effective homeopathic medicines for treating migraine headache that is throbbing and violent in the temporal region of the head. If pain gets triggered without any prior prodromal symptoms and worsens by noise, touching and light, then Belladona is potent in removing the pain. This medicine is also good if you are unable to lie down because of pain and if your face turns red and hot when you are struck with excruciating pain. Have a few drops of Belladona and apply a mild pressure to feel better.
Glonoine for migraine with congestive headache: When you are struck with congestive headache, a rush of blood reaches the head region causing redness in face and head area with intolerable throbbing pain. You may even feel shocks around the head which get aggravated when exposed to heat or sunlight. It becomes impossible to tolerate any kind of warmth, and you may feel a bit relieved when you uncover the head. If you are affected with congestive headache, then consuming Glonoine can be of immense help.
Natrum Mur for migraine from grief and stress: This medicine is widely used for alleviating migraine caused from stress and grief. Natrum Mur is also effective in alleviating anaemic headaches, which mostly affect young women. It often leads to temporary sightlessness, and the pain feels as if thousands of small hammers are being throbbed within the brain. The pain tends to rise up after through the day, and the patient may feel better after sunset. If the pain gets triggered when the eye is strained, then Natrum Mur is the medication for you.
As you see, homeopathic treatments are great for reducing migraine attacks and your doctor will be able to guide you better on this matter. Homoeopathy treats each patient of Migraine by individualization and thus treats the root cause of migraine which could be Sun, stress, exertion etc.

How Homeopathy Helps In Handling Migraine!

There are two primary factors that are more likely to cause a stroke in a person i.e age and a family history. While both are inevitable, this necessarily doesn t have to be the fate of a person. Brain stroke is entirely preventable as with the case of other diseases. By working on the potential health risk factors, a stroke can be prevented. Here is a list of few such steps which, when followed can pay rich dividends to a person facing the risk of a brain stroke:

Blood Pressure: Blood pressure is the single most important factor that can increase the chance of a brain stroke. If a perfect blood pressure reading seems too difficult to achieve, a more realistic blood pressure target of 140/190 should be aimed for. Some of the common steps in order to achieve an acceptable blood pressure figure include reducing salt in the diet, exercising on a daily basis, regular intake of fresh fruits & vegetables and fast processed food containing processed fats. Finally, quitting drinking and smoking goes a long way in ensuring that a person is safe from strokes.

Losing Weight: Obesity increases the risk of diabetes and blood pressure subsequently increasing the risk of a stroke. Being overweight, therefore greatly increases the odds of a stroke. A BMI of 25 should be maintained by engaging in activities such as walking, running and playing on a daily basis.

Regular Exercise: Exercise is a clear mandate for people facing an increased risk of brain strokes. A moderate intensity exercise schedule for a minimum of 5 days per week is necessary. Some simple steps in order to achieve this include taking the stairs while climbing, joining a fitness club, 30 minutes of daily walk in a day etc.

Moderate Drink: Surprising as it may sound, moderate drinking on a daily basis can dramatically reduce the risk of a brain stroke. Red wine should be the choice of preference in this case. It should be ensured that the level of drinking does not surpass more than a glass. Regular drinking in excessive quantity can increase the chance of brain stroke.

Check For Atrial Fibrillation: This is a disease that is related to the heart due to an irregular heartbeat. There is a possibility of the clots travelling to the brain causing a brain stroke. Certain possible symptoms of this disease such as palpitation of heart and shortness of breath should be checked with a doctor to negate the chance of brain stroke. Certain blood thinners like warfarin and aspirin can shield against atrial fibrillation. A doctor has to be consulted before starting any medication related to the heart.

Top Ways To Prevent A Brain Stroke

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:

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

In case you or any of your near ones is affected with brain tumor, you should visit the doctor to know the possible treatments other than surgery and other important questions related to brain tumor.

Brain Tumor - Causes, Symptoms and Treatment

Trigeminal neuralgia is specified by the condition of a chronic pain that influences the trigeminal nerve. This nerve transfers sensation from one s face to his/her brain. If a person is suffering from trigeminal neuralgia, then a gentle stimulation of face (sourced from brushing teeth or applying makeup) might generate a fright of agonizing pain. The affected person might experience short and mild attacks initially. However, the trigeminal neuralgia might progress and generate more-frequently and longer attack of severely critical pain. Women get affected by this situation more than men get and it is more prominently occur in individuals older than 50 years.

Trigeminal neuralgia does not mandatorily mean that you need to experience a lifelong pain. Various types of treatment alternatives are available and so doctors can usually handle the particular condition effectively by taking help of injections, medications or surgery. Various types of triggers might cause the pain regarding trigeminal neuralgia, such as eating, drinking, shaving, brushing teeth, touching face, smiling, washing face etc.

Symptoms

The symptoms of trigeminal neuralgia might comprise of one or more patterns and some of these are described below:

Sequences of serious, jolting or shooting pain that might generate as an electric shock
Spontaneous pain attacks or attacks stimulated by different activities like face touching, speaking, chewing, or brushing teeth. Pain attacks last from a few moments to some minutes.
It is not a comprehensive list because Trigeminal neuralgia hosts various other symptoms as well. If a person feels facial pain, specifically recurring or prolonged pain or if the person does not get relief through the utilization over-the-counter pain relievers, then that person must consult a doctor.
How does Radiofrequency Ablation treat Trigeminal Neuralgia?

Trigeminal Neuralgia is a chronic and painful condition that involves the trigeminal nerve. There are two separate trigeminal nerves on both sides of the face, which carry the sensations like pain from the face to the body. Each nerve has three branches- forehand, midface and chin and trigeminal neuralgia can cause intense pain in any of these areas.

Causes-

This occurs when the trigeminal nerve functioning is disrupted. When the blood vessel/artery and the trigeminal nerve at the base of your brain come in contact, it puts pressure on the nerves and causes pain.
It also occurs as a result of ageing or multiple sclerosis
A disorder that damages the myelin sheath protecting the nerves can trigger pain
Sometimes pain occurs from tumors, which compresses the trigeminal nerves
Surgical strokes, facial trauma or strokes can also be the root cause of excruciating pain
Triggers-

Shaving
Touching your face
Eating and drinking
Putting on makeup
Brushing
Washing your face
Symptoms-

The pain can be mild and for a shorter duration or it can happen frequently for longer durations. Some experience the pain in cycles where it can come and go for days or even for weeks. Gradually the intensity of the pain lessens.

Cure by Radio-frequency Ablation

The treatment of trigeminal neuralgia is often a challenging process in clinical practice. When medicines do not prove as effective, surgery is the desired option.

Procedure-

After applying local anaesthesia, the Pain Specialist carefully inserts a needle through the corner of your mouth to reach the trigeminal nerve
The doctors then wake up the patient after stimulating the nerves and ask them to feel the stimulation at the same place where they undergo pain. This confirms their targeted location
Once you fall asleep again, the Pain Specialist uses radiofrequency heat to injure the nerve enough to create numbness and removes the pain
How Effective is Radio-frequency Ablation?

The pain is cured almost in 98% of the patients. 50% of patients report a recurrence of pain after about two years. Hence the procedure can be repeated in the same patient if necessary.

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

Trigeminal Neuralgia And Radio-Frequency Ablation - What Causes It?

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